"Now that (Indian) companies are growing and becoming more successful, we run the risk they will turn their focus on the developed-country market and lose their sense of social responsibility," Sarah Frew, a researcher at the Center for Global Health at the University of Toronto, told United Press International.

Developing-world biotechnology researchers and drug manufacturers have become the pharmacy for other low-income countries, especially when it comes to vaccines. But some industry observers worry that as those companies become more sophisticated, that will stop. Yet others say growth in developing world biotechnology sectors will only help the world's poor.

Biotechnology in India largely got its start focusing on homegrown solutions for Indian health problems, according to the report in the journal Nature Biotechnology, which studied 21 Indian biotechnology firms.

In the vaccine market, where Indian firms faced little competition, they were able to develop products that targeted diseases of the developing world, like hepatitis B and polio. Because of lower costs and process-side innovations, they have been able to sell those products at dramatically lower costs both in India and in other low-income countries.

Shantha Biotechnics, operating out of the Indian city of Hyperabad, launched a hepatitis B vaccine in 1997 that cost only $.50, compared to the import price of $15.

The reduced price, the result of a more efficient manufacturing process, enabled a much higher rate of vaccination in India. Through partnerships with UNICEF and other aid agencies, the company now also supplies 40 percent of the world's hepatitis B vaccine.

That example, and countless other success stories, have made the Indian biotechnology sector a global player, and more growth is predicted in the future, said study co-author Peter Singer, also of the University of Toronto.

"India's biotech sector is like a baby elephant," Singer told UPI. "When it grows up it will take up a lot of space."

But the outside world has begun courting Indian companies, according to the report. Partnerships between companies in India, the United States and Europe are proliferating. Some Indian firms do research on behalf of pharmaceutical giants like Merck, Pfizer and AstraZeneca, while other partnerships involve Indian firms snapping up the intellectual property of small American companies.

This increasingly global focus means that as the international market for biotechnology continues to expand exponentially, Indian firms will be poised to compete for a share with research firms and manufacturers in other countries, Singer said. But that could be to the detriment of Indians if the firms focus their research on obesity and erectile dysfunction drugs instead of rotavirus and malaria treatments.

"In a country like India, the biotech sector is an engine for health and economic development," he said. "India is researching its way out of ill health."

To make sure that remains the case, government regulation will probably be needed, the report concluded.

But other observers say the explosive growth predicted for the industry will help and not hurt health in developing countries.

The less restrictive government regulations in India, combined with the soaring number of scientists graduating each year, means that incentives to move research overseas are powerful, said Fariborz Ghadar, director of the Center for Global Business Studies at Penn State University.

Meanwhile, the changing economic landscape for drug development means that U.S. and European companies are more likely to outsource research, and research firms need more help marketing the products they develop, he told UPI. "Those kinds of alliances are basically everywhere."

Given that growth, the Indian biotechnology sector will not need to choose between domestic health needs and the global marketplace, Ghadar said. "I think the market's going to grow so rapidly in India that you're going to see all of the above."

And if the country continues to graduate researchers at the same high rate, he said, "if anything, they're going to be hard-pressed to find jobs."

Indian firms have also excelled at turning developing-country markets into sound business propositions, Michael Free at PATH, a global health organization, told UPI.

In the case of rapid diagnostic tests, he said, "Indian companies saw the markets around them. It was an opportunity to them."

Either through international aid organizations or direct marketing, India, China and Brazil -- with their understanding of developing world needs and lower costs -- almost exclusively supply vaccines and other treatments, Free said.

Indian biotechnology sector growth is "an enormous opportunity for replication of essential technology that will serve the country of origin and other parts of the developing world."

The study was partially funded by BIO Ventures for Public Health, the public health arm of the Biotechnology Industry Organization.

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