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The article offers updates on the Indian pharmaceutical industry as of December 2013. It notes that the reach of the country's pharmaceutical industry is enormous as it supplies large and increasing amount of generic drugs globally. As of the said date, India is home to over 150 manufacturing facilities approved by the U.S. Food and Drug Administration.

Global free trade negotiations have been stalled for nearly two decades, yet bilateral trade deals and free trade zones (FTZs) have compensated for this stagnation by continuing to enhance trade and growth. FTZs have flourished in emerging nations, even within autocracies that rhetorically oppose open trade. FTZs possess many attributes of capitalist economies – free exchange, low taxes, no tariffs or other customs rules, and light regulation. All of these traits can attract foreign companies, foreign investment in domestic companies, industrial production, and overall wealth generation. However, such zones are also troubling; they can produce several negative results including a strong mafia presence, massive counterfeit operations, tax evasion, money laundering, and even terror financing. At best, FTZs are workarounds that are desirable only when the political system is captured by vested interests that limit international trade. At worst, they are deniable locations for odious regimes to gain hard currency and even credibility. [ABSTRACT FROM AUTHOR]

According to the US Food and Drug Administration (FDA), pharmaceutical companies in developing countries are increasingly falsifying data about the quality of their medicines. Moreover, a 2010 Pew survey shows that 54 percent of Americans distrust Indian drugs, and 70 percent distrust Chinese drugs. Although the FDA has stringent rules requiring generic-drug manufacturers to prove that their products work as well as the originals, many overseas manufacturers fail to ensure quality control after receiving approval from the FDA. Indian producers in particular strive to reduce costs by substituting cheaper ingredients or skimping on good manufacturing practice, and often patients and well-informed pharmacists alike will overlook the flaws. As Indian products are increasingly imported to the United States, quality concerns will rise. One possible solution is to enact sanctions against companies that fail to provide quality products. [ABSTRACT FROM AUTHOR]

With the entire US budget on the chopping block, small-ticket items such as the US global health budget-- a total expenditure of around $8.6 billion--will necessarily attract less attention than sequestration of the defense budget or cuts to Social Security. But while America's global health budget consumes only a fraction of one percent of total government spending, these funds can mean life or death for thousands around the globe. In straightened financial times, budget cuts should be based on an assessment of which programs work best and an evaluation of how to strengthen the most successful interventions while trimming the fat from less effective ones. This Outlook assesses the impact and effectiveness of the President's Malaria Initiative (PMI) and finds that PMI has been remarkably successful in its management and control practices, cutting malaria incidence and child mortality rates, compensating for failures in other global health programs, and keeping corruption levels low. Despite all these strengths, PMI faces nearly 5 percent budget cuts (or even termination by the end of 2013), while other multilateral programs that are widely acknowledged to be less effective are picking up new money. Without the help of PMI, many of the significant gains that have been made in malaria control could be reversed. [ABSTRACT FROM AUTHOR]