For years, pharmaceutical geopolitics has been mapped through factories: China's sprawling supply chains, India's dominance in low-cost generics, and the concentration of patented drug discovery in wealthier economies. That map is now incomplete. Two developments in China this past week signal a deeper shift in the competition.
Jiangsu province announced support for local drugmakers pursuing overseas acquisitions, licensing, and joint development. A day later, Huawei said it would deepen collaboration with Chinese pharmaceutical firms on AI-assisted drug development and clinical applications. The common thread is the ability to turn molecules, clinical evidence, and biological data into intellectual property, regulatory approvals, and licensable drug assets.
For India, and for African economies trying to build pharmaceutical industries, this distinction matters. China's recent trajectory suggests that manufacturing is no longer the only route to pharmaceutical power.
China's clinical trial boom
According to an IQVIA report, China-headquartered sponsors ran 32% of global clinical trials in 2025, up from just 2% in 2009. That measures trials organized by Chinese sponsors, not all trials physically conducted in China, but it captures a striking shift in who is driving drug development. The money is following. Out-licensing deals by companies in Greater China reached a record $137.7 billion in potential headline value in 2025, including future milestones and royalties.
Global companies are paying attention. Pfizer agreed last year to pay 3SBio $1.25 billion upfront for rights to an experimental cancer drug, with up to $4.8 billion more in milestones. This May, Bristol Myers Squibb and Hengrui announced a 13-program collaboration across oncology, hematology, and immunology, with a potential total value of about $15.2 billion, including $600 million upfront.
The point is not that China has displaced the United States at the top of drug innovation. It has not. Rather, Chinese firms are increasingly originating the assets that move through the pharmaceutical value chain instead of simply manufacturing them.
India's trial boom is not enough
India is also becoming a larger center for clinical research. WHO data reported by the BMJ show that India accounted for 23% of global trial registrations between January 2024 and June 2025, behind China at 24%. WHO's latest data also show South-East Asia's trial numbers rising rapidly, driven largely by India.
The harder question is what India captures from that growth. NITI Aayog estimates that Indian pharmaceutical companies spend about 7% of net sales on research and development, against 15% to 20% for global companies. Indian life-sciences patent filings rose from 440 in 2013 to 3,576 in 2023, while China recorded 61,617 and the US 31,977. NITI still identifies weak R&D intensity as a constraint on India's entry into biologics, biosimilars, and advanced therapies.
A column by the founder of Indian biotech company PopVax and a professor at the Takshashila Institution estimated that India conducts fewer than 40 first-in-human Phase I trials of novel pharmaceuticals each year, compared with more than 1,000 in China and 800 in the US. The figures are estimates rather than official government counts, but they point to an important distinction between hosting clinical research and originating new drugs.
New Delhi knows the problem. Biopharma SHAKTI commits 100 billion rupees ($1.05 billion) over five years to strengthen India's biopharmaceutical ecosystem, including a network of more than 1,000 accredited clinical-trial sites. Last week, the Health Ministry said industry consultations, training workshops, and work on stronger data systems and a site-accreditation framework were already under way.
This infrastructure can help create an Indian innovation ecosystem, or merely make India a more efficient execution layer for somebody else's. The difference lies in who designs studies, analyses the evidence, owns the investigational asset, and negotiates the licence.
Privacy and power are different questions
It is tempting to reduce this contest to a simple proposition: who owns the data owns the medicine. The reality is more complicated. Clinical data do not have a single owner in any straightforward sense. International Good Clinical Practice rules distinguish source records maintained by investigators and institutions from data reported to sponsors, while placing obligations on both sides to protect participant privacy and preserve data integrity. India's Digital Personal Data Protection regime, operationalized through new rules in November 2025, strengthens limits around the collection and use of personal information.
These safeguards matter, but privacy protection is not the same as economic sovereignty. Protocol design, pooled datasets, biostatistics, regulatory dossiers, patents, and licensing rights sit at different points in the chain. A country can protect a participant's personal information while capturing relatively little of the downstream commercial value.
The strategic question is therefore not simply where data is stored. It is who has the institutions and expertise to turn evidence into a drug asset. From trial capacity to drug discovery, the more useful test is what participation in global research leaves behind. Does it strengthen domestic science and help local firms turn research into commercially valuable drugs and intellectual property, or does a country remain primarily a source of patients, trial sites, and data for innovation systems headquartered elsewhere?
India has shown that it can move up this chain. In 2025, Glenmark's innovation unit secured a $700 million upfront payment from AbbVie for an experimental cancer therapy, with up to $1.225 billion more in milestones. But such deals remain rare. The broader pattern is clear: China is building the institutions and expertise to originate drug assets, while India risks being left as an execution layer. For the wider Indo-Pacific, the race is no longer about who makes the pills, but who owns the molecules.
