Global pharma came for our large, treatment-naïve patient pool and lower operational costs, yes, but they also came for our skilled investigators and a regulatory system that was, for a time, becoming more predictable. The 2013 Supreme Court order that severely tightened clinical trial approvals created years of painful uncertainty; protocols stalled in a web of compensation and committees. The 2019 rules tried to streamline that by creating defined timelines and a centralised portal, aiming to restore balance. I know this because my job shifted from submitting dossiers to constantly explaining to our anxious global team why timelines are still more of a hope than a promise, much like I reassure a student who hasn't grasped the formula yet—progress is never a straight line.
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