In November 2008, the Indian government kicked off an ambitious project when it opened the first not-for-profit medicine shop, at Amritsar in Punjab, selling only generic drugs, with no branded versions on the shelves. The opening was part of a grand plan to establish a countrywide chain of such 'Jan Aushadhi', a Hindi term that translates as 'people's drug stores'. But several speakers at a national seminar on pharmaceutical Policy held in Kolkata in February said this plan to bring quality medicines at affordable price has hit roadblocks.

At the recent meeting, a few people went so far as to speculate that corrupt officials and foreign-owned multinational corporations—whose products account for more than a quarter of India's 392 billion rupees ($8.7 billion) drug sales by some estimates—are conspiring to scuttle the scheme. “Of course [the multinationals] are trying their best to protect their market share,” Ramesh Jha, spokesman for Department of Pharmaceuticals, which is implementing the Jan Aushadhi program, told Nature Medicine. “But our scheme is on track.”

The Jan Aushadhi stores are the brainchild of Ram Vilas Paswan, who formerly headed the government ministry that oversees pharmaceuticals. The plan requires that public-sector drug companies supply essential low-priced generics on demand to the Jan Aushadhi stores planned to open in all 612 districts in India. These will be run by government entities, charitable organizations or nongovernmental organizations on the principle of generating minimal profits and eventually become self sustaining. “If implemented as planned, this could be a model for the entire developing world,” says Guruprasad Mohanta, a pharmacy professor at Annamalai University in Chidambaram, Tamil Nadu.

That remains a distant dream, considering that hardly 40 stores have come up so far—in just four out of 28 states—against the target of 275 stores in 12 states by March 2010. Jha blames this on a weak drug supply chain.

However, Lalit Jain, vice-chairman of the Small and Medium Enterprises (SME) Pharma Industries Confederation, says that companies exclusively producing generic drugs have had a tough time contributing their discount-rate meds. “Although 175 of our member companies expressed their willingness to supply the essential drugs and also run the Jan Aushadhi stores, [the Department of Pharmaceuticals] does not want us [to],” he says.

The Kolkata seminar, which was organized in part by an association of sales representatives, identified other problems as well. “There is a need for doctors to develop the culture of generic use, which will clash with conflict of interest,” said seminar organizer Amitava Guha, who heads the federation of medical representatives.

“I have asked all government doctors to prescribe generics from now onwards,” says West Bengal state health minister Surjyakanta Mishra, who spoke at the February conference. “I hope other states will do so.” To promote the Jan Aushadhi program, attendees of the seminar recommended a total exemption of taxes and duties on all generic drugs sold in India.

Chandra Gulhati, editor of Monthly Index of Medical Specialties, an industry watchdog, says the Jan Aushadhi stores represent only a small step, albeit a welcome one, toward improving access to generics. “The stores that are supposed to sell [only generic] medicines are a drop in the ocean, considering that there are more than 300,000 retail drug outlets in the country” selling branded drugs.