> 150 million people still shit in the open in India.

Yet they landed on the moon [1], how about that. I assume they're theoretically capable of producing medicine.

https://en.wikipedia.org/wiki/Chandrayaan-3

I'm not sure that's the brag you think it is.

It's the same kind of brag the USA has. We have this giant military but have a broken health care system.

India has a space program, but a huge portion of their population doesn't have toilets.

-Who funded the moon mission? What are their incentives?

-Who owns the pharmaceutical plants? What are their incentives?

And who is moving these goalposts around?

What goalposts? The government funded the moon mission, they’ll spare no expense in making sure their vanity project succeeds.

Private companies own the pharmaceutical plants in India, their incentive is to maximize profit.. in a country with lots of corruption and poor sanitation.

I’m not making the claim that 10% of India defecating in the open is a moral or cultural failure, I’m saying that, in conjunction with the corruption, it does not inspire confidence in manufacturing goods that need to be sterile.

People still joke about chinesium smoke escaping cheap electronics, yet China likely made many quality devices you use daily. It can work, but it needs strict controls.