Indian pharmaceutical manufacturing facilities have been under regulatory spotlight in recent times. Several large Indian facilities have been issued Warning Letters by the US regulator, creating significant supply chain uncertainty for the companies and the sector. The increasing regulatory action by the United States and other country regulators has also posed a perception problem for Indian companies; as a result long-term prospects for sourcing from India may come under question. In this report, we counter the concerns by comparing generic manufacturing footprint in the United States versus India. We conclude that large-scale plain-vanilla manufacturing has definitively moved to India for the long term with most “non-Indian” generic companies following the trend. In some more complex dosage forms such as injectables, the number of Indian sites are already close to what we have in the United States. Through acquisitions, several Indian companies are also establishing a small manufacturing base in the United States to de-risk their supply chain. We believe that companies with Indian manufacturing base are playing for a long-term sustainable competitive advantage. As the report shows, development of an eco-system of this scale will be hard to replicate anywhere else in the world. We also believe that Indian manufacturing will evolve to incorporate capabilities that are more complex.