# Between technology transfer and South-South collaboration: an Indo-Cuban experiment in biopharmaceutical innovation

Nils Graber, Yves-Marie Rault-Chodankar

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Nils Graber, Yves-Marie Rault-Chodankar. Between technology transfer and South-South collaboration: an Indo-Cuban experiment in biopharmaceutical innovation. BioSocieties, 2026, 10.1057/s41292-025-00371-4. hal-05453116

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# Between technology transfer and South-South collaboration: an Indo-Cuban experiment in biopharmaceutical innovation

Nils Graber¹ · Yves-Marie Rault-Chodankar²

Received: 10 September 2024 / Accepted: 27 September 2025
© The Author(s) 2025

## Abstract

The collaboration between the Cuban Centre of Molecular Immunology (CIM) and the Indian firm Biocon challenges conventional understandings of technology transfer. Initiated in 2003, the joint venture was a unique experiment in South-South biopharmaceutical collaboration. It brought into relation two distinct innovation regimes: Cuba's public health-oriented model, closely tied to the state and its medical diplomacy, and India's market-driven biopharmaceutical industry. However, both regimes were animated by postcolonial aspirations for technoscientific emergence in the Global South. The partnership ultimately dissolved, as structural tensions and divergent industrial objectives proved difficult to reconcile. But its apparent failure was also productive. For CIM, it opened access to resources lacking in Cuba and enabled clinical trials on a wider population. For Biocon, it offered research, development, and manufacturing expertise that supported its rise in the global biosimilar market. Drawing on interviews with key actors in Cuba and India, this study situates the partnership within broader debates on innovation regimes, postcolonial science, and the inequalities that shape the global biopharmaceutical economy. The article shows how South-South collaborations, even when framed as alternatives to asymmetric North-South models, remain entangled in (bio)capitalist logics while still opening possibilities for reimagining technological exchange beyond dominant North/South narratives.

**Keywords** South-South technology transfer · India · Cuba · Innovation regimes · Biopharmaceutical industry · Sociotechnical systems

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<footnote>Both authors contributed equally to this work, including theresearch, analysis, and writing.
Therefore, there is no first or second author designation.</footnote>

<footnote>Extended author information available on the last page of the article</footnote>
Introduction

Behind technology transfers lie untold stories of intricate social relationships and imaginaries that shape the fabric of innovation. This article examines a South–South technology transfer between a Cuban and an Indian organization, analyzing how it sought to reposition the Global South in biopharmaceutical production. Between 2003 and 2009, the Centre of Molecular Immunology (CIM), based in Havana, and the Indian firm Biocon, headquartered in Bangalore, formed a joint venture to develop the production of monoclonal antibodies (mAbs)—a class of biopharmaceuticals increasingly used in treating chronic diseases such as cancer. While economic and material factors were central in this story, as often in such a capital-intensive industry, it also reveals the role of human connections, emotions, and shared postcolonial ambitions. Yet, while this partnership offered an alternative model to North–South transfers, it was not free from structural tensions between two innovation regimes—sociotechnological systems guiding industrial development. Differences in how innovation was envisioned, negotiated, and institutionalized shaped its trajectory, facilitating knowledge production and exchange while also giving rise to unresolved frictions that eventually resulted in its dissolution.

While much of the existing literature on ‘biocapital’ has focused on the mater-
ial, financial, and power dynamics that shape the global biopharmaceutical econ-
omy, often treating it as a relatively homogenous process driven by the Global
North (Rajan 2006; Birch and Tyfield 2013), this South–South case of knowl-
edge exchange complicates that narrative. In line with authors who highlight the
multiplicity of (bio)capitalisms emerging from tensions between Northern and
Southern spaces, corporate and public health contexts, and national and trans-
national governance regimes (Gaudillière and Rajan 2021), it points to alterna-
tive trajectories of pharmaceutical production. Central to these trajectories are
the ways in which technologies circulate and are reimagined in different contexts.
Recent scholarship, with notable case studies in South Africa (Pollock 2019),
Brazil (Cassier and Correa 2018; Cassier 2021), India (Rault-Chodankar 2022)
has begun to explore the role of local values and sociotechnical imaginaries in
shaping emerging pharmaceutical industries. Decolonial aspirations, in particu-
lar, seem to influence how technology is exchanged in the Global South (Pare-
moer and Pollock 2022).

Technology transfers have traditionally been characterized by unidirectional
knowledge flows and strong power asymmetries, largely in favor of firms in the
Global North (e.g., Stewart 1992). The emergence of South–South transfers, how-
ever, inaugurate a paradigm where Southern actors also play a role in the dif-
fusion and adoption of technologies (Lema and Lema 2012; Chen 2018). They
often involve technologies that are better suited to the needs of developing coun-
tries, offering an alternative to the dominant innovative processes shaped by
Northern firms (Kaplinsky et al. 2009). However, much of this scholarship tends
to homogenize the ‘South,’ overlooking the power relations and asymmetries
that persist within these collaborations (de Moraes Achcar 2022). Understanding
the inner working of South-South technology transfers requires moving beyond broad categorizations to analyze the various interests, networks of actors, and values that shape each partnership (Birn et al. 2017; Antonielli 2022). While such collaborations can foster technological autonomy and industrial upgrading, they can also lead to the reconfiguration of national industrial strategies or the creation of new market hierarchies (Chorev 2022). More broadly, while South-South relations create an autonomous sphere of exchange, they can also be shaped by power asymmetries and capitalist market dynamics, without necessarily challenging Euro-American hegemony (Duclos 2021).

This perspective is particularly relevant in the pharmaceutical sector, where North-South dialectics have long served as a dominant analytical framework for understanding its global structure (Bourgain et al. 2021). However, a growing body of Science & Technology Studies (STS) literature suggests that South-South pharmaceutical collaborations offer a potential alternative to the prevailing political economy of the global market, which remains dominated by a few multinational firms based in the Global North (Aginam 2010). One notable example is the role of South-South exchanges in expanding access to antiretroviral treatments in the Global South, as seen in Brazil and India's efforts to support local generic drug production (Cassier and Corrêa 2009, 2010). Such collaborations can be state-led, as in Brazil's direct involvement in supporting pharmaceutical manufacturing in Mozambique (Russo and de Oliveira 2016; Brossard Antonielli 2019), or driven by transnational business networks, where private firms from the Global South facilitate industrial upgrading and market expansion, as seen in India's growing linkages with pharmaceutical companies in other developing countries (Rault-Chodankar & Kale 2023).

Building on the insights of Chorev (2022), this research highlights the pivotal role of non-Northern actors in establishing local infrastructures and expertise in the Global South. These partnerships hold the potential to encourage autonomy amid monopoly-driven politics that contribute to medicine shortages in the Global South (Peterson 2014). At the same time, we examine whether such collaborations actively restructure—or even challenge—the global capitalist system, or if they inadvertently perpetuate power imbalances and common forms of exploitation found in contemporary biocapital (Rajan 2017). While the circulation of knowledge and technology can lead to original assemblages, it can also entail clashes between different paradigms and visions of innovation (Jones and Sivaramakrishnan 2018).

Our case study focuses on biopharmaceuticals, a distinct product category that has received little attention as a technological object produced the Global South. Unlike generic small-molecule drugs, now mass-produced in countries like India and China, biopharmaceuticals are developed through biotechnology (Marks 2015) and are primarily used to treat chronic diseases with targeted therapies such as monoclonal antibodies (mAbs) (Cambrosio and Keating 1995; Hedgecoe 2004). These drugs have largely been developed and remain predominantly manufactured by Northern firms. However, the CIM-Biocon collaboration, initiated in 2000 (see timeline below), challenges this geography, suggesting a shift away from the long-standing dependence of Southern firms on Northern knowledge (Fig. 1).

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<figure><img src="image_5.png" /><figcaption>**Fig. 1** Timeline of the Biocon–CIM collaboration</figcaption></figure>

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Analyzing this partnership helps us shed light on the challenges to align two distinct regimes of pharmaceutical innovation, which we analyze by considering politico-economic processes, material entities and infrastructures, and sociotechnical imaginaries. One of these two regimes, rooted in Cuba's longstanding investment in the biomedical sector, is characterized by state-driven entrepreneurship and a focus on niche patented products (Reid-Henry 2010). The other, in India, is dominated by private firms that prioritize innovation through replication and cost-effective large-scale production (Cassier and Correa 2010).

Previous fieldwork on the Cuban and Indian pharmaceutical industries allowed us to characterize their distinct innovation regimes and compare findings across both contexts. Notably, each of us has written a PhD thesis on the subject (Graber 2019; Rault-Chodankar 2020). In Cuba, Nils Graber conducted in-depth interviews with multiple actors of the biomedical sector, including interviews with key stakeholders at the Centre of Molecular Immunology (CIM). His research involved direct observations and regular interactions with CIM researchers, with a particular focus on the organization of clinical trials and innovation strategies in oncology (n=17). In India, Yves-Marie Rault-Chodankar visited some major local production facilities and interviewed R&D executives and consultants in the rapidly growing biopharmaceutical industry (n=15), including two former employees of the firm Biocon. This dual-site research approach allowed us to analyze not only how the partnership functioned but also how it was perceived and experienced differently in each country.

Furthermore, the networks we have built over these fieldwork years have provided crucial access to key actors involved in the CIM-Biocon partnership, especially two scientists that were at the heart of this collaboration, a Cuban immunologist (Jorge) who worked for about two decades at CIM and now lives in the USA, and an Indian biochemist from Biocon (Vijay), now retired. We conducted online interviews with them using videoconferencing software and recorded them. Each key informant was interviewed individually before a joint interview was held. Their high level of direct involvement and responsibility in the CIM-Biocon partnership was confirmed through cross-verification with other informants. Jorge was one of the co-founders of CIM in 1994 and played a key role in the team that discovered and developed the technology behind the mAbs that were transferred to Biocon. As one of the main scientists and biotech experts involved in the partnership, Jorge traveled to India multiple times, including for long periods, and when the joint venture was terminated in 2010, he was sent to Bangalore where he acted as the Chief Scientific Officer of the department of Experimental Immunology at Biocon until 2015. He has been working in the USA since then. Vijay joined Biocon as a bench scientist in 1999, where he initially worked as part of a small research team before becoming Vice-President of the firm's R&D department, his position when he retired in 2022. He traveled to Cuba multiple times between 2005 and 2008 and worked closely with CIM's scientists to incorporate their technology at Biocon. In line with research ethics practices, the names of all the interviewees have been modified.

Having in-depth insights from both sides of such collaboration enabled us to cross-check the information provided as well as affording us a unique opportunity to analyze both perspectives. The Indian scientist secured a 'blanket approval' from Biocon's corporate directors to discuss the partnership, and its Cuban counterpart

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assured us that he was ‘as spontaneous as possible’ in his interactions with us. They were both highly enthusiastic about talking about this collaboration, which they considered to be a unique case of ‘South–South’ pharmaceutical partnership. However, because our interviewees were primarily involved in R&D activities, certain aspects of the partnership fell beyond the scope of our research. They could, for example, provide only limited information on the financial aspects of the joint venture and the role of their respective national governments in facilitating the collaboration.

In addition to our fieldwork and these in-depth interviews with the two key stakeholders, we draw on secondary sources that include first-hand data on CIM and Biocon, such as Seema Singh's book *Mythbreaker: Kiran Mazumdar-Shaw and the Story of Indian Biotech* (2016), which includes extensive interviews with founder and CEO Kiran Mazumdar-Shaw, and Simon Reid-Henry's *The Cuban Cure* (2010), which contains in-depth information on CIM and a short analysis of the partnership with Biocon. Finally, we also mobilize public information released by the organizations to fill certain gaps in our data.

This article is organized as follows. Section “Introduction” situates the Biocon-CIM partnership within its broader technological and political context. Sections “Changing the landscape of innovation: Northern hegemony and postcolonial aspirations” and “Transferring the ‘heart and soul’ of biopharmaceuticals: patented cell lines and scientific know-how” examines the various interactions that shaped this collaboration, including the transfer of the productive capacities to manufacture mAb and then joint efforts to conduct clinical trials in India, leading up to the partnership’s termination, which is detailed in Section “From technology transfer to biomedical complementation.” The trajectory of this partnership is analyzed in the last section by discussing the frictions and incompatibilities between two different innovation regimes. Lastly, we ask to which extent our findings challenge the conventional understandings of technology transfer.

## Changing the landscape of innovation: Northern hegemony and postcolonial aspirations

What was clear from the very beginning is that the route of innovation is always moving from North to South. [...] I think one of the achievements of this association, this collaboration, is that we were able to change the landscape of innovation.

As Jorge, a Cuban immunologist deeply involved in the partnership, observed, the collaboration was framed as a challenge to entrenched North–South hierarchies in pharmaceutical innovation. This challenge was very much a continuation of earlier efforts by Cuban and Indian states, which steered the rise of pharmaceutical industries through distinct policies aimed at developing self-sufficient health systems and industries in a postcolonial context dominated by the Global North (e.g., Chaudhuri 2005; Lage Dávila 2006). In 1970, the Indian government created a unique patent law that enabled copying for decades by banning patents on pharmaceutical products. This led to the rise of a predominantly private pharmaceutical industry, now

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a key player in low-cost generic drug manufacturing and an iconic example of an innovative regime based on ‘copy work,’ understood as process-oriented experimentation, adaptation, and invention (Cassier and Correa 2009; 2010). Cuba, on the other hand, emerged as a hub of biomedical innovation where major developments took place through state entrepreneurship in the biotech industry in the early 1980s, leading to patented innovation since Cuba adhered to the WHO and the TRIPS agreements in 1995 (Plahte and Reid-Henry 2013).

Biocon emerged within India's rapidly expanding generic industry. Founded in 1978 as the Indian branch of an Irish company, it rapidly developed the production of enzymes for both the food and pharmaceutical industries. Kiran Mamzudar-Shaw, its executive director since inception, one of the rare women heading a pharmaceutical business in India, eventually purchased the company from its foreign owners in 1998 and looked to develop the production of finished biopharmaceutical products through contract manufacturing agreements with Northern firms. New techniques of cell culture and genetic modification had been invented since the 1970s, mostly in the Global North, fueling diverse therapeutic promises (Petersen and Krisjansen 2015). Looking at the possibility of acquiring technology from Northern firms, Mazumdar-Shaw was however faced with strong reluctance from their part and started exploring new pathways. Being turned out eventually led her to Cuba, which was becoming increasingly known for its advancement in the field of biotechnology and biotherapeutics. According to Vijay, she met scientists from the CIM for the first time in 2000:

> [Kiran Mazumdar-Shaw] had a lot of problems because no one wanted to provide them know-how, I mean to share the know-how. She was trying to explore with Genentech, Amgen, and some other companies, and they said "no, no way, forget it". People would not share that [information], and it was for that reason, I think, that she landed in Cuba [...]. And then by chance she got in touch with the person that was working in the commercial or the business area [of CIM].

This excerpt illustrates how the mainstream “biocapital” regime restricts knowledge sharing with the Global South, highlighting India’s rise as a generics producer as a potential threat to multinational corporations’ monopolies in the Global North. Since the 1970s, biotechnology has been central to multinational pharmaceutical strategies. In response to innovation crises caused by production relocation to India and China and expiring patents (Gaudilliere 2021), Northern pharmaceutical firms turned to biotechnology to maintain monopolistic control over innovation. The biotechnology industry not only relies on aggressive intellectual property strategies (Rajan 2006; Mazzucato and Dosi 2006), but also prioritizes secrecy regarding manufacturing processes. Biocon therefore perceived collaboration with CIM as an alternative opportunity to get into biopharmaceuticals. The 2000s also saw India promoting pharmaceutical innovation by encouraging the development of new drug entities and expanding the clinical trial market (Sariola et al. 2015).

Meanwhile, CIM sought foreign partners to advance product development. Originally a department of the National Institute of Oncology and Radiobiology (INOR) in the 1980s, CIM became an independent biotech center in 1994, specializing in
immunotherapies for cancer and autoimmune diseases using mammalian cell-based treatments, particularly antibodies and therapeutic vaccines. Following the collapse of the Soviet Union and COMECON—Cuba's primary economic partners—biotechnology, alongside tourism, became a pillar of economic recovery (Reid-Henry 2010). In the more pragmatic political economy of the post-Soviet context of connecting to global capitalist markets while committing to a socialist project (Brotherton 2008), Cuba readily signed the TRIPS agreement in 1995. It did so to protect its innovations, which emerged in the 1980s, and to commercialize them in global pharmaceutical markets (Plahte and Reid-Henry 2013).

Nils Graber's research on CIM provides insight into an innovation regime that balances a socialist commitment with competition against multinational firms. In a 2016 interview in Havana, CIM's research director, a biochemist, considered that the organizational structures of the Cuban biopharmaceutical sector is like the Genentech model, one the first to become a fully integrated company. References to Genentech serve as a reminder that Cuba's biotech industry emerged in the early 1980s, just a few years after this emblematic U.S. company. The term "fully integrated company" highlights CIM's capacity to oversee the entire product development process, from basic research to clinical trials and commercialization. However, CIM stakeholders also emphasize its distinct politico-economic model, particularly its commitment to the national health system. This argument was central to Augustin Lage, CIM's director from its founding in 1994 until 2018. A leading immunologist and longtime member of the Cuban parliament, Lage conceptualized the Cuban biotech model as a "double-loop" system (Lage 2008): the first loop generates revenue through exports, while the second ensures universal access to locally produced biopharmaceuticals.

As a post-Soviet socialist organization, CIM had to establish ties with foreign capitalist firms. By the time of its first encounter with Biocon, CIM had already signed licensing agreements with Canadian (YM Biosciences), German (Oncoscience), Indian (Dabur), and Argentinian (ELEA) companies (Reid-Henry 2010; Graber 2019) to transfer its biological molecules. These partnerships were crucial for accessing foreign markets and acquiring technologies unavailable in Cuba, which remained isolated due to intensified U.S. sanctions in the 1990s. The U.S. embargo (usually referred to as a "blockade" by CIM researchers) severely restricted Cuba's ability to obtain critical supplies, equipment, spare parts, and loans. However, it did not prevent Cuba from patenting innovations, including in the U.S. market (Reid-Henry 2010). Moreover, the U.S. Treasury granted exemptions to the embargo for select biotech collaborations, including CIM's ongoing partnership with Roswell Park Cancer Center in Buffalo, NY (Schoenfeld 2020; Evans et al. 2018).

At the political level, Indian and Cuban officials actively supported collaboration between their countries. As a state-owned institution with direct political ties through its director, Augustin Lage, CIM secured high-level approval to transfer technology. This political backing was also evident in India, exemplified by public speeches and initiatives that acknowledged this iconic Cuban-Indian biotech partnership. The collaboration was formalized in 2002 as a joint venture, and its governmental approval can be read as a strategy to challenge Northern technological dominance and part of India's non-alignment policies (Tyabji 2012). For CIM, transferring technology to
Biocon aligned with its internationalist vision of South-South solidarity. For Biocon, it meant engaging with a vastly different technological and political system—one shaped by socialism, relative isolation from the U.S., material scarcity, cultural differences, and a strong commitment to public health, as Vijay noted:

> What is very interesting [...] is the fact is that all institutes are closely linked to multiple hospitals. In Havana, it's like an ecosystem of hospitals and research institutes. Every kilometer will have a hospital or a Research Institute. [...] The poverty strikes you. But the important point is that [...] their life expectancy had been dramatically improved by their own indigenous capabilities that they built over the years since the revolution happened.

Cuba's longstanding commitment to public health shaped a 'medical diplomacy' facilitating international exchanges for public health and economic interests, in spite of political divergences (Feinsilver 1993). For CIM, a joint venture with an Indian company offered access to one of Asia's largest emerging pharmaceutical markets while strengthening South-South integration. For Biocon, it provided an opportunity to acquire biopharmaceutical know-how and engage with a distinct innovation regime rooted in patents and national health system integration, thereby supporting its growth as a private company seeking new avenues for capital accumulation. More broadly, the CIM-Biocon partnership echoed the decolonial aspirations of 'Third Worldist' science and medicine, envisioned as a means to foster more equitable global relations (Paremoer and Pollock 2022).

## Transferring the "heart and soul" of biopharmaceuticals: patented cell lines and scientific know-how

The joint venture initially focused on transferring the production of Nimotuzumab, a monoclonal antibody against cancer developed by CIM in the 1990s. The drug directly competed with Cetuximab, marketed as Erbitux by Eli Lilly (U.S.) and Merck KGaA (Germany), then the leading biological treatment for tumors over-expressing the epidermal growth factor receptor (EGFR). Nimotuzumab was also licensed to YM Biosciences (Canada) and later to a Chinese firm for head and neck cancer treatment (Reid-Henry 2010; Graber 2009). It was seen as particularly relevant for Indian patients, where nasopharyngeal and oral cancers—linked to tobacco and betel nut chewing—were highly prevalent.

Beyond its therapeutic and commercial potential, transferring Nimotuzumab to India was part of Biocon's strategy to develop biopharmaceutical production, starting with the construction of a high-tech plant. While Biocon already had strong manufacturing capabilities in fermentation—producing anti-hypercholesterolemic drugs and immunosuppressants—it lacked experience in final formulation and mammalian cell culture, essential for monoclonal antibody (mAb) production. Soon after signing the partnership agreement, Biocon began building a plant in Bangalore with support from Cuban scientists and engineers, who provided expertise in designing Good Manufacturing Practices (GMP)-compliant production facilities, a standard CIM had already met in Cuba (Graber 2019).

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This prompted frequent exchanges between CIM and Biocon specialists. Cuban scientists and engineers traveled to Bangalore, some for months, to oversee the construction of a biopharmaceutical plant in Bommasandra. Meanwhile, Indian scientist Vijay, who also visited Havana multiple times, recalled:

> the first visits were from the Cuban scientists because we had zero understanding about how to develop the capability. [...] They came here and taught us. It was an amazing collaboration where it was a very transparent sharing of information.

The Indian plant was set up quickly, reaching completion in 2004. According to Jorge, the technology transfer was “full,” covering every aspect of the facility’s construction.

The technology transfer was full, was everything. Even the SOPs [Standard Operating Procedures, required for GMP compliance], I mean the copy of the fermenters probably, I mean from the same manufacturing unit [...] a copy of all the systems that were already [at CIM], [...] from the design to the structure of how the pipes should go and which are the best system for the production that we were doing [...], how you have to dress or how do you have to collect the samples.

A crucial aspect of this “full” transfer was the handover of cell lines to Biocon, which Vijay described as *literally the heart and soul of any therapeutic product*. Pharmaceutical companies tightly protect cell lines through patents and trade secrets, reinforcing monopolies and keeping biopharmaceutical costs high (Greene 2018). The CIM had developed its own cell lines using NS0 cells derived from mice, diverging from the industry trend favoring Chinese Hamster Ovary (CHO) cells. CIM’s choice of NS0 stemmed from its lower competition and lack of patent protection:

> So people came to [this choice of cell lines] because the NS0 was not used. The patents were not, I mean... there was an easy access. And, by the way, it had some benefits that we realized later. [...] And there is a company that now is using this in the US. [...] Anyway, so NS0 because accessibility and the patent protection, I mean that was one thing and this I mean was easier. The production was, I would say that was more difficult.

Through its joint venture with CIM, Biocon gained access to manufacturing processes that firms from the Global North were unwilling to share, protecting their technological advantage over the Global South. However, as discussed in the final section, Biocon had to adhere to Cuban biotechnology processes, which posed productivity challenges. Sharing cell lines with Biocon was also a risk for CIM, as India had not yet signed the TRIPS agreement, leaving room for potential replication by other companies. According to Jorge, patents on NS0 cell line production were relatively “weak” but still provided some level of legal protection. CIM was able to derive value from transferring its unique technologies to Biocon. As Vijay explained, the joint venture agreement included a licensing deal

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in which Biocon paid for the transfer of materials and technology. A key factor
in CIM's decision to share its know-how and IP was its trust in Biocon. This
trust stemmed not only from the joint venture's strong political backing but also
from the close personal relationships formed between researchers as they moved
between the two countries, which previously had limited ties.

In 2005, India signed the TRIPS agreement, allowing Biocon to fully engage in the *innovation game* (Vijay) by recognizing pharmaceutical patents. This ensured that any new biopharmaceutical it developed would be protected from replication by Indian competitors. As a result, Biocon selected a second molecule from CIM's portfolio: Itolizumab. Vijay explains:

Itolizumab was different because at the early moment that we had the chat with Kiran, she had the first right of refusal. She took that antibody and she said, OK now I have all the rights. It's a new drug, it is complicated, and so I take the risks. But I take also more chances.

For Biocon, pursuing Itolizumab was a risky strategy. Initially developed as an anti-cancer drug in Cuba, it had only been tested on 14 patients with rheumatoid arthritis, and its mechanism of action for autoimmune diseases remained poorly understood. One Indian collaborator admitted he never expected the Cuban partnership to *give birth to the next blockbuster drug*, but Biocon saw it as a chance to build expertise in innovative biopharmaceuticals at an early development stage. Choosing Itolizumab allowed Biocon to train its scientists in biological drug development.

The key figure sent from Cuba to Bangalore was Jorge, who had discovered Itoli-
zumab's potential for autoimmune diseases at CIM. He relocated with his family and
spent ten years in India, playing a central role in establishing Biocon's biomedical
research infrastructure, particularly in immunology, a field in which Biocon had no
prior expertise but which was critical for monoclonal antibody (mAb) development
(Cambrosio and Keating 1995). Biocon quickly gave Jorge and other Cuban scien-
tists the freedom to build this capacity, supported by Vijay, who led the effort to
integrate Cuba's R&D knowledge into Biocon. Vijay held deep admiration for Jorge,
describing him as *one of the most brilliant scientists I've ever seen in my life*. Jorge
was instrumental in shaping Biocon's R&D capabilities, particularly in therapeutics:

I learned so much about immunology and my guru is [Jorge]. There's no
doubt about that. OK, so the point is that we had a free-willing, absolutely-
uninhibited interaction — scientific interaction — which really built up such
a strong capability within the organization at Biocon, because, definitely, we
were lacking in therapeutic expertise.

From a small research team, Biocon has grown to a staff of 300 across multi-
ple labs in Bangalore, now a key hub for India's biopharmaceutical research. The
company established large-scale scientific and production capacities Producing a
high-quality monoclonal antibody (mAb) with the desired mechanism of action
required developing analytical infrastructures, including flow cytometry and vari-
ous immuno-assays. Biocon set up an immunology lab and an animal facility to
conduct preclinical studies, a prerequisite for clinical trials.
The company rapidly built a dedicated facility at an impressive scale. Jorge, highly impressed, described the newly established animal house as *the best in Asia*. This illustrates how integrating diverse infrastructures was essential to developing a novel biopharmaceutical. Using a Confucian metaphor of the fish, Jorge emphasized that CIM not only transferred technology to Biocon but also empowered it to create its own:

> I would say the conclusion of the transition of Biocon from the second technology transfer [of Itolizumab] wave is that it was closer to innovation and science. So now Biocon has a Biocon Research Centre. It's a 2,000-employee institution and they are doing science [...] I think that we didn't, uh, I mean CIM didn't give to Biocon the fish. They gave the technology to fish and now they move along.

The collaboration took place in a friendly atmosphere, with Indian scientists eager to learn from their Cuban counterparts. Biocon entrusted Cuban scientists with key responsibilities, particularly Jorge, who built a strong research team alongside Vijay. Their relationship extended beyond work, and they remain in touch today.

However, one might question whether CIM placed too much trust in Biocon by fully sharing the *"heart and soul"* of its products. While this aligns with its internationalist vision, it also reveals the complexities of transnational partnerships, where the Global South is not immune to power hierarchies and emerging hegemonies (Duclos 2021). After this initial phase, the transfer evolved toward co-developing clinical trials.

## From technology transfer to biomedical complementation

It's not that there was a technology transfer or something like that. I would say that [the idea] was to create an entity that was superior to the two independent groups. The organization that was born from this interaction was superior to the two. I think this is the legacy of the collaboration. I believe that this is the main achievement.

For Jorge, a Cuban immunologist closely involved in the venture, this legacy of complementarity set the collaboration apart from conventional, one-sided models of technology transfer, a view echoed by all interviewees who emphasized its mutual benefits. Typically, technology transfers involve asymmetrical relations, with a company—often from the Global North but increasingly from the Global South—transferring knowledge to another (Chorev 2022). This dynamic often creates tensions due to power imbalances or differing visions of the partnership's goals (Antonielli 2022). What set the CIM-Biocon collaboration apart was its high level of mutual interest and complementarity. While the initial transfer of Nimotuzumab was more one-sided, Jorge described the Bangalore plant as a *copy-paste with improvement* of the Havana facility, benefitting from India's access to locally produced steel tanks and machinery. The Indian biopharmaceutical plant ultimately surpassed the original pilot plant in Cuba. According to Jorge, it became a *"state-of-the-art"* facility,

<figure><img src="image_11.png" /></figure>
largely due to Biocon's greater financial resources. Biocon's funding, combined with its expertise in large-scale pharmaceutical manufacturing, allowed for an improved plant design based on the Cuban model, which had more limited production capacity. Vijay emphasized that India already had strong manufacturing expertise:

> This facility building was not truly a technology transfer because we have our own strong teams who can deliver on it. It's only the product manufacturing that was a technology transfer. Yes, there are scientists, the process scientists, and the engineers from Havana, definitely helped us in discussing the design of the facility, etc. But we have got our own capability. It's not at all a problem for us. We can build any type of facility.

With its strong financial capacity and unrestricted access to Indian manufacturers, Biocon could acquire more advanced equipment, including larger fermenters and cutting-edge analytical tools for studying mAbs. Meanwhile, Cuban manufacturing processes benefited from Biocon's better access to equipment and experience in large-scale production. As the R&D collaboration deepened, CIM's scientific expertise also grew, gaining access to sophisticated research tools such as flow cytometry, imaging technology, reagents, radioactive materials, and T-cell proliferation assays—essential for understanding mechanisms of action. Alongside this scientific and material complementarity, CIM contributed new knowledge and key elements like cell lines (see previous section). At the same time, Biocon offered Cuban biotech a critical opportunity: expanding its products to a wider public and potentially tapping into a much larger market.

The approval of Nimotuzumab, commercialized in India as BioMAb EGFR, for the treatment of head and neck cancer was a strategic achievement for the Indo-Cuban joint venture. At the time, India's drug agency had yet to establish clear regulations for novel biopharmaceuticals, but the partners navigated the process in less than two years. Approval was based on a small Phase III trial in India, which demonstrated similarity to the Cuban-manufactured mAb using Cuba's clinical data. This made Nimotuzumab the first monoclonal antibody produced in India to receive national regulatory approval.

However, sales remained limited, likely due to the small market for oncology drugs at the time, when cancer treatment was largely accessible only to wealthy patients. More recently, policies have aimed to expand access to cancer care (Caduff et al. 2019). In contrast, India appeared far better suited for the development of Itolizumab, given its large population affected by autoimmune diseases, which generally require less costly and complex treatment than cancer. The country also provided a more favorable setting for large-scale clinical trials—something CIM could not conduct in Cuba due to its smaller population, as Jorge explained:

> The molecule was already there. We would probably not be able to continue beyond the Phase 1-2 that we were doing [...], no, we didn't have enough population. India presented many therapeutic opportunities: in the autoimmunity field, there were many indications that were very peculiar for India like for example, Vitiligo. And even multiple sclerosis. And psoriasis and rheumatoid arthritis that were similar to the West. So why not try?
Under the contract, Biocon would produce the molecule and distribute it in Latin America for CIM, benefiting both organizations. Biocon could manufacture at a larger scale and lower cost, while CIM gained access to broader distribution. Scientists from both institutions closely collaborated on clinical trials in India, progressing through Phase I, Phase II (40 patients), and Phase III (~225 patients). To conduct these trials, Biocon established Clinigene, a Contract Research Organization (CRO) that facilitated rapid patient recruitment. While India has often been analyzed as a hub for the clinical development of pharmaceuticals owned by the Global North (Petryna 2009), the CIM-Biocon partnership illustrates a new South-South model of biomedical research. The collaboration also benefited from Bangalore's strong academic and research institutions, providing specialized expertise. Biocon successfully engaged physicians across Indian hospitals, who played an active role in the trials—*completely part of the creative process*, as Jorge described. For him, the connections forged between researchers and clinicians were one of the partnership's most significant achievements.

It was one of the most gratifying things that happened during the interaction. Frankly, I remember the first meeting that we had with the clinicians for the first trial of Itolizumab. It was in Bangalore in that hotel that was close to the old airport. The doctors were so enthusiastic to be involved in the innovation, to be part of the transformation of the scientific history of India.

The research collaboration between doctors and companies was crucial to Biocon's biopharmaceutical development—an aspect previously lacking in India. This gap is partly because generic drug production does not require large-scale clinical trials. In Cuba, the state biotech industry leverages the public health system to conduct trials at lower costs, using ordinary hospitals and a state-run Contract Research Organization (CRO), CENCEC (Gorry 2016; Graber 2019). In contrast, firms like Biocon must hire CROs for large-scale trials, which requires significant financial resources to coordinate work between laboratory research and clinical practice (Petryna 2009). It also involves cultivating key opinion leaders to influence the medical community (Timmermans 2005). The CIM brought its extensive experience in clinical trials, supported by biotechnology experts and leading clinicians, while also gaining insights into India's distinct biomedical research environment.

After Phase 2 trials, the team opted to pursue clinical trials for psoriasis instead of rheumatoid arthritis, originally targeted by Cuban researchers, as results were more promising. This shift highlights how the collaboration redefined the drug's intended therapeutic use. Itolizumab received approval in India within 7 years—a relatively short timeline for a company with little prior experience in large-scale clinical trials. The all-India trial spanned over 20 hospitals nationwide. The CIM-Biocon joint venture ultimately led to the development of a new treatment for autoimmune diseases. Both sides learned from each other, engaging not only in biomedical collaboration but also in cultural exchanges, as Vijay emphasized:

> I went to Francina's home [a CIM's scientist] in Havana, for lunch, and she knows that I'm a vegetarian. I don't eat meat, I eat eggs, but I cannot eat beyond that anything else. She had cooked passionately vegetarian meals for

<figure><img src="image_12.png" /></figure>
me because she had learned how to cook vegetarian meals in India when she was staying there. It's just amazing. We're like a family when we built all these capabilities together.

The food metaphor effectively illustrates both the synergies and the mutual respect underpinning the partnership. By describing the collaboration as being “like a family,” Vijay emphasized that unlike traditional technology transfer models, this venture rested on shared commitment and reciprocity, with both partners equally invested in developing the molecule. As Vijay emphasized, *We were co-developers of the molecule, CIM and Biocon together, adding that it was not just a transfer of technology, but actually co-learning.* The partnership produced tangible scientific outcomes, including three co-authored publications by Indian and Cuban scientists and several patents related to production processes.

A shared vision of the Global South's rise in technoscience seemed to encourage the Cubans to share knowledge more openly. As Jorge explained: *We did not only transfer. They knew how to do that because we helped them. We worked with them. [...] And then you see the growth, the South, the real South.* Unlike conventional technology transfers driven by financial interests, this partnership emphasized mutual benefit and the development of Southern countries. For Jorge, it was not just about transferring technology but creating synergies through close collaboration. He saw this integration as essential, arguing that no single country in the Global South can develop innovative biopharmaceuticals entirely on its own. Achieving this requires strong complementarity and mutual learning. Hence, the CIM-Biocon partnership evolved from a straightforward technology transfer into a deeper collaboration in biomedical research, particularly in the development of Itolizumab, moving from lab work to clinical trials. This challenges the conventional notion of technology transfer, as for a time, the high level of complementarity appeared to diminish hierarchy and emphasize mutual benefit. Beyond pharmaceuticals, the partnership contributed to biomedical research in postcolonial contexts, shaped by distinct material conditions and political aspirations (Anderson 2014; Paremoer and Pollock 2022). However, despite its positive impact on India's biomedical infrastructure, structural differences in innovation approaches created tensions that ultimately led to the partnership's dissolution.

"Getting divorced": between novel drugs and biosimilars

This is the toughest question you can ask anyone working in this collaboration. OK, usually I mean you know when people get married, it's easy. And people around them say that they are lovely, that they love each other. But when people get divorced, I mean, usually people don't want to say why, and I would say that this is the simplest way to respond to these questions in a very practical way.

When asked about the end of the CIM-Biocon joint venture, Jorge struggled to provide a definitive answer. His metaphor underscored the sensitivity of the topic,
as the breakup stemmed less from a single cause than from accumulated frictions and incompatibilities between two different innovation regimes. The joint venture formally ended with Biocon's announcement in its 2009–2010 financial report, stating that it had acquired CIM's 49% equity stake. This followed a reported net profit loss of $55.2 million (5.1 crore rupees) in the previous financial year. This effectively gave Biocon full control, marking a departure from other CIM joint ventures where Cuba typically held a majority share (Reid-Henry 2010). While CIM retained control over the pricing of materials coming from Cuba, Biocon had long been making most executive decisions, including determining the price of Itolizumab outside Cuba and negotiating with national and supranational health systems. The financial details of the transaction were not disclosed.

The sales of Nimotuzumab and Itolizumab did not meet Biocon's financial expectations. The company had taken out a large loan to build a massive biopharmaceutical facility but struggled to recover its investment, as the plant was not operating at full capacity. Nimotuzumab was licensed only in India, while CIM and its other partners retained rights for the rest of the world. Itolizumab, for which Biocon held the rights, was licensed in several emerging markets but saw disappointing sales. Hence, Biocon's direction decided to prioritize low-risk drugs that could be developed quickly and generate immediate profits. As Jorge explained, Itolizumab had a complex mechanism of action that required long-term use to be effective. While he acknowledged that profitability drives innovation, he noted that CIM's approach to biological research and development followed a different logic:

> Sometimes in the South we lose opportunities. Creating business that guarantees the full cycle of innovation, that mentality is not very well ingrained into the culture. And this is something I think I've learned working with Biocon. I mean, innovation is essential for health. But then the only way that you can sustain a system is with the incomes. [...] What we learned in India was the value of flexibility in the business.

The Cuban innovation regime relies on strong ties between scientific research and industrialization to develop patented products. However, Jorge acknowledged that this system prioritizes objectives beyond profit. While Biocon initially sought to emulate the Cuban model, it struggled with the constraints of such an approach, shaped by specific sociotechnical imaginaries and industrial frameworks. Biocon also faced inherent disadvantages in the innovative pharmaceutical segment. Indian firms are largely seen as producers of unbranded, low-cost drugs, making it difficult to convince doctors, patients, and regulatory agencies to trust drugs invented in India (Quet 2017).

Credibility remained a major challenge. Although Biocon filed a few patents with CIM, these were mostly process patents, not product ones, limiting the company's ability to secure a strong market position like Northern pharmaceutical firms. As a result, it struggled to monetize its R&D efforts. Furthermore, the Indian Academy of Sciences did not fully recognize Biocon's role in developing Itolizumab, likely considering it an in-licensed drug rather than an in-house innovation. This reflects a form of biomedical nationalism that prioritizes domestically developed products over transnational collaborations—even within the Global South (Duclos 2021).

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By contrast, in 2011, the Cuban Academy of Sciences awarded scientists from both CIM and Biocon for their contributions to the development of Itolizumab for auto-immune diseases.

Beyond profitability and scientific credibility, Biocon aimed to scale up monoclonal antibody (mAb) production. However, the manufacturing processes transferred from CIM were not the most efficient for large-scale biopharmaceutical production, as Vijay explained:

> The efficiency of the process was not great. We improved on it, honestly speaking, but the first process, what we obtained from Havana into Bangalore cannot be changed because what we decided was to get into a commercial agreement to launch [...] the first monoclonal antibody in India.

CIM's NS0 murine cell lines initially enabled innovation but later hindered large-scale production. Less productive than CHO cells—the industry standard—these limitations pushed Biocon to seek new pathways. As explained above, the company eventually entered a co-development agreement with a well-established generics organization from the Global North to jointly develop biosimilars—biological products highly similar to an original patented medicine, usually introduced after patent expiry. Biocon's own development and manufacturing teams drove the improvement of production processes. The split between CIM and Biocon reflected diverging long-term goals. CIM focused on developing patented niche products, while Biocon sought entry into the growing biosimilars market. With numerous patents expiring in the 2010s, biosimilars became a major opportunity. However, demand remained low in the Global South, while the US and Europe sought cheaper monoclonal antibodies.

Despite expectations, the biosimilar market has not significantly reduced biopharmaceutical prices in the US, as patented cell lines or costly comparative studies, including clinical trials, remain necessary (Greene 2018). Once Biocon had acquired the necessary technology and infrastructure, it turned to the lucrative Northern markets to compete with firms like Amgen and Genentech, which had previously refused to share their technologies with Kiran Mazumdar-Shaw. Vijay explained that shifting regulations in the Global North and the establishment of biosimilar approval pathways were key reasons for the company's pivot toward this sector. Clear regulatory pathways for biosimilars in high-income markets only appeared in the 2010's, creating new opportunities for Indian manufacturers (Singh et al. 2023). As a pharmaceutical company, Biocon initially focused on small molecules before moving into biosimilar insulin and insulin analogs. Given emerging opportunities, re-entering this market seemed logical:

> The business model of Biocon was overall generics, so if you look at it, we developed small molecules. From there we moved to biosimilar insulins, then we needed to get learnings on monoclonal antibody therapeutics. So, we got into this fantastic collaboration with CIM, and we learned that, and we used all the learning to run the biosimilar business. [...] I think nothing failed between CIM and Biocon, honestly speaking, but the commercial outcomes from such wonderful drugs CIM gave us as part of our joint collaboration has not been
definitely realized [...] The focus was more about consolidating our drug discovery and development capabilities.

Vijay emphasized that Biocon's primary goal was to establish itself as a major player in the generics market. Partnering with CIM, he suggested, was a strategic move to build technological capacity for biosimilar manufacturing rather than compete directly with innovator firms. By the time the partnership ended, Biocon was already exploring collaborations with other companies. In 2009, it entered a global partnership with US generics firm Mylan to co-develop biosimilars for oncology and autoimmune diseases, followed in 2010 by a brief agreement with Pfizer for insulin commercialization in the Global North. A former Biocon executive, who led R&D from 2015 to 2019 and oversaw the development of the Trastuzumab biosimilar with Mylan, stressed that the early collaboration with CIM was instrumental in shaping Biocon's biosimilar expertise. Interviewed in March 2022, he explained:

> Biocon had been developing biologics when Mylan joined for close to 10 years before that. So they had got a head start of working on biologics, making proteins in fermenters, and you know, process development of biologics. So Biocon had a lot of experience in developing biologics, so they brought the technical part of the relationship, and Mylan brought the financial and the global part of the relationship.

His account suggests that the technological expertise Biocon gained through its joint venture with CIM provided the foundation for its successful biosimilar development, ultimately leading to regulatory approvals in the US and Europe. As Vijay noted, the collaboration was not an endpoint but a learning experience that contributed to Biocon's biopharmaceutical expertise. Meanwhile, Jorge expressed regret that the partnership ended prematurely, believing that it still had potential to yield more innovative biologics. However, both acknowledged that the closure of the joint venture was not an end, but rather a turning point—one that allowed Biocon to fully incorporate the knowledge gained and take flight on its own, expanding its role in the biopharmaceutical industry with greater autonomy.

This perspective aligns with recent STS scholarship on innovation failure as a process that can be either restrictive of generative of new dynamics (Baxter et al. 2023; Marres and McGoey 2012; Pollock 2019). Failure is often provisional and situated—what may seem like an ending for one actor can be a necessary reconfiguration for another. From Biocon perspective, rather than signaling collapse, the dissolution of the joint venture marked a transition, where the Indian company leveraged the expertise gained from CIM to establish itself as a leader in biosimilars. While Jorge saw the closure as premature and limiting CIM's ability to export on the Indian market, Biocon's leadership viewed it as a natural evolution.

Biocon did acknowledge that it could not innovate in the same way large firms from the Global North do, but did not entirely give up its technological ambitions. The company invested in a small R&D startup registered in the US (Bio Fusion Therapeutics), but operating from Bangalore. Moreover, Biocon wanted to continue its work around Itolizumab, for which the firm got an approval in 2013 in India. This mAb was in Phase 3 clinical trials in US. The molecule was also

<figure><img src="image_14.png" /></figure>
licensed to a company called Equilium in the US for graft-versus-host diseases. The legacy of this partnership is probably much deeper. Biocon was the first firm from the South to commercialize a biosimilar in the Northern market, the breast cancer drug Trastuzumab, in collaboration with Mylan. Jorge, who now works in the USA where he has filed several patents, sees the trajectory of Itolizumab as a unique example of South-South technology transfer that ultimately facilitated greater participation of the Global South in Northern pharmaceutical R&D.

Additionally, the Biocon-CIM partnership is now widely recognized within India's biopharmaceutical industry as a pivotal moment in the country's shift toward biologics. Several industry leaders we interviewed acknowledged Cuba's advanced biotechnological expertise and its contributions to India's early biosimilar developments. One such example is the CEO of an innovative biopharmaceutical firm that has developed pioneering processes of continuous manufacturing in India and started its own production facility in the US. Interviewed in December 2021, he stressed that Cuba had long been strong in biotechnology, particularly in bioprocessing, and that some of the early clones in India—including Biocon's molecules—originated from Cuban partnerships.

While Cuban cell lines are no longer used at Biocon—having been replaced by the more productive CHO cells—the partnership left a lasting mark on India's biosimilar ecosystem. This underscores how South-South collaborations can foster industrial learning, even if their technical legacies are sometimes sidelined. The closure of the joint venture did not diminish CIM's standing as an innovative biotech player in the Global South. The Biocon partnership remains a key reference in CIM's biomedical diplomacy, alongside collaborations with China and Brazil (Graber 2019). This is particularly significant for a relatively small and isolated country Cuba, which must navigate state entrepreneurship while upholding its socialist commitments to public health, education, and scientific development (Reid-Henry 2010).

But did the partnership truly end with the joint venture's closure, or did it evolved in new ways? In 2020, at the onset of the pandemic, Jorge phoned Biocon's CEO, Kiran Mazumdar-Shaw, suggesting Itolizumab's repurposing for COVID-19 treatment. The idea was immediately taken up by the firm and became an important niche for the company, with tens of thousands of patients treated over the following years. As CIM's head of clinical trials and former director recalled in an interview in September 2021, his organization directly interacted with Biocon for the implementation of clinical trials in India, while it simultaneously ran trials in Cuba for severe Covid-19 cases.

The legacy of this partnership endures at the institutional level within CIM and Biocon—now a major biopharmaceutical company with a market capitalization of about 6 billion dollars in 2025—but also in the informal networks that can still be reactivated at an interpersonal level. As Vijay recounted, this collaboration generated so much hope and passion that the remains of Joaquin Valin, a key CIM scientist and one of the main actors in this collaboration, were laid to rest on Biocon's Bangalore campus—a powerful testament to the enduring ties forged through this partnership.

<figure><img src="image_15.png" /></figure>
He was so passionate about this collaboration, that one of his last wishes was
that his ashes must be put in a small area in the facility we built together, and a
tree must be planted. That tree has grown into a big tree now.

Discussion and conclusion

The CIM-Biocon partnership outlines the increasing role of Global South players in diffusing and adopting biopharmaceuticals—an area historically dominated by firms in the Global North through patented processes (Bourgain et al. 2021; Rajan 2006). The technology transfer from CIM to Biocon highlights the necessary infrastructural alignment for local biopharmaceutical production, spanning cell lines, bioreactors, immunology labs, and clinical trials. The joint venture demonstrated that alternative pathways exist outside the models established by multinational pharmaceutical firms. By adopting distinct production choices—such as using NS0 cell lines instead of CHO—and jointly organizing clinical trials, CIM and Biocon sought to carve out new technological leadership in biopharmaceuticals. This echoes earlier patterns in which pharmaceutical industries in the Global South developed their own infrastructures to ensure access, such as partnership built on an active and reciprocal exchange of knowledge, technology, and intellectual property to develop generic antiretrovirals (see Cassier and Correa 2009). However, unlike previous approaches centered on innovation through local reproduction in the field of chemical generics (e.g., reverse-engineering generics, as seen in Cassier and Correa (2009)), this collaboration focused on patented new biopharmaceuticals. In this sense, the case study contributes to efforts to reposition the postcolonial world within the global landscape of technoscientific discovery (Pollock 2019).

Yet, this attempt at knowledge-sharing and synergy raises fundamental questions about the very notion of technology transfer. Our findings reveal that even the key actors in this partnership struggled to define their collaboration within conventional frameworks. Instead of describing it as a linear movement of knowledge from one entity to another, interviewees spoke of “co-learning,” “complementation,” and even “social transfer” to better capture the nature of their exchange. The lack of an alternative conceptualization forced them to retain the term “technology transfer,” despite its inadequacy in describing the nonlinear, bidirectional, and highly adaptive nature of their collaboration. It is also true that the collaboration has taken different forms, from an initial phase in which the direction of transfer was clearly from Cuba to India, to a phase of biomedical complementarity in which each party benefited from the strengths of the other. This shows how this Indo-Cuban biotech partnership can challenge the dominant assumption that technology transfers are unidirectional and dictated by power asymmetries between sender and receiver, thus contributing to a growing scholarship on biomedical innovation within the Global South (Kameda 2021; Pollock 2019).

At the same time, power imbalances still shaped this South–South partnership. While the collaboration initially aimed to establish a more symmetrical innovation regime, our study found that North–South asymmetries were partially reproduced, as Biocon ultimately withdrew its financial support from the joint venture to focus

<figure><img src="image_16.png" /></figure>
on biosimilars with a priority given to export on the Euro-American markets. This highlights a paradox: although this joint effort sought to develop novel biopharmaceuticals in the postcolonial world, it foreshadowed emerging divergences between the two countries as their industrial goals shifted in different directions (Chorev 2022; Antonielli 2022).

Biocon and the CIM invested various values, imaginaries, and emotions in this partnership. Some of them formed a common foundation for technological exchanges and biomedical collaboration—including the joint organization of clinical trials —, but in the end, it seemed that the divergences were too strong to be dismissed. The common hope to see novel biologics emerging from the Global South was faced with the harsh material realities of the structure of biocapital (Rajan 2006), that ultimately prioritized profit margins over the shared vision of advancing biologics development in the Global South. Its subsequent R&D projects would be led in collaboration with Northern firms, which are safeguarding their position as the key entry points to international biopharmaceutical markets.

As the partnership unfolded, the initial enthusiasm for collaboration became overshadowed by the challenges posed by market forces, intellectual property issues, and the unequal distribution of resources. The clash between the lofty ideals of scientific innovation and the profit-driven motives underscores the complex nature of forging alternative forms of partnership in the biopharmaceutical industry. Our case study reveals deeper tensions between two regimes of innovation in the field of biopharmaceuticals developed in the Global South. One regime, embodied by Cuba's CIM, sees the Global South's role as developing novel, patented drugs to offer alternatives to the Global North's dominance in biomedical innovation. CIM is also committed to a socialist project consisting of the development of innovative products to be both made widely available in the national health system and shared with the Global South as a form of internationalist solidarity (Reid-Henry 2010; Graber 2019). This occurs in a post-Soviet environment marked by a growing sense of pragmatism, facilitating the emergence of new forms of transactions, including market-driven export policies in the health and medical sectors (Brotherton 2008). Biocon, in turn, adopted a strategy of innovation through a 'copy work' (Cassier and Correa 2009, pp. 82–84), focusing on biosimilar production as a way to enhance national biopharmaceutical capacities and scale up manufacturing. Although not necessarily rooted in a public health policy, this approach primarily aims to reduce the cost of products whose therapeutic efficacy has already been established elsewhere.

For a time, Biocon followed the CIM innovation regime, which illustrates the complex interactions and potential hybridity between innovation regimes. This South–South partnership partly reflects long-standing, yet often overlooked, transnational biomedical networks between socialist and postcolonial countries (Vargha 2023). However, in the context of increasing global demand for biosimilars, the pressures of profit-driven scaling ultimately overrode the vision of a Southern-led biopharmaceutical innovation hub. This dynamic reflects the broader diversity of innovation modes challenging the hegemonic form of biocapital driven by the Global North, as discussed by Gaudillière and Rajan (2021). Overall, the demise of this South–South biotechnological partnership was driven not only by financial and market factors but also by the underlying tensions
between these two innovation regimes. Biocon benefited from CIM's expertise to pursue its strategy of innovation through a copy work, this time in the field of biosimilars. This also suggests how “naïve” state-entrepreneurship in Cuba can be toward the Global South (Graber 2019), as a post-Soviet socialist country desperately seeking transnational partnerships. The CIM tended to conceive the Global South in a homogenized way that overlooked power relations, particularly India's rise as a regional biomedical leader (Duclos 2021). Moreover, Biocon still perceives the Indian market as less lucrative than the Global North, highlighting how India's universal health coverage remains nascent in most states despite growing investments in healthcare infrastructure including in oncology (Caduff et al. 2019).

However, this partnership's failure also generated new dynamics (Marres and McGoey 2012), reinforcing both innovation regimes. While CIM lost access to the Indian market and missed opportunities for co-developing novel biopharmaceuticals, its transnational partnerships endured, and it remains highly regarded in India's biotech sector. Meanwhile, Biocon leveraged the partnership to establish itself in biopharmaceuticals. Beyond the specific case of CIM-Biocon, this study highlights broader transformations in the biopharmaceutical landscape of the Global South. While historically concentrated in the Global North (Rajan 2006), biopharmaceutical innovation is now expanding across new regions, leading to alternative forms of organization, knowledge production, and biomedical research practices. In an era marked by global health challenges, from infectious disease outbreaks to the growing burden of chronic illnesses in the Global South (Reubi et al. 2016), the globalization of biopharmaceuticals presents new opportunities for redefining innovation networks and fostering South-South collaborations. However, our case study underscores the difficulties of sustaining such partnerships under existing market conditions, regulatory frameworks, and global value chains.

The CIM-Biocon partnership can be seen as a politico-economic experiment in biopharmaceuticals—exchanging scientific, manufacturing, and commercial expertise alongside moral values and aspirations (Marres and McGoey 2012). Its cohesion stemmed from a shared commitment to challenging global hierarchies in technology and knowledge production (Pollock 2019). In this pursuit, they not only envisioned but actively paved the way for emerging paradigms of drug innovation that extended beyond the models upheld by the Northern firms. This South-South collaboration, despite its eventual dissolution, demonstrates the potential for redefining global biopharmaceutical innovation—even as it reveals the persistent structural constraints that shape these ambitions. Though ultimately terminated, as many experiments are, documenting this process sheds light on technology transfer as a dynamic articulation between two innovation regimes aiming at biopharmaceutical sovereignty, yet also generating new hierarchies within the Global South (Duclos 2021). This partnership momentarily offered an alternative to dominant biomedical innovation models. As sociologist Maurice Cassier argues, social sciences should recognize such alternative spaces without idealizing them neither overstating their closure (Cassier 2023).

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**Funding** Open Access funding enabled and organized by Projekt DEAL. This article is part of a project that has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (Grant agreement No. 949639). Research funding was also provided by the Global Research Institute of Paris (GRIP).

**Data availability** We hereby confirm that the manuscript is comprised of original material and is not under review elsewhere. The authors declare no competing interests, either intellectual or financial, related to the research detailed in this manuscript.

**Declarations**

**Conflict of interest** On behalf of all authors, the corresponding author states that there is no conflict of interest.

**Open Access** This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Nils Graber is a postdoctoral researcher at the Chair for the History of Science at Humboldt-Universität zu Berlin, focusing on socialist medicine and global biomedicine, particularly in Cuba. His PhD, completed at the École des Hautes Études en Sciences Sociales (EHESS), explored Cuban innovation in cancer immunotherapy, clinical trials, and primary care on the periphery of globalization. As a postdoctoral fellow at the STS Lab at the University of Lausanne, he also worked on experimental care in immuno-oncology.

Yves-Marie Rault-Chodankar is an Associate Professor at Université Paris 1 Panthéon-Sorbonne and a researcher at PRODIG. His work focuses on local industrial development and global value chains in emerging economies. His PhD thesis, completed at Université Paris Cité, examined the South–South globalization of India’s pharmaceutical industry.

## Authors and Affiliations

Nils Graber<fnref n="1" /> · Yves-Marie Rault-Chodankar<fnref n="2" />

☒ Nils Graber
nils.graber@hu-berlin.de

☒ Yves-Marie Rault-Chodankar
yves-marie.rault-chodankar@univ-paris1.fr

<figure><img src="image_20.png" /></figure>

<footnote n="1">¹ Chair for the History of Science, Humboldt Universität, Unter den Linden 6, 10117 Berlin, Germany</footnote>

<footnote n="2">² Université Paris 1 Panthéon-Sorbonne, Pôle de recherche pour l'organisation et la diffusion de l'information géographique (Prodig), Institut de Géographie, 191 Rue Saint-Jacques, 75005 Paris, France</footnote>