When the U. S. administration led by President Donald Trump announced a doubling of duties on a wide swath of Indian imports to 50 % this August, the immediate image most people saw was apparel and gems caught in an economic vise. But behind the headlines of factories idling and exporters re-routing shipments was a quieter, deeper tremor: India’ s biotech and healthcare sectors— the factories, research benches and contract labs that have become central to global medicine supply chains— were suddenly faced with a new and unnerving reality. Even where pharmaceuticals were temporarily exempted from the list of products hit directly by the 50 % levy, the move and the administration’ s public threats to tarry with drug-specific duties have already rewritten strategy, investor calculus and patient risk assessments on both sides.