“Global pharma” is useful shorthand, but it hides major structural differences.
Different maps overlap
Market size, manufacturing power, innovation capacity, regulatory authority, and patient access are different maps. The United States, Europe, China, Japan, India, the Gulf, and individual African markets combine them differently.
Authorization is not access
A regulator may decide that a medicine can be sold. A separate set of institutions determines whether it is reimbursed, purchased, distributed, prescribed, and affordable.