One of the topics that comes up repeated in my conversations with regional headquarters for medtech companies in the APAC region is the topic of India.
Long a distant cousin in terms of market attractiveness to Japan, to China within the same region. Today, that story has largely changed. What we've seen is the emergence of India in terms of an uncapped opportunity, the perspective that there is a very long path to growth and an already significant market albeit mainly in volume terms rather than in value terms. We've seen a lot of drivers underpin the long term expectations of growth around India, and the short term attractiveness of that.
One of those is the burgeoning middle or wealthy class, which is not just consuming healthcare and not just preventative healthcare, but actually willing and able to afford high quality treatment using the latest global medical devices at whatever price they're available at. We've seen emergence and an interest from payers in the market to support access to innovative and high quality products. That's a discussion that was incredibly difficult to have just five or ten years ago. We've now seen that emerge in a much more balanced picture come through around exactly what can be reimbursed, when and how, and what are the criteria that go into considerations around the pricing levels for that.
India has also emerged as a manufacturing centre. Of course, on paper this looks great and has always been great with a low cost, deep labour pool, highly educated, but it has never really fulfilled its potential on the manufacturing side, particularly for high complexity products like medical devices. That's now changing. Some of the global OEMs, global brand names in medtech are moving into the market to establish supply chain and we've also seen the emergence of really credible onshore OEMs, domestic brands and domestic platforms which maybe five years ago we were only really seeing scaled operators of services.
Now we're genuinely seeing OEMs emerge in the local market and take their challenges to the global multinationals from Europe and the US, taking their challenges into their own home markets. So India is a market that is clearly very complicated. We're a market of different states that operate largely independently from the perspective of health delivery, from the perspective of reimbursement. That's an important dynamic and one that needs to be worked through as you think about not just what the national level market opportunity, but actually realistically what do you need to do in terms of investment to access that.
Investment in partnerships that may be needed across such a diverse and expansive geographic market. Also investments in terms of clinical and selling capabilities as you address a very diversified dispersed set of clinicians, and institutions across a very broad range of geographies.
