A key problem is that non-European foreign manufacturers are often either shoddy, sloppy, or corrupt. It may be caused by culture-inherent incompetence, mediocre management, or penny-pinching cuts that endanger quality. Often certain countries have shoddy medical industry regulation.

As for India, the entire country is ridden with germs. (so is China, where the culture supports babies openly shitting on the ground in cities. That is why they have the custom of leaving your shoes at the front door. The streets are full of e coli.)

I would not trust pharmaceuticals from a country where people shit in the Ganges river and yet bathe downstream.