While the outbreak of the Coronavirus has brought to fore what was already well-known, i.e. a dilapidated health infrastructure, a particularly important aspect of the debate remains lesser discussed— Pakistan’s pharmaceutical industry. Given the lack of masks, ventilators, medicines, and personal protective equipment (PPE) in the current crisis, the deficiencies in the industry are becoming visible. By now, desperate circumstances have produced some measure of response, with a domestic start-up (Ventilate) claiming to produce low-cost ventilators, and another group (PAC-V) using 3D printing to print necessary medical and safety equipment. But all this should invite an even more important question: why did all this happen in the presence of an industry that has over 700 listed firms?