There are moments when knowledge does not come from books or structured lectures, but from the quiet authority of lived experience. I have increasingly come to believe that the most important knowledge comes from listening—listening to people as they recount what they have built, what they have struggled against, and what they have learnt in the process. These narratives are never entirely free from bias; no human telling ever is. Yet, when spoken openly before an audience, they carry a certain irreducible truth. One cannot sustain a falsehood in full public view for long.

Perhaps that is why platforms like TED have become so relevant in our times. They are not merely stages for ideas; they are spaces where experience is distilled into insight. I have had the privilege of standing on such a stage myself—speaking on ‘Innovation is All about New Vision’ in 2019 at MVR College of Engineering & Technology, Hyderabad, and later on ‘Connecting Human and Artificial Intelligence’ in 2024 at BITS Pilani, Hyderabad Campus. Each time, I came away with the same realisation: innovation is not an abstract construct. It is deeply human, shaped as much by intent as by intellect.

It was in this frame of mind that I attended a talk by Dr. B. Soma Raju on innovation in medicine. What unfolded was not merely a recounting of achievements but a journey into the very anatomy of innovation.

He spoke of a time in the mid-1990s when the idea of developing an indigenous coronary stent first took root—not as a technological ambition, but as a response to an ethical unease. The imported stents available at the time were prohibitively expensive, often costing more than the angioplasty procedure itself. For a vast majority of patients, the choice was stark: health or affordability, survival or surrender.

The challenge was immense. A coronary stent is not just a device; it is a silent companion to the human heart, required to endure its relentless rhythm within an oxygen-rich environment—without corroding, without failing. It demands a material that is both resilient and biocompatible—a rare balance.

At that time, I found myself drawn to this mission, entrusted with developing the required steel. Working alongside a metallurgical scientist and my seniors at Defence Metallurgical Research Laboratory (DMRL)—Dr. A. Venugopal Reddy and Dr. Koneru Bose. We navigated a path that was as much about science as it was about purpose. It was also a moment of personal transition. I chose to step away from DRDO, moving into the private sector with the conviction that innovation aimed at public good needed a different kind of ecosystem.

Three decades later, listening to Dr. Soma Raju narrate that journey with clarity and authenticity felt like returning to a story that time had paused, but never truly ended. He spoke of the stent, of the then-emerging balloon valvuloplasty procedure, of the courage to challenge the status quo, and of the subtle yet decisive role of political will. Beneath his words, one could sense the deeper currents of innovation—the interplay of dominant forces and quiet rebellions, the constant churning of the human mind striving to do better. The hall rose in unison, not merely in applause, but in acknowledgement of a journey that had touched something deeper in the collective conscience.

And yet, as I stepped out of the hall, my thoughts turned away from history towards the dilemmas of the present. What happens when innovation itself is captured?

Not captured in any dramatic sense, but gradually absorbed—by corporate priorities, by regulatory frameworks, by distribution systems, and ultimately by markets that determine what is worth building. When science aligns itself primarily with profitability, a subtle shift occurs. The question is no longer what is needed, but what will sell. Then who builds for the needy billion?

There was a time when Dr. A. P. J. Abdul Kalam articulated a vision that sought to bridge this gap—precisely, the idea of civilian spinoffs from defence technology. It was a powerful model: technologies developed in the pursuit of national strength could be redirected towards societal well-being. It was not merely a transfer of technology; it was a transfer of intent. That bridge, today, seems washed off.

In its place stands a new ferry service—incubation centres, start-ups, venture capital, valuation cycles. It is energetic, ambitious, and, in many ways, necessary. But it is also shaped by a different logic. Innovation is nurtured, but within the boundaries of market viability. Success is celebrated when a start-up is acquired, scales, or exits. Failure, which is intrinsic to innovation, is quietly borne by individuals—often at the cost of their most creative years.

Those who align themselves with what may be called the ‘Big Machine’ are often seamlessly accommodated within its architecture—rewarded, amplified, and carried upward by its momentum. Those who remain outside it, however capable or accomplished, frequently find themselves navigating a quieter and more constrained terrain. This is rarely a reflection of individual inadequacy. It arises from a deeper structural asymmetry embedded within the ecosystem itself. And for a country like India, with its immense reservoir of talent and aspiration, such asymmetry cannot be viewed merely through the lens of economics or career mobility. It ultimately raises a larger ethical question about fairness, access and the nation’s responsibility towards its own innovators.

A billion people cannot be served by an innovation that is designed only for those who can pay. Nor can we afford to romanticise a past that cannot be recreated. The question, therefore, is not whether we choose between enterprise and public good. It is whether we can integrate the two.

We need pathways to ensure that public-funded research once again aligns with essential healthcare needs, with affordability not an afterthought but a design principle. We need to value innovations not merely for their market success, but for their societal impact. A low-cost device that reaches millions carries a significance that no valuation can fully capture.

We must also recognise that innovation does not end with invention. It must travel through manufacturing, through distribution, through systems that ensure it reaches those who need it most. Affordability is not an accident; it is engineered through intent, policy and persistence.

As we step further into an era shaped by artificial intelligence, another dimension emerges. Technology now has the capacity to learn not just from structured data, but from human experience itself. The narratives we share—the stories of patients, of doctors, of innovators—can become part of a larger intelligence system. In that sense, every lived experience is no longer just a memory; it is a data point in the making of future solutions.

As I reflect on that evening, on the journey from a metallurgical challenge in a laboratory to a larger question about the future of innovation, I am left with a simple, persistent thought. Innovation is not merely about changing the status quo. It is about choosing whose status quo we seek to change. And in that choice lies the answer to a question that will define our times: Who builds for the needy billion?

In that answer lives the spirit of Dr. Kalam, who saw beyond laboratories and launch pads into the lives of ordinary people, and reminded us that technology finds its highest purpose when it serves humanity. In that answer resonates the work of Dr. B. Soma Raju, who chose not the convenience of imports, but the courage of creation, and in doing so, expanded the reach of healing.

And in that answer rests a quiet blessing for the countless innovators who continue despite adversity; who persist without certainty, build without applause, who fail and rise again—not for valuation, but for value. May more such minds emerge, for it is they who will ultimately build not merely for markets, but for the aspirations of a billion people.