Since the early 2000s, the development of India's generic industry has generated a lot of hope and interest amongst researchers and practitioners of Global Health. This article documents the ambiguous dreams, aspirations, and hopes of the managers of micro, small, and medium companies involved in manufacturing, marketing, and distributing low-cost generic medicine. The analysis draws on semi-structured interviews with managers (n ¼ 66) and shows that they contrast sharply with the universalist, tech-intensive, and salvationary imaginaries often associated with the global pharmaceutical industry. On the one hand, India's small-scale entrepreneurs see themselves as instrumental to their family's financial welfare and the economic development of their local social groups. On the other hand, they like to imagine themselves as part of India's emergence on the international stage and better global access to affordable medicine. Such imaginaries form a low-tech approach to Global Health where generic pharmaceuticals are not taken as transformative technologies but are meant to play specific socioeconomic roles at different scales.