With 46 percent of its $16 billion in annual revenue hailing from foreign shores, Medtronic, the world’s biggest medical devices company has an ambitious goal to develop new and cost-effective products such as pacemakers for the poor, while simultaneously selling its existing ones to the growing middle classes in emerging markets.

The company’s new CEO, 55-year-old Syed Omar Ishrak was raised in South Asia (Bangladesh) and  believes that Medtronic can expand its reach even more, particularly in the emerging markets of India, China and Latin America. “Huge opportunities,” he says. “Huge.” How exactly Ishrak’s globalization strategy will play out remains to be seen according to the Minneapolis Star Tribune last year.

Syed Omar Ishrak, CEO Medtronic

At the Davos World Economic Forum last month, Ishrak, who was recruited from General Electric and has a PhD from King’s College in London,  continued the theme, “One has to be realistic about affordability in the under-served segment,” he said adding that the new generation of simpler devices should be five to 10 times cheaper than current high-specification products.

“To accelerate healthcare access one has to think about disruptive methods — disruptive technology and disruptive delivery mechanisms,” he said. While the work is still at an early stage, Ishrak has already identified heart pacemakers as the most likely area for initial research and development.

“I’d like to challenge all our businesses to start thinking this way but the area where we are furthest ahead is perhaps pacemakers, where we’re thinking of real disruption in terms of cost and simplicity,” he said.

What this means

At my company, Amritt, we have been advising our clients to look at emerging markets such as India, in exactly this manner not only in medical devices but in many other sectors that affect consumers. I had the good fortune to get to know the late legendary Professory C.K. Prahalad of the University  (the man who first became famous for coining the term “core competence”).  “CK” as he was know to all friends and acquaintances later wrote the ground-breaking “Fortune at the Bottom of the Pyramid” where he pointed out dozens of examples of profitable business models that address wallet sizes different from the American middle class.

It is good to see that Medtronic has aspirations to address the needs of consumers  beyond the richest 1 billion global citizens. They are early in their journey, but doubtless the GE and Bangladesh heritage will carry Ishrak’s vision. We will watch this closely.

In American today there is a bit of a rush toward India. “The 1.4 trillion dollar economy, growing at 7 percent. They like India. The last three US presidents have visited India, much more so than before.” All this is true.

But some foreign companies have been doing business in India since the early 20th Century. (And I don’t include the colonials of the British East India company).

General Electric supplied a hydroelectric plant in over a hundred years ago. And Nestlé began India operations in 1912.  According to Consumer Goods Technology,Nestlé’s first sales agents in India began work in Chennai and Kolkata in 1912. Today, the company directly employs 6,000 people in India  and tts products are sold in more than 3.5 million outlets across the country. Nestlé recorded sales of CHF 1.4 billion in India in 2010. Its most popular brands are Maggi, the country’s leader in instant noodles, and Nescafé instant coffee. I grew up in (admittedly tea-drinking)north India thinking that coffee and Nescafe were the same thing.

What this means to new entrants:

You’re the new kids on the block in India. Be prepared to pay your dues before you can succeed. In most markets in India, there are smart local and foreign companies who can run you over if you don’t go fully prepared and with good advisors.

GMR Energy  announced the signing of a long-term service agreement with GE Energy for the expansion of the Vemagiri power plant in Andhra Pradesh.

Powered by two GE frame 9FA gas turbine-generators, the plant will produce over 768 MW of additional electricity by 2012. Under a 15-year contractual service agreement, GE will supply parts, services and repairs for the gas turbines. “By teaming up with GE, we are positioning the Vemagiri plant to make a long-term contribution to a modern and efficient energy infrastructure,” GMR Group CEO (Energy) Raaj Kumar said.

When I was part of the Presidential Executive Mission to India last November,  General Electric CEO Jeff Immelt and Boeing CEO Jim McNerney flanked Barack Obama in his first public appearances in Mumbai.  Immelt’s  GE Energy unit had just won its largest order  in India to supply  six gas turbines, three steam turbines and generators for a 2,400 megawatt power plants being built by billionaire Anil Ambani’s Reliance Energy in the small town of Samalkota, Andhra Pradesh.

Last month, President Obama was at General Electric’s plant where these turbines are being built. Here is what he had to say

That’s why I traveled to India a few months ago — and Jeff was there with us — where our businesses were able to reach agreement to export $10 billion in goods and services to India.  And that’s going to lead to another 50,000 jobs here in the United States.  (Applause.)  Part of the reason I wanted to come to this plant is because this plant is what that trip was all about.  As part of the deal we struck in India, GE is going sell advanced turbines — the ones you guys make — to generate power at a plant in Samalkot, India — Samalkot, India.  Most of you hadn’t heard of Samalkot — (laughter) — but now you need to know about it, because you’re going to be selling to Samalkot, India.  And that new business halfway around the world is going to help support more than 1,200 manufacturing jobs and more than 400 engineering jobs right here in this community — because of that sale.  (Applause.)

So it’s a perfect example of why promoting exports is so important.  That’s why I’ve set a goal of doubling American exports within five years.  And we’re on track to do it.  We’re already up 18 percent and we’re just going to keep on going, because we’re going to sell more and more stuff all around the world.  (Applause.)   When a company sells products overseas, it leads to hiring on our shores.  The deal in Samalkot means jobs in Schenectady.  That’s how we accelerate growth.

I have maintained that exports from America are crucial to the recovery. Exports to India can go up by 500 percent or more in five years, if governments are supportive. This is good for poor farmers in near Samalkot whose children can’t get light to study at night. It is good for engineers in New York.  Let’s make it happen, friends.

France’s Areva has signed an EUR 7 billion framework agreement with Nuclear Power Corporation of India Ltd (NPCIL) for the construction of two EPR reactors at Jaitapur in Maharashtra state, to be commissioned in 2017-18, along with uranium fuel of 25 years.  Alstom will supply the turbine- generators separately.  Site work will begin next year with a view to begin construction from 2013.   Jaitapur is to be a 9600 MWe energy park with six EPR units.  Areva promises “maximum localization” of component production, and points to its 2009 agreement with Bharat Forge of Pune to set up by 2012 a new casting and forging facility in India for heavy nuclear components, to supply both domestic and export markets.

“In the field of nuclear energy, negotiations have reached an advance stage to pave the way for launching of nuclear power reactors in Jaitapur in partnership with Indian industry,” India’s Prime Minister Manmohan Singh said at a joint news conference in New Delhi with French President Nicolas Sarkozy, while on a four-day India working trip, accompanied by several chiefs of French companies. NPCIL had earlier signed an initial agreement with Areva for the supply of six nuclear reactors in February 2009. On Nov. 29, NPCIL received environmental clearance for the Jaitapur plant, clearing another vital hurdle for the project.

The agreements were signed by Areva’s Chief Executive Anne Lauvergeon and NPCIL’s Chairman and Managing Director S. K. Jain. The pacts with Areva are likely to speed up the French company’s entry into the sizable Indian civilian nuclear power sector, ahead of its American rivals.

The process of setting up the reactors slowed after the U.S.-based companies raised concerns over a law passed by India in August that made them liable for damages in the event of a nuclear accident. Subsequently similar concerns have been expressed from France, the UK, Canada and elsewhere. The India Experts expects India take up these concerns in side agreements and regulations that convert its new liability law into actionable rules of engagement. Stay tuned.