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KARACHI: Pakistan is facing a shortage of high quality insulin, a dire situation for a country where over one-fourth of the adult population is diabetic, amid unfavorable policies and bureaucratic red tape that have hindered investment in the local industry.

Industry experts Business Recorder reached out to said the issue among the many faced by the pharmaceutical sector is not close to resolution as years of neglect, under-investment, and lack of conducive policies have resulted in a situation where reliance on imports is growing and causing strain on depleting foreign exchange reserves.

Pakistan has around 34 million people or 26.7% of the adult population (20-79 years) who are diabetic, much higher than the global average of 1 out of every 10 persons, according to the International Diabetes Federation (IDF). Pakistan also has the third highest number of diabetes patients, only behind India and China. With sugar intake high, the situation is likely to continue to worsen, say experts.

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While there are three major players providing Pakistan with insulin; two MNCs Eli Lilly, Novo Nordisk and local player Getz Pharma, an official said the preference remains to procure the ones provided by a multi-national.

“If you have to buy insulin for a family member, which insulin would you prefer? Certainly the ones provided by MNCs,” said Abdul Razzak, whose family has run a medicine sale/distribution network in Pakistan for decades, and was thus, well-placed to comment on individual preferences.

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Ayesha T Haq, Executive Director Pharma Bureau a representative body of 22 multinational pharmaceutical companies in Pakistan told Business Recorder that the shortage is due to supply-chain issues.

Six months ago, Eli Lilly, which scaled back its operations in Pakistan in November 2022, asked for a ‘source change’ but government authorities have yet to give approval, highlighting the bureaucratic red tape and hurdles faced by businesses in the country. “The company in Pakistan got its last shipment in December. They have yet to receive permission from the government. A shortage is imminent,” she said.

Pakistan was importing Eli Lilly’s insulin from the US, but supply-chain issues meant the company wanted to change it source to a country geographically closer. Some experts say the company wants to re-direct it from its manufacturing facility in India.

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Industry officials said Pakistan needs to learn from Bangladesh and how Dhaka has been able garner investment that has made it self-reliant when it comes to the pharmaceutical sector.

It should be noted that Bangladesh has favorable policies for investment that has led to the sector’s significant growth including two insulin manufacturing plants set up by Eli Lilly and Novo Nordisk.

“Pakistan used to have 30 manufacturing multinational companies but there are only four left, which are GSK, Abbott, Novartis and Bayer. It’s due to lack of certainty in policies. Nobody is willing to invest in Pakistan. Multinational companies end up winding or trimming their operations,” said Haq.

“MNCs and local companies both need to have a growth trajectory. You cannot have a pharma sector without MNCs as they bring innovation, new therapies and R&D. They have always been the nurseries for the national industry and set best practices.” She cited the case of a drug, which has its price fixed at Rs700 under the government’s price regulatory regime, which most industry officials call anti-business.

The company asked for a hardship price of Rs 1,300 but did not get approval. The company stopped manufacturing and it is now being sold in the black market for at least ten times more than the hardship price.

Former Pakistan Pharmaceutical Manufacturers Association (PPMA) Chairman Dr Kaiser Waheed also confirmed a ‘short’ supply of insulin in the country. Waheed said price-regulation is one of the reasons for shortages.

An official privy to the matter said insulin is widely available. However the official acknowledged that brand-specific shortage currently existed.

It was reported by state-owned APP last month that the registration board of Drug Regulatory Authority of Pakistan (DRAP) has approved the registration of five insulin products.

Copyright Business Recorder, 2024

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Make in Pakistan Jan 16, 2024 02:32pm
How long will we go on importing each and everything? 250+ million peoples can't survive with imports alone but people seem to be inclined more towards parking money in real estate than investing in businesses.
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