The unrestricted supply of spurious and expired drugs poses a big hazard to people's health not only in this city but also all over the country. How serious the problem is can be judged from the fact that "chalk or starch is used to make a capsule or pill", according to senior executives of multinational pharmaceutical companies.
Although an inexorable crime, the markets are flooded with unregistered and spurious drugs supplied by illegal manufacturers, obviously in connivance with government officials, they say. The government, instead of stalling counterfeiting, appears to have turned a blind eye towards this menace. Stringent rules and full documentation of sale and purchase can halt manufacturing of spurious drugs.
The situation is appalling, indeed, as culprits operate at will, being sure that in case they are apprehended, dolling out some money would let them go, or a telephone call from any high official, or political leader, would save their skin.
On every drug, one can see clearly written" "store it in a cool and dry place", but, if one has a closer look at most of the chemists' shops, drugs are not kept at the required temperature. Just a cursory look at the conditions in rural areas is enough to send shivers down the spine. The rural people are deprived of basic health facilities as medicines and dispensaries are practically non-existent. Drugs and injections are directly exposed to sunlight and the chemists even sell expired drugs to the sick and needy people. The government needs to check, balance and control the competence of the chemist or the licence holders.
Unfortunately, students from rural areas come to the urban centres, complete their education and, instead of serving in their hometown, opt to stay in the cities where they can make more money.
Billions are invested in pharmaceutical industry to keep pace with new inventions and innovations. Price fixation mechanism needs critical thinking. There should be some kind of rationale to periodically revise across-the-board prices.
Haseeb Khan, President of Brooks Pharma, in an interview, told Business Recorder that most of the population has been devoid of basic health facilities due to deteriorating system, double policy standards and commercial approach. Government hospitals do not provide facilities, which should be their foremost responsibility, and this is the main reason why people rush to private hospitals, mostly running on commercial basis.
He said that there are no restrictions on imports, but one has to face many restrictions on exports. If the pharmacist wants to export any drug it takes three years to get it registered but if someone wants to import any drug it takes just a week. Free imports should not be allowed and there should be some restrictions.
Drugs imported from other countries, especially from China, have adverse effect because nobody knows whether they are manufactured legally or illegally and nowadays they are easily available in the market on relatively low price.
Bangladesh has banned Pakistani drugs, but it exports medicines to this country, which does not sound exciting at all. Export is must, because out of thousands, only 8 to 10 active materials and two to three inactive materials are available in Pakistan.
Pharmaceutical companies running their business here have several pertaining problems. An adequate amount is given to the government as research funds. If it is not given, the licence is not renewed. There is no research and development in Pakistan. They name the inactive changes as development but still no research work has been carried out yet.
The alternative inexpensive drugs are available in the market, but doctors prescribe expensive drugs to patients because. in return, they enjoy foreign sponsored tours, along with their families, by the manufacturers of expensive drugs.
The two main sectors in any region, which should be treated as priority, are education and health sector but here in this country only two to three percent budget is allocated for the health sector which, when distributed among the total population, a person only gets approximately 46 rupees monthly.
Promotion of domestic industry is the need of the hour. Formulation of the national health policy and health-related issues should be addressed as priority.
Government should focus on strengthening the implementation and regulation of the pharmaceutical sector at state level rather than on simply introducing new regulations.
Similarly, rational use of drugs needs to be emphasised, as it is significant, cost saving to the government and to consumers, in addition to positive impact on health.
Problems related with availability, affordability and rational use of good quality, cost-effective essential drugs have persisted in most parts of our country. Clear guidelines on self-medication, prescription and dispensing have not been enforced in the public sector.
About 685 pharmaceutical companies are currently working in Pakistan. Out of this 29 are multinationals. Top 50 Karachi-based pharmaceuticals have captured 76 percent of total market share, and top 100 companies have captured 96 percent of the market share. It is quite evident from the statistics (provided by the chairman of the leading local pharmaceutical company) that no standard system has been established to keep complete check on the working of the companies. Quality standards differ from company to company.
There are several licensed companies which produce and supply substandard medicines. These companies are least bothered about CGMP (Current Goods Manufacturing Practices) which is an international quality control standard that basically establishes what level should be maintained. Local pharmaceutical industry needs to adopt European quality standards to promote exports of medicines manufactured in Pakistan.