Pakistan’s pharmaceutical industry

EXPENDITURE on medicine is an integral part of a healthcare system. According to a World Health Organization study, “World Medicine Situation”, Pakistanis are spending 77 per cent of their healthcare budgets on buying medicines. This shows the lack of government public health financing (Pakistan is spending on an average a mere 0.5-0.8 per cent of the GNP on health) and the absence of a national health insurance programme. In spite of buying medicines from their own pockets, consumers are still victims of irrational drug use and fake medicines. This also illustrates that Pakistan’s national medicine policy has failed to achieve its public health objectives.

In Pakistan, both multinational and national pharmaceutical companies are heavily involved in the unethical marketing of medicines — indirectly exploiting the consumers. Marketing incentives are so lucrative that many physicians are prescribing patients drugs which they really don’t need. These medicines are posing an unnecessary risk to the health of the people.

According to BUKO Pharma-Kampange — a Germany-based non-governmental organization monitoring the practices of German pharmaceutical industry in the Third World countries — 70 per cent of patients in Pakistan are treated with antibiotics although a majority of them don’t need these medicines. It also states that in Pakistan, 32 per cent of drugs sold by German pharmaceutical companies are irrational and 61 per cent of drugs were not even present on the WHO essential drug list. Some of the drugs that were sold in the country were harmful and have been banned in developed western nations or have no added therapeutic value. A European Union study states that 50 per cent of medicines available in Pakistan are counterfeit.

Pakistan’s total medicine market is about US$1 billion, with more than 400 pharmaceutical companies operating here. The Pakistani industry has grown significantly, even when exports of most of the middle-income countries are on the lower side. According to WHO, Pakistan’s exports share doubled from 1.1 per cent to 2.9 per cent during 1980-1999. The industry is also a champion in providing jobs, earning foreign exchange and claims to play a pivotal role in the healthcare sector. One cannot deny the role of the pharmaceutical industry in the healthcare system but one has to be cautious if the industry is also heavily involved in promoting irrational drug use. The question is how to draw the line between human health and business?

Pakistan does have a medicine policy and a Drug Act of 1976 but the ministry of health does not have a clear view of what it is up to. The ministry maintains a cordial relationship with pharmaceutical companies and publishes a newsletter with the industry’s support. In the newsletter one can see names and advertisements of Pakistani pharmaceutical companies. In most of the developed and developing countries, ministries act as independent, liberal and unbiased authorities and do not accept any funding or support from the industry. Professional societies like the Pakistan Pharmacists Association do not have the vision to debate or discuss the issues of medicine use. Pakistan Medical Association also does not seem to be aware of the challenges in the global scenario.

So what can be done? There is a need to promote awareness in civil society. We need pharmaceutical industry watchdogs (there is one working in Islamabad but we need many more). More healthcare professionals who can be trained in pharmaceutical policy issues are also required.

Concerned professionals — doctors, pharmacists, academics and other socially conscious persons — should join forces to create awareness about drug use in society. There is a need to voice out these concerns in both houses of the parliament. The Drug Act of 1976 safeguards the interest of Pakistani consumers but what about the enforcement of the law? Do we have the necessary manpower and commitment? Furthermore, the media should be well informed so that it can educate consumers at large.

ZAHEER UD DIN BABAR
Kuala Lumpur, Malaysia

Copyright laws

THE recent crackdown on pirated software simultaneously in Pakistan, India, Indonesia and China is not merely coincidental. It is a well-designed campaign by lawyers and spin doctors from the global cartels of DVD and CD business houses to expand their insatiable appetite for profits.

Copyright laws for the entertainment industry and other software are a classical western tool of business which may be of relevance to the western economies but its implications for Third World countries are devastating.

Pakistan’s economy is way too weak to pay the prices of these software in US dollars. These media and software companies are run by shrewd lawyers which want to make the end-users pay by blood so long as they can suck some money out of the end user’s pockets. Their profits are based on multiple costing which is sheer exploitation.

Imagine a hypothetical and bizarre example: a doctor charges a patient for every single day of his/her life once he has saved his patient’s life in the past; an engineer continues to charge every single car (every time it crosses) a bridge which the engineer had helped design and erect. These software and media cartels are doing exactly the same thing with their products.

Is it possible to have a debate whether or not Pakistan should be a signatory to the global copyright laws? It would be in our best interest to not acknowledge them in our country. Pakistan can function as a legitimate safe heaven for products without copyright restrictions.

For example, this year alone Elvis Presley records have yielded a post-tax profit of $35 million to the company which holds the copyrights to his records. Elvis has been dead for four decades now.

Say no to copyright laws. These companies may choose not to do their business in Pakistan. In the end its going to be them and not us who would lose.

DR NOUMAN IKRAM ALVI
Edinburgh, Scotland

Winds of political change

ELECTIONS have been held recently in Afghanistan, Iraq and Palestine and millions of people have come out to vote after decades of being denied the opportunity. However it is not just elections that bind these three nations together; another common factor is that all these countries were under foreign occupation at the time of their elections.

This in itself invalidates any concept of these elections being an exercise in measuring whether a government or a leader has legitimacy separate from that which is conferred by the occupying authority. It would have been like the founding fathers of America organising an election while British forces still occupied Philadelphia in 1776 under a constitution previously agreed in Westminster.

In imposing interim constitutional arrangements, such as the Transitional Administrative Law in Iraq, provisions were made to exclude non-secular parties from the outset, i.e., the rules of the game were preset to ensure a favourable outcome. In so doing it is not surprising that pro-western secular leaders have been elected in Kabul, Gaza and Baghdad. It is very clear and evident that the West is not interested in democratizing the Islamic world, but imposing secular western-oriented rulers on the Muslims who protect and promote their interests.

It is time the Muslim Ummah took their destiny in their own hands by challenging the current political setup. The winds of change are beginning to blow and an ideological change is around the corner.

JUNAID ASLAM
Islamabad

Criminalization of politics

THE biggest danger to democracy at present stems from the criminalization of politics. Unfortunately, a significant number of our political leaders are revelling in self- aggrandizement and are patronizing criminals. Also, quite a few criminals have converted themselves into political leaders and are benefiting from the loot which automatically accrues to ruling politicians and administrators.

Democracy in our country has had a chequered and turbulent journey because many of our politicians and top administrators have been practising what could be called AEIOU, a virulent amalgam of Apathy, Evasiveness, Incompetence, Obstructionism and Urge for Unwarranted Power.

All discerning observers of the Pakistan scene have correctly warned us that if at present the democratic institutions are prevented from striking deep roots and making further progress, this could have calamitous consequences for the country.

To avoid this our political leaders should carefully ponder over the following profound statement of George Santayana: “Those who cannot remember the past are condemned to repeat it”.

AFTAB AHMAD KHAN
Karachi

Quaid’s house in Mumbai

I WAS really shocked to read that Ms Dina Wadia has laid claim to the Quaid-i-Azam’s house on Mount Pleasant, Malabar Hill, Mumbai.

Perhaps she has made her claim in accordance with current Indian law under which the property can devolve to her during her own lifetime and then to her son. If she is not given ownership during her lifetime, her son will not be able to inherit any property of the Quaid-i-Azam.

But under the Shariat, Ms Dina Wadia cannot have claims on the property as the Quaid was a Muslim and a Pakistani.

The best alternative for India with regard to the Quaid’s house in Bombay is that it should be handed over to Pakistan and the office of the consul-general of Pakistan in Mumbai may be located there. India shall earn the gratitude of the Muslims of the entire subcontinent.

SAMEEN KHAN
Karachi

Korangi 8000

THIS has reference to Mr S. Nayyar Iqbal Raza’s letter “Colours of Korangi 8000” (May 17). In fact, there is no sewerage system in the Korangi industrial area.

The city nazim has already recommended to the government allocation of Rs1,000 million for development of the sewerage system and construction of Road-8000. We hope that work would start soon.

NIHAL AKHTAR
Secretary, Korangi Association of Trade & Industry, Karachi

What does jihad mean?

THE Arabic term “jihad” mentioned in the Holy Quran has been commonly mistranslated as “holy war”. The Arabic equivalent of the English expression “holy war” is “harb muqaddasah”, an expression which is not found anywhere in the Quran or in the authentic sayings of the Holy Prophet of Islam (PBUH). Even when the Quran speaks about defensive war, it never glorifies it or calls it “holy”, but as something which is inherently hated (2:216-217). However, as a last resort, it may be better (than doing nothing in the face of aggression or oppression).

Furthermore, the term “holy war” means, lexically, a fight on behalf of one religion against the other(s). There is no verse in the Quran that condones fighting any peaceful non-Muslim on the sole ground that he/she is a non-Muslim. The Quran prohibits compulsion in religion (2:256) and even allows some form of interfaith marriage. For example, a Muslim male may marry a Jewish or Christian woman (5:5). It may be argued from the religious perspectives that the expression “holy war” is a contradiction in terms as there is nothing “holy” about war and its results; bloodshed, destruction and human suffering. It may be a lesser evil, but not holy in itself.

“Jihad” is an Arabic term derived from the root “jhd” which means, literally, to strive or exert effort. The term jihad and other similar terms derived from the same root are used in the Quran and in Hadith in three contexts.

First, it is used in the context of prayers, doing righteous deeds and self-purification; inward jihad or struggle against evil inclinations within oneself (Quran — 22:77-78; 29:4-7).

Second, it is used in the context of social jihad, or striving for truth, justice and goodness in one’s relationship with other humans. Examples of this usage include the payment of charity to the needy (49:15) and striving to persuade those who reject God’s prophets by referring to the arguments presented in the Quran (25:51-52).

Third, it is used in the context of the battlefield, which is often called, more specifically, Qital, which means fighting. The later form, the combative jihad, is allowed in the Quran for legitimate self-defence in the face of unprovoked aggression or in resisting severe oppression, on religious or other grounds (2:190-194). No other verse in the Quran, when placed in its proper textual and historical context, permits fighting others on the basis of their faith, ethnicity or nationality (60:8-9).

The Quran recognizes plurality in human societies, including religious plurality, as part of God’s plan in creation (10:19; 11:118-119). It calls for peaceful and respectful dialogue, not forced conversion whether through war or other forms of coercion (3:64, 16:125, and 29:46).

Combative jihad is not only restricted in terms of what may or may not justify it; it is also strictly regulated. Prophet Muhammad (PBUH) taught how to behave in the battlefield. As a “hated act”, war should not be resorted to if other peaceful and just means may stop aggression or oppression. Intentions must be pure and no selfish personal or nationalistic agenda should be the driving force. There must be a declaration of war by a legitimate authority after due consultation. No non-combatants should be hurt. All must refrain from looting and unnecessary destruction. Prisoners of war and the injured must be treated humanely.

It should be noted, in the long history of Muslim people, there were times when such conditions and rules were adhered to and other times where there were violations in differing degrees. There were also some misinterpretations of the concept by some scholars, possibly influenced by the circumstances of the world in which they lived. The fact remains, however, that Islamic teachings are not to be driven either by what some Muslims did or are doing today, nor by misinterpretations, past or present.

It is a duty of Muslim scholars to clarify these issues to both Muslims and non-Muslims alike. Some are already doing that in the pursuit of the true Quranic vision of a peaceful and just society and world.

DR JAMAL BADAWI
Halifax, Canada

Karachi’s stray dogs

THE Karachi city government’s decision to poison stray dogs in an attempt to contain their growing numbers is ill-founded and inhumane. It shows a total disregard for non-lethal alternatives presented to the city government officials by animal rights activists, doctors, health officials and citizens.

Their proposal was based on the recommendations of the World Health Organization which has extensive experience in this area. More and more countries, including developing nations, are implementing non-lethal spay/neuter methods to control the surplus population of animals. Many use euthanasia only as a last resort for sick and/or injured and rabid animals.

Dogs are a part of our urban ecology. Poisoning them can create an environmental disorder of an unprecedented magnitude. For example, the remains of dogs will be eaten by insects, birds and other animals whose droppings will contaminate the environment. Moreover, poisoning is a painful way to kill animals

The city government is requested to refrain from inhumane slaughter of dogs and join the team of experts and organizations that truly understand how to address this complex issue.

SYED RIZVI
San Jose, USA

Cellular service

A cellular company recently launched its services in 28 cities of Pakistan. I was one of the many people anxiously waiting for a good tariff package due to be announced by the company.

When the company launched its 30-second billing structure, I rushed to get my new connection. I loaded my scratch card worth Rs250 via company’s card uploading number “123”. Just to check the newly-introduced 30-second billing claim I made a call on the same network for 22 seconds. When I checked my credit I was shocked to discover that I had been charged for one minute. After making several calls on the helpline number “312” for three days without getting any response I finally threw away the SIM.

PTA needs to take a hard look at what is being promised and what is being delivered to the helpless consumers. We have been living in mediocrity for too long and even this new foreign telecom operator has disappointed us yet again.

RAZIM KHAN
Islamabad

Privatization of PTCL

DESPITE the great harm caused to telephone users and embarrassment to the government, why is such leniency being shown to the PTCL’s erring staff? Surprisingly only 28 union leaders have been sacked.

The PTCL should easily get rid of a minimum of 280 trouble-makers to show that it means business — after what the public has suffered for decades at the hands of these workers, not a single citizen will sympathize with them.

On a visit to any telephone exchange or for that matter to any of its offices anywhere from Karachi to Khyber, one will only notice corruption and nepotism. The present PTCL set up is similar to the police, customs and the income tax departments.

Our ignorant and equally corrupt political leaders who are encouraging and supporting the unions against the government are doing a great disservice to nation. Privatize.

ABU IBAD
Karachi

Investments in banks

THE Supreme Court of Pakistan gave a bold decision on June 3 in the arrest of the ex-registrar of the Supreme Court, the president of the Islamic Investment Bank Ltd (IIBL) and all directors of IIBL for their alleged involvement in a scam of Rs633 million. It appears that IIBL was operating without any checks and balances by the State Bank.

The authorities have frozen all accounts in IIBL, resulting in chaos and hardship among the people who have investments in the bank, which include poor citizens and pensioners. I request the SBP governor to take immediate action to release the money to the people or merge IIBL with any other bank.

MOHAMMAD ASLAM
Peshawar

Senior citizens

THOSE government servants who retired from service before 1972, when the scales of pay were extremely low and the rules of pensions most severe, their case needs no pleading. In view of the present position, justice and sympathy demand that they should be provided with a lumpsum instead of any percentage increased to enable them to live honourably.

RAFAT AHMAD KHAN
Karachi