December 18, 2006	Monday	Ziqa'ad 26, 1427

SOME questionable practices by medical professionals, pharmaceutical industry, and also lack of oversight by authorities, are worrisome.

For example, drug companies often provide doctors various facilities and sponsor leisure foreign trips just to increase sales of their medicine, majority of which are costlier, while a few of them may be associated with some harmful side-effects.

Health authorities know that the products marketed by multinationals in Pakistan are much costlier than the neighbouring countries like India, Bangladesh, Iran or Sri Lanka.

There is a huge difference in prices of products made by national and multinational companies. But no concrete step is taken to bring prices of medicine to a reasonable level.

Unsurprisingly, it is not only the prices that are very high in Pakistan but the quality of few products may not be as effective as in the country of their origin because of difference in climate.

But the story does not end here. Some of the outdated medicines associated with serious cardiac illness have been banned all over the world except in Pakistan.

Authorities also are planning to prohibit the use of a pain-killer which is administered to animals. The same enthusiasm is not shown by authorities for human-beings. Two decades back the government imposed a ban on multi dose vial to avoid the risk of hepatitis or HIV but they are still available in the domestic market.

Another major problem that needs urgent attention by health authorities is abuse of addictive medicines and any one can purchase them without prescription. This addiction results in increase in antisocial activities.

The root cause of unethical practices is the absence of a strict health policy.

Our local industry is marketing products that are researched products of foreign companies; they just pack the old molecule with new brand name. But one impact of this is that the prices of such medicines are very cheep as compared to the brand leader. Latest research has helped multinational companies to market hundreds of new medicines at very high price. But these companies never conducted research in Pakistan.

In India and other neighbouring countries these multinationals are bound to conduct research for new products and establish factories based on local material by local industrialists. This resulted in very healthy competition among local and multinational companies. Indian government also has a strict check on prices of medicine. These all steps result in low prices.

The national pharmaceutical industry has suffered from various restrictions limiting them to just packing and marketing. Multinationals have not developed new drugs in Pakistan nor have shown any interest in establishing factories for processing raw material.

They never conducted industry-funded clinical trials in Pakistan which is the first step in research. Neither the pharma industry nor our universities are interested to conduct original research for any new molecule. Only few people like Dr Saleem-uz-Zaman Sidiqui have done some exceptional work in this field.

Research is costly and time consuming. Every day a number of new compounds are created in laboratories, it is estimated that out of 1,000 new drugs only one is permitted for manufacturing and marketing because of strict rules made by regulatory authorities; not only the efficacy of these drugs but side-effect are thoroughly assessed by authorities continuously.

If any of the medicines is found to be associated with harmful effects manufacturers are bound to withdraw them immediately. But in Pakistan these dangerous medicines are freely available despite the presence of health authorities.

Unfortunately in Pakistan there is a symbiotic but unhealthy and unhelpful relationship at work between physician and pharmaceutical companies, which enforces the disproportionate medication.

Policy-makers, politicians, and health professionals have all had a part to play in generating an over-reliance on medication. But what is still most important is absence of vigilance of health authorities.

Health system of Pakistan needs reforms – a health policy with a social approach of distress – based support. There is a need to go beyond ‘symptoms of illness’ and treatment of ailing patients.