PAKISTAN’S struggling health sector is back in the spotlight, once more for unfortunate reasons. Five cough syrups have been banned by the Punjab government following a WHO alert. These syrups were found to contain dangerously high alcohol levels and potentially toxic substances. This alarming discovery, sparked by complaints from the Maldives, underscores a shameful international dimension to the scandal: these dangerous products were not only sold locally but also exported, risking lives beyond our borders. It marks the second drug-related scandal to have come to light in Punjab in recent weeks, after patients lost their vision following the off-label use of a cancer drug to treat diabetes-related eye conditions. The international manufacturer released a statement saying that the drug is “not approved for any use in the eye”. Misuse of other drugs, such as one globally recognised to treat migraines but marketed in Pakistan as an ‘appetite stimulant’, is dangerously commonplace. These episodes are not isolated events but symptoms of a systemic failure in Pakistan’s drug regulatory framework. They highlight significant flaws in oversight, from manufacturing to distribution, and expose the informal, often unsafe, transportation methods employed within the industry. Ongoing medical malpractice, such as the 2021 debacle in which expired stents were used on cardiac patients in Lahore, further illustrate the appalling state of our healthcare system.

These continuing healthcare failures underscore a dire need for comprehensive reform in drug regulation. The Drug Regulatory Authority of Pakistan must enforce stricter controls and ensure transparency and accountability in the drug manufacturing and distribution process. This includes establishing a reliable and authoritative national formulary to guide medical practitioners and patients, thereby preventing the misuse of medication. The absence of an official drug guide is a glaring gap that needs immediate attention. The government must recognise that there is an urgent need to overhaul the regulatory mechanisms governing the pharma industry. This should include not only rigorous checks on manufacturing standards but also a comprehensive review of how drugs are marketed, prescribed, and distributed. The public’s health and safety must be the foremost priority; any negligence or malpractice in this regard should entail strict legal consequences. Only through decisive action and systemic reforms can we prevent such incidents from recurring and safeguard the health of our citizens.

Published in Dawn, November 20th, 2023