At least three out of ten heart patients ask for pills of foreign brands at local drug stores after the Lahore incident, according to anecdotal evidence. The disturbed manufacturers are said to be involved in in-house deliberations and the Punjab government is trying to minimise political backlash by taking measures to sooth raw nerves.
The federal government, however, remains unfazed as it sees itself absolved of the responsibility of public health post-18 Amendment that has placed the subject under provincial authority.
It is sad that even a human tragedy of the magnitude where hundred innocent lives were lost failed to generate an informed response not just from the government but also from other stakeholders. In this case, drug companies, doctors, pharmacists and others in the health sector and the media (the self-proclaimed watchdog of the public interest), kept themselves busy with details at the cost of ignoring the real issues of constitutional violation, mis-governance and apathy.
It is hard to fathom why the distressed nation recovering from the shock of deaths in Lahore last week missed the link of the incident to non-existence of any formal authority vested with the expressed responsibility of managing the booming pharmaceutical sector that ought to be regulated under 1976 Drug Act.
“To me, the absence of a federal authority oversight over drug sector is a constitutional violation as the Drug Act is not in abeyance,” commented a frustrated expert.
The Drug Act of 1976, the law regulating pharmaceutical sector, and the regulatory structures formed under it for registration, manufacturing, quality assurance of medicines and adjudication of contraventions, etc, also do not exist anymore under the 18th Amendment. There is no provincial legislation at the moment to fill the gap.
After the reports of deaths ‘caused’ by consuming certain medicines an inquiry was constituted, criminal cases registered, arrests made and the compensation announced by the Punjab government for victims. All this, however, adds up to a frivolous handling of a potentially disastrous situation facing a nation of 180 million with not too enviable a heath record.
“Unfortunately, the handling of the Lahore case so far by the Punjab government depicts political ambitions, and confusion more than a serious effort to put things right to minimise chances of reoccurrence of similar tragedy elsewhere in the country,” said an expert closely monitoring the response.
Many informed people contacted were reluctant to come on record either citing the reason that the subject is sub-judice or admitting of being afraid of earning ire of what they called ‘vindictive health establishment’. The government official could not make themselves available for comments.
“We are worried how the incident would impact the local drug industry. If it erodes consumers trust on local pharmaceutical products, it would hurt the business prospects of local pharmaceuticals. The public perception is important for any business but in our line of trade it is crucial,” a proprietor of a local company told Dawn.
Some medical professionals contacted in Karachi expressed reservations about the medical explanation of the deaths. They pointed out that absence of proper laboratory facilities equipped with modern gadgets might render the technical investigation report inconclusive.
“There are no quality-testing facilities available in the country though drug companies pay one per cent of their profit as research tax. The total collection runs in billions of rupees. Where do the resources thus generated disappear? Your guess is as good as mine,” said a senior medical practitioner who believed that Lahorites who died of blood thinning medicines had suppressed dengue beside heart ailment that aggravated their conditions.
“If medicines were deadly, why no deaths were reported from other places in the country. They were not necessarily manufactured in Lahore or distributed at limited pharmacies. I know for a fact that medicines of the same batch of at least of the four medicines were disbursed all over the country. No complaint was reported from other places. Why?” he made his point.
“We cannot assess the toxicology of medicines. There is no facility available in the public or any private hospital, medical university or laboratory. So, yes, it would be hard to establish the actual cause of deaths in Lahore,” confirmed a drug maker.
Nargis Sethi, the cabinet secretary, who has recently been given the additional charge of defence was also holding addition charge of the ministry of health till June 2010 when it was disbanded. “Technically she still heads the Drug Control Authority in its neutered form. However, for all practical purposes, it ceased to function, with her preoccupation with other more pressing agendas,” Salman Burney, former chairman Pharma Bureau commented offhand when reached over phone.
All attempts to contact Sethi to solicit her view proved futile.
“The Lahore case is a blessing in disguise for multinational pharmaceutical companies that are expected to benefit by default as fortunes of domestic drug companies take a dip,” said a worried drug maker in Punjab.
“We are waiting for the lab report on the medicines that are suspected to have caused deaths before we announce our public position on the issue,” chairman, Pakistan Pharmaceutical Association told Dawn over telephone from Islamabad.
“The government must not be allowed to hide behind the ‘18th Amendment. The government at the federal and provincial levels must take the matter to the Council of Common interest and put a structure in place to save people and industry both,” concluded Qaisar Waheed, a former chairman, Pakistan Pharmaceutical Manufacturers Association.