Drugs that kill

Published February 1, 2012

WHAT had started out as a case of negligence on the part of a few individuals assigned to select and supply drugs to the Punjab Institute of Cardiology in Lahore has turned into a tragic exposé of malaise that implicates more than one administration and government in the country. The situation reads like a dark saga of a system that most knew to be ailing but which parties with vested interests had still wanted to perpetuate. Now, with the rising death toll of PIC patients, apparently from the use of contaminated drugs, the search for a new system has been given greater impetus by a flurry of news reports. Doctors have voiced a very reasonable demand about replacing bureaucrats with experts as drug monitors. There are calls for completing devolution from the centre to the province under the 18th Amendment. The Punjab and federal governments have been held guilty of adding to the panic, with a somewhat uncertain media groping in the dark as it comes up with one horrifying story after another. In part, this has been the outcome of a general lack of information among the sources the media taps.

As patients are scared away from public-sector hospitals, pharmacies from all over Pakistan are reporting a huge switch from locally produced medicines to more costly — and reliable — foreign substitutes. The people fear that the supply of medicines may not have been limited to the PIC and they can hardly be faulted for thinking so given the absence of a clear and timely explanation based on the frank sharing of facts. For instance, a certain percentage of the revenues earned by pharmaceutical companies is supposed to be spent on research and quality control. There is no discussion on how much is collected under this head and how much of the amount is spent, especially when Pakistan continues to be dependent on laboratories abroad for tests on medicines. This requires more than a simple explanation.

Other aspects too must be given consideration. Of these, the completion of the devolution scheme tops the list, although the argument that the country cannot do without a centralised body to monitor drugs is a valid one. At the moment, no one is sure about the validity of the Drugs Act of 1976 or about the Drug Control Authority as it existed under federal control. Building alternative watchdogs is something the squabbling provincial legislators would be better off spending their energies on. There is plenty to do and plenty to say to make the current debate more meaningful than it has been so far.

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