DEFICIENCY of thyroid hormone in children leads to permanent physical and mental disability. The authorised price of Thyroxin tablets is about one rupee for a tablet. Thyroxin is either not available or its suggested version without any quality check is available in the black market for Rs60 to Rs100 for a tablet which is beyond the reach of common people. The black marketing is done with the connivance of drug control officials.

Likewise, overacting of the thyroid gland, called hyperthyroidism, also causes serious physical and mental disturbances. For its treatment, the essential drugs carbamizole and propyle-thiouracil are either being sold in the black market or not available or scarcely available or the smuggled ones are available in the black market at a high price.

There are large numbers of other essential life-saving drugs which are not available in markets. The first-line life-saving antibacterial drugs like penicillin V, erythromycin and furadantin are also not available, compelling the use of expensive second-and third-line antibacterial drugs which many patients cannot afford and are left without treatment. Their use, rather misuse, leads to serious side-effects and bacterial development of drug resistance which is a serious health hazard.

Hypertension has high prevalence in Pakistan. The affordable essential drugs belonging to thiazides category are generally not available with the result that many patients are left without treatment and serious consequences.

However, an expensive analogue of thiazides is available. Methyldopa, hydralazine, labetalol, etc., needed for the treatment of hypertension during pregnancy, are generally not available.

Iron deficiency known as anaemia is a very common disorder in Pakistan, particularly among the lower socioeconomic strata. For its treatment, the affordable essential drug ferrous sulphate is usually not available, while the market is flooded with irrational expensive iron preparations.

This situation has been obviously created to aid the companies marketing expensive preparations to make financial gains at the cost of poor patients and the country.

The same is the case with multivitamins and mineral preparations of the affordable ones listed in the essential drug category.

Digoxin, an essential drug for the treatment of cardiac failure, is also not available. A conjugated oestrogen preparation needed for the treatment of women suffering from common post-menopausal disorder is also not available, while expensive illegally given fourth drug is available.

Unfortunately, this situation is unique in Pakistan. In all other countries, including Saarc ones, essential drugs are available. In some Saarc countries they are even available free of cost.

This is all due to corrupt practices and incompetence of the health officials in Pakistan. It is pertinent to note that quite often directors-general, health, have been appointed heading the drug regulatory authority who did not even possess basic knowledge of drugs.

Scandals like ephedrine and deaths at the Punjab Cardiac Institute are just the tip of the iceberg. The ministry of health meant for the welfare of the people has been used by rulers for exploitation.

The government is least concerned about the welfare of the people. It is pathetic to note that organisations like the PMDC, medical associates, a vast network of medical institutions with rare exceptions, have shown no interest to safeguard the basic rights of patients and to mitigate their sufferings.

The government must make all essential drugs available to the people. The Drug Act, 1976, empowers the government to force companies to produce essential drugs or cancel licences of those who do not produce these.

DR (Prof) M. AHMAD AKHTAR Via-email