Karachi, India (NI) – ‘India isn’t just making the world’s drugs, it’s taking them too,’ New Internationalist co-editor Hazel Healy wrote to me. Made me stop and think. I’ve read and written about the Indian pharmaceutical drug scenario since my monthly New Internationalist column in 1991. Sometimes with pride. Sometimes in despair.
India has been justifiably called the pharmacy of the world.
In 1991, I wrote proudly that our government fought patents which would enable pharmaceutical companies to triple or quadruple prices and make patented drugs unaffordable for the world’s poor. It was difficult for me to explain GATT (General Agreement on Tariffs and Trade) and the harm done by its partner-in-crime, the WTO (World Trade Organization), to anyone. It was so complex and so boringly, bureaucratically written, even reading it was excruciatingly tedious. I finally told our doctor friends, ‘what it means to us, is that drug prices will skyrocket, making it impossible to treat the poor.’
That got everyone’s attention.
I was proud that Indian pharma companies were producing anti-retroviral drugs to help Africans with HIV/AIDs at a fraction of the cost that big transnationals were charging them. It was a huge battle and we won. Our pharmaceutical companies were raking in profits too – they were not doing it out of the golden goodness of their hearts – but their profits were reasonable.
Former US President Bill Clinton lauded the efforts of Indian generic pharma companies such as Cipla and Ranbaxy, which supply cheap drugs to HIV/AIDS patients in Africa. Kudos to Africa’s pharmacy, went the stories. The Clinton Foundation then established partnerships with the generic companies to supply drugs priced as low as $79 per person per year, compared to $10,000 per person per year back in 2000. Millions of African lives could have been saved if this battle against Big Pharma profits had been won earlier.
What drives me to despair are the huge numbers of unlicensed, unauthorized drug companies in India which manufacture spurious medicines endangering the lives of people. I become incandescent whenever my husband’s insulin, bought in an emergency from an unknown pharmacy, sends his sugar levels sky-rocketing because either the cold chain has not been maintained or it is from a spurious supply. His diabetes has gone out of control as a result. But who in India cares about the general welfare of our citizens? A friend in Bangalore had to be hospitalized and almost lost her leg because the insulin she bought was a diabolically made fake substitute. The company paid her compensation on condition she did not publicize the case. Secrecy at what price?
We have a huge unregulated mess, where imitation medicines are sold to an unsuspecting public. When educated, savvy, veteran, decade-old diabetics can be duped, can we begin to comprehend the fate of the poor, the illiterate who have no clue about good or bad medicines? We need to urgently stop the manufacture of banned drugs which are still routinely prescribed. We need to address the issue of innumerable banned and dangerous fixed-dose combinations. One of the worst I’ve read about is a potentially lethal combination, an anti-psychotic containing 2 drugs from the same class, both individually associated with major toxicity, including sudden death.
Concerned medical professionals have tried to fight the corruption but manufacturers have lobbied against regulatory change, making ‘an earnest appeal’ to government to ‘maintain status quo’. And that is exactly what has happened.
In 1987, I read about LOCOST, founded in Baroda, Gujarat in 1983, to serve the poor by making only rational, essential, quality drugs at the lowest possible prices. It is fairly obvious that solutions are possible. We need the will, we need more individuals, from the medical profession to figh the big battle to resolve these problems and clean up the pharmaceutical industry. The government and other concerned groups together can do it. The question is, will they?