PHA-Exchange> Pakistan's pharmaceutical industry

[ZAHEER U.D.DIN.BABAR]

Dear Claudio

Today 'Dawn" - a Pakistani newspaper published my article on Pakistani Pharmaceutical Industry. URL is below. (Copied as fair use).
http://www.dawn.com/2005/06/17/letted.htm#1

Pakistan's pharmaceutical industry


EXPENDITURE on medicine is an integral part of a healthcare system. According to a World Health Organization study, "World Medicine Situation", Pakistanis are spending 77 per cent of their healthcare budgets on buying medicines. This shows the lack of government public health financing (Pakistan is spending on an average a mere 0.5-0.8 per cent of the GNP on health) and the absence of a national health insurance programme. In spite of buying medicines from their own pockets, consumers are still victims of irrational drug use and fake medicines. This also illustrates that Pakistan's national medicine policy has failed to achieve its public health objectives.

In Pakistan, both multinational and national pharmaceutical companies are heavily involved in the unethical marketing of medicines - indirectly exploiting the consumers. Marketing incentives are so lucrative that many physicians are prescribing patients drugs which they really don't need. These medicines are posing an unnecessary risk to the health of the people.

According to BUKO Pharma-Kampange - a Germany-based non-governmental organization monitoring the practices of German pharmaceutical industry in the Third World countries - 70 per cent of patients in Pakistan are treated with antibiotics although a majority of them don't need these medicines. It also states that in Pakistan, 32 per cent of drugs sold by German pharmaceutical companies are irrational and 61 per cent of drugs were not even present on the WHO essential drug list. Some of the drugs that were sold in the country were harmful and have been banned in developed western nations or have no added therapeutic value. A European Union study states that 50 per cent of medicines available in Pakistan are counterfeit.

Pakistan's total medicine market is about US$1 billion, with more than 400 pharmaceutical companies operating here. The Pakistani industry has grown significantly, even when exports of most of the middle-income countries are on the lower side. According to WHO, Pakistan's exports share doubled from 1.1 per cent to 2.9 per cent during 1980-1999. The industry is also a champion in providing jobs, earning foreign exchange and claims to play a pivotal role in the healthcare sector. One cannot deny the role of the pharmaceutical industry in the healthcare system but one has to be cautious if the industry is also heavily involved in promoting irrational drug use. The question is how to draw the line between human health and business?

Pakistan does have a medicine policy and a Drug Act of 1976 but the ministry of health does not have a clear view of what it is up to. The ministry maintains a cordial relationship with pharmaceutical companies and publishes a newsletter with the industry's support. In the newsletter one can see names and advertisements of Pakistani pharmaceutical companies. In most of the developed and developing countries, ministries act as independent, liberal and unbiased authorities and do not accept any funding or support from the industry. Professional societies like the Pakistan Pharmacists Association do not have the vision to debate or discuss the issues of medicine use. Pakistan Medical Association also does not seem to be aware of the challenges in the global scenario.

So what can be done? There is a need to promote awareness in civil society. We need pharmaceutical industry watchdogs (there is one working in Islamabad but we need many more). More healthcare professionals who can be trained in pharmaceutical policy issues are also required.

Concerned professionals - doctors, pharmacists, academics and other socially conscious persons - should join forces to create awareness about drug use in society. There is a need to voice out these concerns in both houses of the parliament. The Drug Act of 1976 safeguards the interest of Pakistani consumers but what about the enforcement of the law? Do we have the necessary manpower and commitment? Furthermore, the media should be well informed so that it can educate consumers at large.

ZAHEER UD DIN BABAR 
Kuala Lumpur, Malaysia

Regards


Zaheer-Ud-din Babar B.Pharm., R.Ph. MScPharm
Senior Lecturer
School of Pharmacy
University College Sedaya International
Lot 18113, Off Jalan Cerdas
Taman Connaught, Cheras, 56000
Kuala-Lumpur. Malaysia

Tel: +60-3-91018880 Ext :383
Fax: +60-3-91023606









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