PHA-Exchange> No drugs to treat anaemia - a study from India

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From: Gopal Dabade 
Drug Action Forum - Karnataka, ( http://daf-k.cjb.net/ ) an independent, not for profit, non government organisation based in India has brought out a publication titled "A Study On Drugs For Treating Anaemia - A Campaign For Access to Essential Drugs" based on a study that it conducted. A copy of the study can be had from us (see below). 

This publication of 54 pages is an attempt to bring to the notice of the consumer action groups, the plethora of antianaemia drugs available for the treatment of anaemia in India. It gives sound guidance on selecting rational antianaemia preparations and reveals the inaction by the state authorities towards making these essential drugs available to the people who need them. It also reveals the profit maximising behaviors of the drug industry which includes the promotion of irrational, sometimes harmful and expensive medicines to the unsuspecting and helpless consumer. An article regarding this publication had appeared in a local paper and is copied below. 


Copies of this publication can be sent. For details please contact:-
Dr Gopal Dabade,
drdabade at gmail.com



http://deccanherald.com/deccanherald/jan42007/editpage22538200713.asp 

DECCAN HERALD, 4th January 2007 



Medication: Out of reach of people

Despite earning huge profits, pharmaceutical companies do not care for public health.

Nutritional anaemia is rampant and a major public health problem, mostly affecting women and children and is a sensitive indicator of poverty. The treatment for this problem is also simple. A preparation containing iron in the form of ferrous sulphate with folic acid for a duration of two to three months is the most effective treatment, which is well established in the medical field. But the issue is not that simple. In fact, as per a study, there are hardly any proper drugs to treat this problem. In other words there is a poverty of drugs to treat the condition that affects the poor and the marginalised. 

A study by Drug Action Forum-Karnataka has revealed that drugs available in the market to treat anaemia are unscientific, ie they do not match any standard textbook medicine or the World Health Organisation's (WHO) recommendations. While textbooks and the WHO advise that the scientific way of treating anaemia needs only ferrous sulphate with folic acid, drug companies add up a whole lot of things to this. 


Profit motive 


     
For example, Vitamin C is added; drug manufacturing companies argue that it enhances absorption of ferrous sulphate, ie iron. Textbooks explain that such a combination is not only useless but may even prove counter productive as this may unnecessarily increase chances of side effects of iron and give no added advantage. Apart from this, some companies add Vitamin B-12 to iron. A popular misconception among people is that it gives strength! The list of items that the drug companies add goes on. Even zinc, copper, Vitamin B-6, alcohol and haemoglobin are added. 

Why do drug companies add up unnecessary ingredients? The only reason that comes to our mind is that they want to make more profit. It only adds up to the cost of the drug. 

Most of the preparations to treat anaemia are sold in the capsule form, which again is not advisable. Tablet form is most suited. The cost of the drugs is several times higher (even 45 times higher) than the scientific ones. Scientific and correct preparations are not available with most local chemists. Local chemists argue that it is not profitable enough to keep such drugs, as they do not have a good profit margin. This is a good example to show that market forces cannot take care of people's health. 

One wonders if the drug companies in India are not making enough profit to manufacture such primary drugs. The Indian drug industry is the most profit making one today. It is one of the leading global players in manufacturing drugs — fourth in terms of volume and 13th in terms of production. Despite such huge profits, the industry has been reluctant to manufacture drugs needed to treat anaemia and other common complaints. 

Forced poverty 

The National Sample Survey (NSS) shows that "one quarter of hospitalised Indians fall below the poverty line due to hospitalisation and drug related costs". A substantial amount of money of the patient is spent to buy drugs. According to an estimate, it is 40 to 50 per cent, which is almost double that in the US and other European countries. 



It is to be noted that in spite of such a successful and highly profit making Indian drug industry, 65 per cent of the Indian population does not have access to basic, simple and essential medicines. This in reality means lack of medicines to treat even simple symptoms like fever. 

These life saving, essential drugs which could be manufactured at low cost are not available at even government health centres. There is often a shortage, which is outrageous, as the poor are compelled to go to government health centres. 

These issues should attract urgent intervention of the government for a public health cause. So, till the government wakes up people will continue to be anaemic.

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