Business Recorder editorial Feb 14, 2017

Drugs regulation issue The Punjab government’s well meant effort to tackle the issue of spurious and substandard drugs through amendments in the Drug Regulatory Authority Act 1976 has set off a chain of events that have an underpinning of tragedy. For one, the protest rally by the Pakistan Pharmaceuticals Manufacturers Association (PPMA) and 12 other organisations of pharmacists, distributors, wholesalers and retailers of drugs and medicines that started from the Lahore Press Club was subjected to a terrible terrorist attack in front of the Punjab Assembly on February 13. The day had seen a strike by a majority of pharmacies and medical stores in all major cities of Punjab and large parts of the rest of the country. The notable exceptions were pharmaceuticals and medical stores inside government hospitals and a few outside these hospitals. The few outlets open had a field day overcharging desperate customers for their products, while patients and their attendants ran from pillar to post to find scarce medicines, including life saving drugs. The PPMA North Zone Chairman, Dr Tahir Azam, said all pharmaceutical factories and medical stores would remain shut till the withdrawal of the ‘cruel’ amendments by the Punjab government in the 1976 Act. But there were dissident voices from the retail community too. Pakistan Chemists and Druggists Association Chairman Ishaq Meo said there was no justification for the strike when a high level committee had been constituted for resolving the issues. The complaint of the striking protestors is that all the stakeholders were not consulted before the amendments were promulgated and that the provincial government of Punjab is not empowered to make amendments to the provisions of the federal drug regulatory Act. Punjab Minister for Primary and Secondary Healthcare Khwaja Imran Nazeer on the other hand defended his government’s steps by pointing out that Punjab had discussed the issue with the other provinces without result and in the meantime had taken a decision not to allow itself to be blackmailed by those manufacturing or selling spurious and substandard drugs. He went on to say that negotiations were underway with the stakeholders. He argued that the amendments had nothing in them regarding pharmaceutical dealers and medical stores but because of their dependence on and close relations with the manufacturers, the former were protesting at the behest of the latter. The minister’s remarks and the visible split in the ranks of the pharmaceutical community indicate that part of that community sees wisdom in engaging with the government while what the government regards as a vested interest is bent on pressurising the government to give in to their demands, whether reasonable or not. It may be that the vested interests have precipitated this confrontation at the cost of patients and their worried families. But it may also be the case that the Punjab government failed to engage all the stakeholders (including, of necessity, the manufacturers) before amending the law. The amendments provide punishments for producing or selling fake, spurious or substandard drugs and medicines ranging from six months to 10 years imprisonment and fines ranging from Rs one to 50 million. They also enhance the importance of the Punjab Quality Control Board, Chief Drugs Controller and drug testing laboratories. This is reasonable, necessary and critical for the safety and health of the citizens. Reportedly, a majority of medical stores throughout the country do not have pharmacists on their staff. The amendments prescribe such qualified experts to ensure the proper dispensing of medicines. There is also reportedly a dearth of registered medicines at drug stores, as well as unregistered (herbal) medicines easily available. Most drug stores lack refrigerated storages for medicines requiring refrigeration, thereby compromising their quality. Complaints regarding such lacunae have been around for years, without the real authority, the federal government, moving to address these shortcomings. While the initiative of the Punjab government is correct in principle, the issue of its locus standi can be resolved by the protestors moving the courts instead of causing pain and difficulty to the public. For the governments, provincial and federal, perhaps the time has come to put their heads together, promulgate appropriate legislation, set in place proper monitoring of drugs and medicines through the supply chain, and ensure the best possible healthcare is thereby made available to long suffering citizens.