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This would be the last part of the Blog Series on fake/spurious/sub-standard/counterfeit drugs. We talk about possible solutions.
It has been a special series owing to the importance and sensitivity of the topic. Too much noise is already surrounding this topic. I wanted to stay close to facts, and away from noise. I also wanted to raise the awareness about drug manufacturing and regulatory mechanism without getting too technical.
Solutions of problems are always found either in the root cause or in scenarios leading to it. In case of fake etc. drugs we know the root cause as well as the scenarios. It may therefore be easy to suggest solutions. Implementation, however, always requires will and determination.
The root cause is one; satisfying greed through wrong means. This is a larger problem at the society level. It is not limited to Pharma; it is unlimited to all segments and tiers of society. Corruption in all Pharma related segments encourages wrong practices. And finally, all unholy stakeholders get benefited. Replacing current staff with new staff is not the solution. New entrants quickly get trained in malpractices because they catch the same virus which had infected their predecessors. Solution 1 is to bring in better qualified staff and compensate them adequately so that they do not get tempted to corruption easily. Solution 2 is to hand out harsh sentences to delinquents, which would be a deterrent.
Other solutions are suggested here in some detail. These include a three-pronged approach; Regulators, Business, and Public. The major onus is on Regulators anyway because they have the knowledge and mechanism.
- The regulatory mechanism should be strengthened. It is not just about increasing the number of regulators; it is also about increasing the number of tiers so as to create multiple supervisory levels. People complain that more regulators mean more money has to be given. It may not be entirely wrong but if layer upon layer of supervisors is built properly, this practice can be discouraged.
- The hierarchical structure and its influence be strengthened. The reporting structure is there but the respect for it is missing. There is an old saying, “Everyone in this Lanka is 52 yards tall”. This is the current environment which gives undesirable freedom to regulator to operate in the way he or she wishes.
- New means and ways should be taken from international regulatory authorities; and existing staff be trained on these for implementation. Those who are unwilling, and/or incapable of learning should be relieved or transferred elsewhere.
- Government, for once, should appoint relevant people as ministers at least in health and education. It has been a long time that one nincompoop has followed another in these ministries. The ruling party can place their less intelligent people in other ministries but at least these sectors should be developed as a target. I can assure that this effort shall pay off politically also.
- The disconnect between federal and provincial regulatory mechanism be addressed. These should be made to compliment and support one another; not compete and antagonize.
- Provincial regulatory structure needs special attention because they control the retail sales outlets where fake/ spurious drugs may be sold.
- DRAP is upgrading its inspectors to ensure implementation of higher/ international standards in manufacturing. This is laudable. Provinces should also do something similar to upgrade their staff.
- The policies and efforts to upgrade Pharma manufacturing has been around for several years. It has yielded good results also. This effort should be reinforced.
- Legislation should be done to increase penalties and sentences related to drug crimes. At the same time, it should be understood that new legislation does not open new avenues of corruption.
- DRAP Act should be amended to recognize Marketing companies. These should be brought into mainstream and regulated.
- The Pharma industry should develop a system of its own policing and cleansing. Just by becoming a member of PPMA should not exempt any unit from review.
- PPMA has never done anything to curb manufacturing and selling of fake/spurious drugs. The industry should understand that it is bringing bad name to entire industry. PPMA should recognize this issue and support steps to eliminate this menace.
- PPMA is the only representative body of Pharma manufacturers. It should treat all members equally and watch the interests of all.
- PPMA should join hands with DRAP for upgrading the manufacturing, rather than resisting it, which it had been doing for a long.
- Pakistan Chemist and Druggists Association (PCDA) is an active representative of retailers and wholesalers of medicines. PCDA should work with its members and design and adopt a Code of Conduct for business.
- Public should mobilize itself against fake drugs business. Consumer groups should be formed which should educate general public and mobilize resources to pressurize the regulators and businesspeople.
- Public should see carefully while buying medicines. They should buy from reliable outlets and see the packaging carefully.
Fake/Spurious/Counterfeit Drugs business is like Narcotics business. It is done as it brings quick money and huge money. The temptation to do wrong is part of human nature and will not be eliminated. The effort to curb temptation has to be more that the temptation itself; only then it would be able to achieve success.
Fortunately, there are no organized groups or cartels who are indulged in fake drugs business. It is still at individual and regional level. It is still easier to handle and should be done, now.