THIS is apropos of the letter ‘Lahore tragedy and healthcare (Dec 3). It is indeed very depressing that 256 persons died in Punjab in two separate incidents of drug toxicity. This shows a serious situation in health governance and institution management.

After the 18th Amendment the provincial health department should have played a key role in resolving health-related and pharmaceutical problems.

Unfortunately the healthcare system has seen no strengthening or betterment after the devolution of subject of health. Present conditions allow neither the availability of pharmacists at each drug outlet nor can patients afford to seek medical prescription from a physician for common ailments to buy medicine.

Manufacturing, quality assurance, distribution and sale of drugs are far from standard good practices. The Punjab government has not announced any drug policy so far.

The periodic episodes of drug reactions only degrade the image of our country and our pharmaceutical industry.

To avoid future tragedies resulting from adverse drug reaction, the following measures need immediate attention:

The drug sale licence (DSL) should require proper criteria, qualification, training, refresher courses and computerisation of record of the DSL.

The Punjab Pharmacy Council should be reactivated and play its due role.

All violations of drug rules should be recorded on licence and be punishable.

The qualified pharmacist should undergo internship as drug inspector with induction programme.

The drug inspector, like an area SHO, should be responsible for bad drug stores doing malpractice.

The drug inspector needs transport, staff and summary powers for quick redress of complaints.

The decisions of quality control boards should be expedited and implemented on time.

The drug-testing laboratory should be strengthened for accurate results on time.

The penalty for heinous crimes should be enhanced and disposal of cases be expedited by drug courts. A qualified person of the drug store with multiple violations or committing a major offence should be banned for licence.

Reporting of adverse drug reactions or health-related problems should be done by the health information system instead of the spicy media.

Last, in civilised societies persons take the responsibility for such accidents and vacate their positions for better ones.

DR S. ANWAAR AHMAD BUGVI Former Adviser, Public Health Department Lahore