Medicine Harm: A rule rather than exception
There has been an epidemic of drug related illnesses and deaths reported from Pakistan in the press in 2012. Just the last week cough syrup consumption has killed 33 people. In November, at least 25 people died in Lahore after drinking the toxic cough syrup. Earlier in January, an adulterated heart medicine dispensed by the Punjab Institute of Cardiology claimed lives of 150 heart patients.
These seemingly unending deaths, and the associated ill health and suffering due to adulterated, counterfeited and badly manufactured medicines demonstrate a total breakdown of regulatory system in this country. This is in wake of the controversial Drug Regulatory Authority (DRA) purported to replace the existing diseased pharmaceutical regulation.
Secondly, the much hyped saga of the ephedrine quota involving the Prime Minister’s son, which played on during most of 2012, indicates narcotics mafia’s deep rooted pharmaceutical and political connections in this country. It clearly demonstrates that regulators and political dispensation have public’s interest as the last on their priority list.
While neither DRA nor the political dispensation seems likely to make any improvements in the state of affairs in 2013, these incidents of harm to the consumers should be seen in the larger perspective of the so-called modern medicine. The very system we call “bio-medical” that forms the modern health care paradigm should be looked into to develop a fuller perspective and understanding of the issues involved.
Cough syrups have been at the center of several cases of mass poisonings around the world in recent years, often involving accidental or intentional use of industrial solvents – diethylene glycol – as a cheap sweetener by the manufacturers. Diethylene glycol is known for causing severe toxicity and death. The effects of such poisoning can be widened because cough syrup is frequently abused by people who use it to get high. It was the most likely scenario in Panama when at least 94 people died from taking cough syrups in 2006 (3).
A 7-year-old boy died in Manila in February this year after he suffered a seizure believed to have been caused by taking cough medicine. Another five year old fell victim in Colorado, US on February 12 this year after taking the over-the-counter cough medicine to treat flu-like symptoms. Similar incidents are reported from around the world totaling a massive number.
Besides such clear incidences of toxicity, some seemingly innocuous medicines like iron supplements may account for more than 30% of reported medicine related fatalities in children.
Antidepressants, cardiovascular medications, and methyl salicylate follow in frequency of pharmaceutical related deaths in children.
In fact, prescription drugs constitute the major treatment modality of scientific medicine today.
Their utility has from the beginning, however, been overrated as manufacturers and promoters of these chemical drugs promised much more than they delivered. Far beyond not working, the drugs are known to cause incalculable side effects. Even when properly prescribed, these drugs have side effects that can be fatal. The situation would seem even worse considering the potential of human error.
Some studies have shown that there might be as many as 106,000 deaths annually due to medicinal reactions happening in United States causing around $12 billion in economic losses. These are to be added to an annual figures of 98,000 deaths and &2 billion losses shown as a result of human errors.
But these put together would seem conservative in comparison to another study has shown much higher estimates figured at 420,000 deaths and $200 billion in economic losses in a year. In a New England Journal of Medicine study, an alarming one in four patients have been shown to suffer observable side effects from the more than 3.34 billion prescription drugs filled in USA in 2002.
Besides the incalculable harm caused by the medicines as listed above, the death and suffering caused additionally due to hospital acquired infections, unnecessary procedures including surgeries, negligence and error brought forth by the healer reaches mind boggling dimensions. It would appear that causing harm is a rule rather than exception in the era of modern medicine.
A look at the broader picture shows that medicine – as conventionally practiced – has failed to meet effectively many of the challenges of modern health care and instead of being part of a solution has become part of the problem.
Ayyaz Kiani is a public health specialist. He heads Devnet – a network of development consultants. Based in Islamabad, he has travelled around the world and continues to do so to meet fellow travelers. He can be contacted at firstname.lastname@example.org
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