CLOWNS in Germany and Gaza perform for the elderly and children, respectively, to cheer up those in isolation. Uber and takeaway firm Deliveroo are offering hundreds of thousands of free trips and meals to National Health Service Staff in the United Kingdom. While the industries unrelated to the coronavirus outbreak find ways to contribute, the Pakistani pharmaceutical sector is notably absent in the midst of the health crisis.

When questioned what measures the pharmaceutical sector is taking, Pharma Bureau Executive Director Ayesha Tammy Haq said pharma companies have increased production but were facing problems in keeping pace with regular demand. Lockdowns in China and India have hindered movement, making it hard to acquire active pharmaceutical ingredients.

In a conversation on March 31 with Dawn, Ms Haq lamented that other than pricing, directors for all other divisions in the Drug Regulatory Authority of Pakistan (Drap) had as yet not been notified for which she was trying unsuccessfully to talk to the health secretary.

Is it not their responsibility to sell drugs at cost at least to reduce the financial burden on ordinary people?

Quotas for drugs have to be allocated by the Ministry of Narcotics and the Ministry of Health. While this exercise should have been undertaken in January, she explained, in the absence of directors it had been delayed to at least April, which could lead to huge shortages of a lot of medicines.

Distribution

“March saw the highest sales ever recorded for the pharmaceutical sector,” said a well-placed source in one of the biggest distribution companies in Pakistan. Panic buying of chronic therapy medicines shot up sales from March 15 to March 28.

While a lot of small shops are closed in Karachi, the buying volume was led by big stores such as Imtiaz, Kausar Medico and Bin Qasim. While the numbers were booming in the first quarter, the second quarter will most likely post smaller numbers as people will already have stores of medicine.

The pharma responsibility

Citing well-known problems of import dependency, depreciating rupee and price controls, the $3.2 billion industry (in 2017) has a woe-is-me attitude that cannot find a way to be of use to the country in its hour of need.

The table shows the top- and bottom-line numbers of listed pharmaceutical companies whose financial year ended in December 2019. All companies posted a profit. Given the global scale, if and when there is a vaccine or cure, the debate of who bears the cost from production to patient is going to be a one that will be covered across all forms of media.

But for now, the question arises about the moral responsibility of pharmaceutical companies in the face of this health crisis.

Different doctors and medical officials consulted for treatment for coronavirus symptoms agree that anti-malarial medicine chloroquine has under certain conditions and within limited studies produced positive results. Azithromycin is another medicine that a couple of doctors said is being used to treat some symptoms.

While it is not a cure, 30 million doses of hydroxylchloroquine sulphate have been donated by Sandoz, a division of Novartis, to the US Department of Health and Human Services. Another company, Mylan, is ramping up production to make 50m tablets. Teva is donating 16m tablets to hospitals and Amneal has pledged to make 20m tablets by mid-April.

In Pakistan, on the other hand, there are conflicting views on its availability. Contrary to medical advice, when the news of its potential efficacy first surfaced in the media, there was an increase in its purchases by laypeople. Some of the stakeholders consulted assert that there is a shortage in the market of this medicine and production cannot be increased due to the global lockdown.

Others say that the pharmaceutical companies operate with three to six months of raw material stocks and can increase production if there is a sufficient rise in demand. Whichever the scenario, no company has yet announced the donation of this drug to aid in the treatment of Covid-19.

Given that the United States has the largest number of Covid-19 cases and that President Trump is pushing the malaria drug for treatment, the increase in production and donations makes a lot more sense for themthan it does for Pakistan.

However, if not donations, then the pharmaceutical companies can at least sell Covid-19–related drugs that can ease fever, joint pains, cough symptoms and antibiotics that treat secondary infections at cost. Most sectors in the economy have taken substantial hits, but it is unlikely that the pharmaceutical sector will suffer.

In such a scenario, is it not the pharmaceutical sector’s responsibility to at least subsidise the medicine available to reduce the burden on the common man as well as the beleaguered government struggling to keep the economy afloat?

Published in Dawn, The Business and Finance Weekly, April 13th, 2020