REGULATORY hurdles and heavy-handed government policies have created some dangerous externalities for the country’s healthcare sector, where we may soon see an unprecedented crisis if immediate action is not taken. Stakeholders have warned of a wide-ranging emergency in the coming weeks as healthcare providers run out of essential medicines, medical devices, laboratory tests and various implements needed for the entire spectrum of medical and surgical procedures, including lifesaving interventions. In fact, according to representatives of the pharmaceutical and medical devices industries, the country has already crossed the crisis threshold. They blame months of inaction by the federal cabinet in response to a trifecta of challenges that have seriously hampered their industries’ ability to cater to domestic needs. These challenges include bank delays in opening letters of credit for most importers; a condition requiring the registration of all medical imports with the Drug Regulatory Authority of Pakistan; and the government’s continuing failure to revise drug prices despite drastic changes in the pharma economy over the past year.

In recent months, there have been multiple warning signs about the deteriorating situation in the healthcare sector. The most prominent of these was the shortage of basic drugs in local markets, such as Panadol. Likewise, citizens who recently required important medical procedures, such as the implantation of cardiac pacemakers, reported being told to wait as hospitals were rationing available devices due to supply constraints. The drug shortage was attributable to the flawed regime used to regulate medicine prices, while the device shortages were a direct result of banks controlling how many L/Cs were being issued to importers. The third issue cropped up more recently when the government failed to extend the deadline for the registration of medical imports with Drap, which expired on Dec 31, 2022. As a result, the import of most critical medical devices is currently not just difficult but also illegal.

These issues spell disaster not just for the healthcare sector but for countless sick people who need imported items for the treatment of their afflictions. It has previously been asked whether it is more important to have cheap medicines but no availability or slightly expensive medicines with ready availability. We clearly cannot have both, especially after the increased prices of all manufacturing inputs. Likewise, the government must immediately review the tactics being used to delay the issuance of L/Cs for importers of medical inputs and devices, as it directly affects sick citizens. As far as the requirement to register medical imports with Drap is concerned, the regulator needs to be given sufficient manpower to process the hundreds of thousands of applications already pending with it, and the government must suspend the registration condition till such time the process is streamlined. The looming disaster can only be averted with quick action. The government must take note.

Published in Dawn, January 6th, 2023