“The news of my death is exaggerated.” — Mark Twain

At the time of Pakistan’s independence in 1947, there were few pharmaceutical production units in the country. Now, Pakistan has over 800 large-volume pharmaceutical formulation units supplying around 90 per cent of the country’s demand for finished dosage forms and 4pc of active ingredients.

In 2020, Pakistan’s pharmaceutical sector’s value was around $3.2 billion, doubling from $1.64bn in 2011. Total exports in 2019 stood at $218 million, from $44.4m in 2003. Yet exports from the sector accounted for only 0.9pc, listing Pakistan as number 61 out of 138 countries worldwide.

These numbers should be viewed from the industry size perspective, which is about $1.5 trillion. Most of the medicines from Pakistan are exported to Kenya, Cambodia, Thailand, and Vietnam.

Pakistan’s total share of global pharmaceutical exports is 0.03pc, the lowest in the world based on per capita calculation.

The past few months have seen dozens of reports and articles declaring the demise of the pharmaceutical industry in Pakistan. The industry leaders are also in concurrence with the media, further suggesting that immediate government actions are needed as many drugs are about to go out of the market.

Instead of playing a blame game, industry leaders should invest in developing drugs and therapies domestically

The primary cause is attributed to the crash of the Pakistani currency since more than 80pc of all components in the pharma products in Pakistan are imported, even the packaging materials, let alone the chemical drugs. The drop in the currency’s value could have been a boon for the industry if it were export-oriented.

So, why is Pakistan so far behind in an industry that never goes under during a recession? The history is long, but it is summarised as the failure of the leadership in the country.

Pakistan imports the bulk of its components because the essential material industry never developed in Pakistan. Could the government have done more to promote the necessary chemical and packaging industry? The answer is yes, but the industry leaders should have taken the lead.

It is necessary to realise that no country rises above because of its government leaders; it is often despite their government. An excellent example of this assertion is the complete lack of newer medicines in Pakistan.

No biological drugs are made in Pakistan, while 90pc are made in India for their need. This should not include the companies that import the drug substance and fill it in Pakistan; this is not allowed for biological drugs.

The same holds for the vaccines. No vaccines are made in Pakistan; they are filled only and wrongly labelled as made in Pakistan. A couple of Pakistan NIH [National Institutes of Health] vaccines are redundant and archaic.

Luckily, Pakistan did not get hit by Covid-19, as did other countries, but the US’s $4bn donation to Covax might have saved Pakistan.

Even many vaccines imported were destroyed by a lack of proper storage systems. Recently, the United States Agency for International Development programme provided a few of these facilities that were thanked for by the Pakistan government instead of feeling embarrassed.

One clear sign of lack of vision comes from a complete absence of biological product manufacturing in Pakistan; these products now constitute 70pc of all new products and bring treatment to diseases like cancer that are untreatable.

These products require manufacturing the drug substance — active pharmaceutical ingredients — and despite the available resources, no one has taken these projects; the industry is planning to import the drug substance that is not allowed as a lower-cost choice.

Again, Pakistan is missing out on the opportunity as before. The cost of setting up biological products is not high and readily affordable by many companies in Pakistan; India has dozens, and so does Bangladesh, but not Pakistan.

There is no shortage of resources within the pharma industry in Pakistan to introduce biological medicines and export their products to countries with higher profit margins. The shortage is that of vision and determination.

US’s growth stems from the country having the highest venture investments, such as $270bn in 2022; the next highest investments were in the UK with $32bn and India at $29bn. Pakistan did not make the list of the top 100 in terms of startups, according to startup data portal Crunchbase. On a per capita basis, the investment in Pakistan and Bangladesh was $1, the lowest recorded, whereas it was $20 in India and $42 in China.

The main issue is quality control (QC), with no World Health Organisation-approved QC lab and very little ability to export to semi-regulated markets, let alone the EU, UK, and US. The US Food and Drug Administration (FDA) has not approved any licensed manufacturing exporting units in Pakistan.

A few national companies have the WHO pre-qualification certification; however, these pre-qualifications have little value since the WHO is not a regulatory agency.

There is a dire need for industry leaders to rise to the occasion. Instead of blaming government policies, they should work on coordinating higher investments in Pakistan that will enable qualifications to sell their products globally, as well as expand manufacturing to biological drugs, while planning how Pakistan’s needs for future therapies like gene therapy, mRNA vaccines, and other similar technologies can be met domestically.

This advice is not unrealistic; the industry has the resources and needs a fresh vision. One must understand that nations rise not because but despite their governments; the individuals make the difference. Pakistan has leaders who can take this challenge.

The writer is a professor at the University of Illinois, USA

Published in Dawn, The Business and Finance Weekly, November 27th, 2023