• Over 50pc life-saving medication samples found ‘fake’
• Officials’ apathy provides a boost to business of counterfeits

KARACHI: The state of national health sector is in grave danger as authorities have found samples of over half-dozen life-saving medicines, including those used for treatment of mental illnesses, to be ‘fake and spurious’ while samples of 30 other drugs are found to be substandard, officials and sources said.

They said the Drug Regulatory Authority of Pakistan (Drap) over the past few months had collected samples from different sources that included retail markets, and their proper testing and examinations revealed disturbing facts. Apart from seven spurious and fake drugs, they said, substandard copies of at least 30 essential and life-saving medicines were found in the market with little check from the relevant authorities and agencies.

“These seven fake and spurious medicines include Isoflurane and Alprazolam which are sold under different brand names,” said a source citing the recent data compiled by Drap and the Sindh’s Drug Testing Laboratory (DTL). “They are very crucial medicines and used as general anaesthetic potent tranquilisers. The fake and spurious drugs mean that they don’t have any active pharmaceutical ingredient as they mostly contain chalk or starch.”

The other spurious samples were found of Meropenem injection, Cefim DS Suspension, Glucantime and Tablin Capsule along with other medicines. During the market surveillance in different areas, the source said, the regulatory field force identified the suspected samples of different pharmaceutical products and sent them for analysis to laboratory.

“The provincial drugs testing laboratory has declared the samples of all these seven medicines as spurious,” said an official.

“The stated manufacturers on the label have informed that they have not manufactured this batch number of products. On part of the government, the regulatory field force has been directed to increase market surveillance and confiscate the mentioned batch of the product. All pharmacists and chemists working at distributions and pharmacies are directed to immediately check the stock and stop supplying that product.”

He advised people to buy drugs from large medical stores and community pharmacies that usually buy medicines directly from manufacturers.

Dr Faraz Hashmi, the medical director of Ehad Medical and Pharmacy, stressed the need for running medical stores in an organised way with qualified pharmacists.

“For instance at our facilities, we go through multiple checks; we are under direct contact with manufactures, leaving no chance for any spurious drugs,” he claimed.

“Instead of visiting pharmacies near clinics and hospitals, people should approach large pharmacies that directly buy medicines from manufacturers and keep them in temperature-controlled environments to maintain their efficacy. There’s a misconception that they charge higher prices. Instead they offer medicines at much cheaper rates than random medical stores,” he said.

The fresh findings of Drap came only weeks when the DTL Sindh reported that all the 18 samples of life-saving drugs confiscated during raids in Karachi and Hyderabad were found to be “spurious and fake”.

Adnan Rizvi, chief of Sindh’s laboratory, agreed that the situation was alarming.

“We received samples collected through the raids; those included life-saving drug Azithromycin which is used to treat extensively drug resistant (XDR) typhoid and all of them were found to be fake and spurious. It is for the first time that all of the 18 samples we received were substandard or of low quality. They all were fake and spurious which means that the medicines seized contained only calcium carbonate or chalk, and not any active pharmaceutical ingredient.”

Damaging revelation; organised crime

The healthcare professionals see the business of spurious drugs as a form of organised crime and recommends strong action as well as punishment for those involved in this illegal activity.

The latest revelation may shake the very foundations of the healthcare sector because all efforts of patients to go to hospitals, see doctors and pay their high fees, massive government spending on hospitals, and health experts painstaking research on diagnosis of patients’ problems and their illnesses likely to go in vain if a prescribed drug does not work because it’s a fake and counterfeit drug.

“This has put our whole health care system at stake,” said Dr Qaiser Sajjad, former secretary general of the Pakistan Medical Association (PMA).

“For instance, an ulcer patient is prescribed a certain medicine after he is properly diagnosed by a qualified doctor so his ailment can be treated. But if the medicine he or she consumes is fake one can imagine what would happen? His or her minor problem would turn into a cancer or life-threatening disease and we would doubt our whole health care system.”

He said the PMA in the past had several times engaged with authorities and forwarded its proposals to counter the menace of spurious drugs, but required action was still awaited.

“I personally believe that those involved in such businesses should be charged under Section 302 [premeditated murder] of the Pakistan Penal Code. It’s a heinous crime. We need strong legislation against these activities,” said Dr. Sajjad.

Published in Dawn, December 12th, 2022