Trade in fake medicines
The health sector is regarded as a fundamental subject in national and international documents. The government of Bangladesh has also signed many international documents on this subject. In reality, we see that the number of private hospitals is increasing much faster than that of public hospitals. This has resulted in roaring business for the private hospitals because of inadequate number of government hospitals, and is due to gradual transfer of health service from the public to the private sector. This trend is seen in developing countries like India, Kenya, Cambodia, Vietnam and Pakistan. Simultaneously, allocation of resources to the health sector is also decreasing proportionately.
In Bangladesh, health service in the private sector got legal coverage through proclamation of an ordinance in 1982. In 1984, another ordinance amending the 1982 ordinance was issued. Health service in private sector increased further during the 5th Five Year Plan in 1996-2001. It received further incentives for growth in 200-06.
It has been alleged in a meeting of a Parliamentary Committee that common people do not get medicine from government hospitals though large quantities of time expired medicine are seen in the toilets of those hospitals. Due to such state of affairs people are forced to buy medicines from outside.
Out of 168 pharmaceutical companies in the country only 62 follow the guidelines of the World Health Organization (WHO). Only twelve of them are manufacturing medicines as per standard laid down by WHO, and in majority of the laboratories there is dearth of proper equipment and skilled personnel, mismanagement, lack of monitoring and illegal entry of banned medicines.
Factories making fake and adulterated medicines have come up in many places, including rural areas. In the largest wholesale market of medicines in the Mitford area in Dhaka, the trading of these medicines is going on with impunity due to indifference or lack of monitoring by the authorities concerned.
There are more than 250 companies that make allopathic medicines. There are also 800 companies which are producing unani, ayurvedic, herbal and homeopathic medicines. Bangladesh exports 85 items of medicines to 72 countries. However, experts say that only 50 to 60 pharmaceutical companies produce medicines of good standard and 50% to 60% of the companies are producing medicines of low quality.
In July 2009, intake of fake paracetamol tablets resulted in the death of 28 children. The writ petition moved by Human Rights and Peace for Bangladesh before the High Court resulted in stoppage of production and marketing of eight medicines.
The drug administration has taken action against pharmaceutical companies. Apart from this, an enquiry conducted by the permanent parliamentary committee on the ministry of health found that the standards of more than one hundred companies do not meet WHO guidelines and some of the products are far below standard.
Smuggling of banned medicines is rampant. The tendency of doctors to prescribe more medicines than needed has been revealed in a research paper of Bangladesh Health Watch in 2009.
There are about two lac twenty five thousand medicine shops in the country, out of which 82,000 hold valid license. The majority of these pharmacies are run by inexperienced and unskilled personnel.
As per government estimate, the number of generic medicines in the country is 1,200. There are only two government drug testing laboratories which can test only three to four thousand medicines yearly. We need at least ten more testing laboratories to satisfy our demand.
Though the government is proceeding gradually to privatise the major part of the health sector, it must provide good standard of medicines to the nation. It is surprising that though a national medicine policy was formulated in 2005 it has remained "controversial" during the last six years. It is time that recommendations of the parliamentary committee on ministry of health are implemented as far as possible and as quickly as possible.