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Dangerous medicine

SPURIOUS OR COUNTERFEIT drugs are a public menace. They are mostly ineffective and can cause grievous injury or even death. The existence of spurious drugs in India is well known, although not the precise extent. The Government has decided to bring in legislation to hand out the death penalty to those who manufacture or sell spurious drugs that cause grievous injury or death. This is in line with the recommendations made by the Mashelkar Committee in its interim report. This newspaper has long opposed capital punishment but the point is that stern penalties are a necessary but insufficient condition for putting an end to the spurious drug industry. The present system has serious shortcomings that need to be overcome before any tangible results can be seen. For instance, the Committee found the drug control infrastructure both at the State and Central levels grossly inadequate to tackle the menace. There is a dearth of trained drug inspectors across States. Further, only 15 States have a drug-testing laboratory, of which hardly seven are reasonably staffed and equipped. Non-uniformity of enforcement among States has not helped the cause either. Although committees constituted in the past made many recommendations, the core issues have remained unresolved. The top priority must be to strengthen the drug control machinery and give enforcement teeth. The fact that not a single prosecution has resulted in life imprisonment since the Drugs and Cosmetics Act was amended in 1982 to provide for this enhanced punishment shows that legislation alone does not suffice.

Although the Central and State Governments share the responsibility for keeping a check on spurious drugs, the pharmaceutical industry cannot disown responsibility. The weakest link here is the distribution network. No amount of policing by the Government will help unless the companies beef up their distribution networks. While some manufacturers have their own clearing and forwarding agents to handle certain drugs, the need for a well established distribution network for all drugs cannot be ignored. The Mashelkar Committee makes the sensible suggestion that the pharmaceutical industry should work closely with the Government and also have a surveillance mechanism. The manufacturers should put in place an effective system for handling public complaints and encourage any information on spurious drugs from the public. Educating wholesalers and retailers to identify spurious drugs is another suggestion made by the Committee; this is a challenging task as the packaging is close to perfect and even experts find it difficult to tell the genuine from the fake. One of the ways to beat the counterfeiters is to use advanced packing technology. This will become a reality only if the Government makes it mandatory for at least antibiotics and life saving drugs.

Consumers have a crucial role to play in arresting the proliferation of spurious drugs. Being the least equipped to tell genuine from spurious drugs, they should be advised to buy drugs only from reputed and well-established chemists. Insisting on bills with the batch number of medicines clearly mentioned, staying clear of chemists who sell drugs at a discounted price, and destroying used containers bearing the manufacturer's name indelibly marked are simple ways of ensuring that the drugs being bought are genuine. Consumers need to be wary of doctors themselves providing drugs rather than prescriptions. Finally, drug testing carried out by some public service organisations enjoying wide consumer acceptance will go a long way in supplementing the Government's efforts. Educating the public on the circulation of spurious drugs and the dangers they pose should be high on the agenda of the Government, the pharmaceutical industry, and the media.

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