Monday, February 28, 2011

once again, the healthcare of a superpower?

In the midst of the Cricket World Cup, and if people can take their minds off it, the happenings in Libya and the rest of the Middle East, 12 would-be mothers lost their lives in the past two weeks in Jodhpur after being put on infected glucose IV drips. There were 7 deaths in the Umaid Hospital, and 5 deaths in the Mahatma Gandhi Hospital. The toll could go higher, with a few mothers battling for their lives in these hospitals currently. In Umaid hospital some time ago, a few children were infused with HIV positive blood.

Okay, what does this do to the trust that the local population has on the government machinery for healthcare? On the same note, what other options do the poor populace of the region have to obtain their basic healthcare?

Both are rhetorical questions but unfortunately, will never invoke the kind of self-analysis or debate that our society should be doing about the ability of the state to provide even the minimum required healthcare to its citizenry. Like I said, we are too busy trying to a global economic power, and I am quite sure that for a politician, providing incentives to business interests is any day easier than providing the most basic social infrastructure to his or her constituency, which in the case of the Governmint of India, is the citizens of the Republic of India.

Coming back to the tragedy in Jodhpur, the government, both at the state and center, seems to have swung into action, and everything seems to be pointing to the cause being spurious IV fluids being supplied to the hospital. Some officials from the Hospitals and other regional officials have been suspended, including the drug inspector for the area and a high level committee comprising a few doctors will look into the matter and give a report to the government in some time. This article from the Indian Express provides a timeline of the dealths, and also mentions that the health minister of the state actually visited the hospital after the first few deaths were reported but gave a clean chit to the hospital.

Would it be out of the ordinary for anybody to expect that everybody will forget about this tragedy in a few days, the media will move onto the next scandal, and after some exchange of funds and some scapegoats, life will be on as usual in our government hospitals?

While the news is being reported in the national media, their usual penchant for sensationalism and yellow journalism gets the better of them sometimes, as this headline from Prannoy Roy's New Delhi Television demonstrates: Jodhpur Tragedy: the Hospital that Orphaned 12 babies.

This permeation of spurious medication is widely prevalent all across the country, and it is very very dangerous, apart from being apalling that the Goverment of India and all the state governments are not keen to tackle this at a war footing. There is not one corner of this country which is safe from the tentacles of this potential tragedy. In Manipur, a fake racket was busted, and what shocked me the most was this line in that story: The two organisations set Surjit Singh free after making him sign an agreement that he would not repeat such fraud in future. Such people who have been making money at the cost of risking the lives of thousands of people do not deserve such mercy that the two NGO's of Manipur showered on this spurious drug manufacturer. He should have been castrated and then handed over to the police who should have thrashed him more and then registered a case.

There was another news item I came across recently, about the government finally waking up to the gravity of the situation, and medicine strips will have bar codes on them to allow for better monitoring.

Drug Consultative Committee (DCC) -- in its last meeting on Febuary 15 -- has approved the proposal that for every strip of medicine available in India ought to have a 2D bar code and a unique randomly generated numeric code (UID).

A phone number will be mentioned above the bar code, where the consumer can SMS the UID. A message will tell the consumer whether the drug is an original.

DCC's recommendation will now be sent to Drug Technical Advisory Board. The final notification will come from the Union health ministry.

Once approved, India will join Italy,
Malaysia and the European Union to make 2D bar code and UID mandatory in an effort to curb spurious and counterfeit drugs.

DCGI will have to amend Rule 96 (manner of labelling requirement) of Drugs and Cosmetics Act, saying "every drugs manufactured in India shall bear on its primary label Unique Identifier Code and 2D bar code that shall be used for anyone to verify the drug through a system of SMS by mobile phone."

Experts say the proposal might face serious opposition from the small and medium scale drug firms,
who will have to buy equipment for bar-coding which will increase their production cost.

"We will give these firms a good enough phase out time. However, we have seen that if 2D bar code and UID is printed on the strips, production cost goes up by just around 30 paisa. It will come down to 10 paisa once the technology is used by everyone," Dr Singh said.

Earlier, commerce ministry had passed a rule that all medicine packs manufactured in India only for export must carry a barcode as of July 1, 2011. This will allow medicines to be traced and tracked to its source of origin.


The fact is that while Indians suffer constantly from the menace of counterfeit drugs, fake Indian drugs have been making their way abroad as well, particularly into Africa. While there is a lot of things that the third world is suffering from, this issue of counterfeit drugs is something that is in their own hands to eradicate. No country can act as a silo today, and while I am calling for an urgent effort in India to eliminate spurious drugs and bring the manufacturers to justice, I would like to see this happen all across the world.

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