Count the missing billions – Journal

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Pakistan can provide better public health care. The success of the Covid-19 containment efforts has shown the power of political will and collective action. These days, it is unreasonable to let someone’s salary amount decide whether a curable disease will be fatal.

It really can’t be an accident that Pakistan has done better than most in handling the pandemic. From the rapid establishment of the National Command and Control Center to operating multiple public outreach platforms, the government has even launched a massive vaccination program across the country, surprising itself and others. All of this was accomplished from our crumbling health infrastructure.

No one expects the free market to provide affordable health coverage independent of government. Today, the performance of a modern pharmaceutical market is assessed by monitoring whether it provides drugs quickly and cheaply. Even when pharmaceuticals generate profit, questions arise about their sustainability and purpose if patients cannot access the drugs. This explains the public hostility towards drug manufacturers in Pakistan despite their active involvement in supporting social causes.

The changing composition of the drug market with an increasing share of local manufacturers has done little to improve the accessibility or quality of drugs. The ruling party’s focus on social services helped. The PTI health card system and the policy to expand its coverage are laudable but insufficient.

Imran Khan’s government has yet to adjust the regulatory framework and streamline financial affairs. Research and technological advancement and the achievement of global standards are essential for the advancement of the pharmaceutical industry. There is no justification for not having a single laboratory certified by the FDA (US Food and Drug Administration). The lack of a globally recognized medicine certification center raises doubts about the quality of medicines available and places limits on the extent of medicine exports.

“People and businesses have a right to know how the billions raised for medical research over the past 45 years are being used”

Pakistan lacks basic research infrastructure, although drug makers are required by law to contribute one percent of their pre-tax profits annually to the Central Research Fund (CRF). Pharmaceutical industry watchers estimate annual sales to be around $ 3.2 billion (499 billion rupees). This means that drug makers collectively contribute billions to CRF each year.

“People and businesses have a right to know how the billions raised for research over the past 45 years are being used. The country does not produce any vaccine or pharmaceutical ingredient for lack of research infrastructure. The lack of credible certification compromises the reach of drug exports. The government must drop this tax, ”commented Ayesha T Haq, spokesperson for the Parma Bureau, a platform of multinational drug makers.

Leaders of the Pakistan Pharmaceutical Manufacturers Association, a local business group, said the government had not used the research and development (R&D) fund effectively and should leave it to the private sector. manage it. “Instead of collecting royalties for research, the government can force drug manufacturers to spend 1 pc of their income on research,” said Dr Sheikh Kaiser Waheed, an executive of the PPMA.

The PPMA rejected the perception of the pharmaceutical industry’s underperformance in the current health emergency. “We have ensured a constant supply of all medicines in the most difficult areas over the past year and have quickly adjusted our production to meet market needs (disinfectants, disinfectants and demand for personal protective equipment). The production of Covid vaccines takes more than a wish. In the absence of advanced research and plant infrastructure, this was not possible, ”said Tauqeer ul Haq, president of the PPMA.

Dr Azra Peechuhu, Minister of Health of Sindh, blamed the federal government. “The drug makers in Pakistan do not produce any vaccines, even for routine vaccinations. Large investments are needed for research and development. The federal government should provide funding in partnership with the NIH (National Institute of Health) for this purpose.

Dr Faisal Sultan, Special Assistant to the Prime Minister for Health, addressed the research tax request to the Pakistan Medicines Regulatory Authority (Drap). Asim Rauf, CEO of Drap, did not share details of the Central Research Fund account. Responding to Dawn’s question, he conveyed a cautious statement. “The R&D fund is invoiced under section 12 (b) of the 1976 Drugs Act. It is invoiced at the level of 1 pc of gross profit before tax under Rule 19 (14) of the Drug Rules. drugs (license, registration and advertising), 1976. This fund is used by the research and development committee under the 1978 rules on drugs (research).

“Currently, the fund has not been used due to the non-establishment of the aforementioned committee. Now, after the appointments of the provincial governments, the file is sent to Cabinet for approval of the composition of the committee according to the law.

Regarding use, he writes: “The fund has not been frozen for 45 years. A number of research proposals / projects have been approved and implemented ”.

He disputed claims from the private sector over laboratory facilities. “Alhamdulillah in Pakistan has three laboratories certified by the World Health Organization: the PTRD Lab Sunder, the Drug Testing Laboratory Faislabad and the Prime labs Islamabad. Two other laboratories, the Central Drugs Laboratory Karachi and the Drug Testing Laboratory Rawalpindi, are in the final stages of certification. He ignored the issue of FDA certification.

There are around 700 drug manufacturers in Pakistan. Multinational drug makers, barely 4% of the total, account for about 33% of the industry’s annual turnover. After growing above 20pc for many years since the mid-2000s, the growth rate of local businesses has moderated to 12pc. Today, six of the ten largest drug companies are locals. Almost 60% of total consumer spending on health is spent on the purchase of drugs.

Posted in Dawn, The Business and Finance Weekly, June 28, 2021

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