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                        <title>The Express Tribune</title>
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                        <description>The Express Tribune keeps you up to date with all the latest happenings from Pakistan and across the world!</description>
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			<title>Coughing up death in Lahore</title>
			<link>https://tribune.com.pk/story/471714/coughing-up-death-in-lahore</link>
			<comments>https://tribune.com.pk/story/471714/coughing-up-death-in-lahore#comments</comments>
			<pubDate>Tue, 27 Nov 12 18:16:18 +0500</pubDate>
			<dc:creator>
				<![CDATA[Muhammad Hamid Zaman]]>
			</dc:creator>
			<category><![CDATA[Opinion]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=471714</guid>
			<description>
				<![CDATA[Existing policies on medicines are not working, either due to poor enforcement or failure to comprehend challenges.]]>
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				<![CDATA[I had planned to write about the Punjab Institute of Cardiology (PIC) drug scandal next month to mark the anniversary of this dark chapter of our national public health management. The idea to talk about drug quality control was to make sure that we all remain acutely aware of our history and ensure that nothing of this sort happens again. It gives me no comfort that I did not have to bring this reminder to the fore and our own lack of oversight has done the job for me. The tainted cough syrups in Lahore have brought a powerful yet sad reminder of the vulnerability of our drugs and our national public health.

It is irrelevant what underlying conditions the deceased had, or whether the drug was misused here. While drug misuse and abuse is a major problem in Pakistan, that is not the point in this case. The issue of drug toxicity, either due to malicious intent or due to incompetence, paints a very grim picture of the regulation, oversight and enforcement of good manufacturing processes and this demonstrates the inability of our drug testing mechanisms for public safety. It pains me to see that those who are at the economic and social fringes of our society are routinely exposed to poisonous cocktails, sold supposedly to cure the sick and heal the suffering.

The challenges of counterfeit, substandard or inactive medicines are universal and no country, even the most developed ones are immune from these issues. However, what separates us from them is the resolve to address the issues comprehensively and take necessary actions at all levels to eradicate or at least minimise the problem. In the case of Pakistan, it is the unfolding of multiple crises, within the same year and lack of robust responses from the regulators that make the problem much worse. While I laud the efforts by the local government in taking immediate action to stop further proliferation of these tainted cough syrups, I am particularly concerned about lack of efforts in finding the root causes and doing something about them at the systems level. Shutting down an individual company or a pharmacy does not provide a long-term systematic solution to a pervasive problem that can lead to a major public health disaster in the sixth most populous country in the world.

It is also important to realise that tainted, substandard or outright fake medicines are not just problematic because they lead to the loss of life of an innocent few or may cause panic or add to the public health burden on our already-stressed hospitals. These tainted drugs also lead to the long-term resistance that can affect all of us and make our existing drugs worthless in controlling, curing or managing a myriad of diseases for our future generations. Problems like tuberculosis, malaria and other infections continue to acquire drug resistance and if we continue on this road of ineffective and substandard medicines, our next generations will be a lot more vulnerable.

Clearly, the existing policies to safeguard our essential medicines are not working, either due to being poorly enforced or due to the inability of our policymakers to comprehend the deep rooted challenges. What we need is not just the police raid on the pharmacy and the manufacturer, but a national commission and a scientific discourse that is able to create a robust mechanism of drug testing, enforcement of quality control and awareness about the deadly problems due to poor manufacture among pharmacists and pharmaceutical companies. We also need to encourage and provide incentives to our students, pharmacists, entrepreneurs, innovators, scientists and engineers to come up with new and better technologies and solutions to curb the problem at all levels. In the end, this problem, if not dealt with today, will not just affect the poor citizens of Lahore, but has the potential to affect the entire nation. Yet, at the same time, we have an opportunity, once again, to show leadership in solving a problem that affects so many countries and for once, we may be known as those who made an impact in improving the quality of life around the world.

Published in The Express Tribune, November 28th, 2012.

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			<title>Contamination of intellect and medicines</title>
			<link>https://tribune.com.pk/story/446325/contamination-of-intellect-and-medicines</link>
			<comments>https://tribune.com.pk/story/446325/contamination-of-intellect-and-medicines#comments</comments>
			<pubDate>Wed, 03 Oct 12 16:57:27 +0500</pubDate>
			<dc:creator>
				<![CDATA[Muhammad Hamid Zaman]]>
			</dc:creator>
			<category><![CDATA[Opinion]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=446325</guid>
			<description>
				<![CDATA[Insist on a little bit of quality control and we might be able to save ourselves and our intellect from contamination.]]>
			</description>
			<content:encoded>
				<![CDATA[A collective short memory is a mixed blessing. We continue to provide ourselves with news that should make stories for the ages but a short memory, fortunately, allows us to dust off any shock or frustration and we move on to the next day. But every now and then, it is worthwhile to go back, take stock and ask ourselves did we learn anything, anything at all? Are we better off today after the incident?

So today, I want to go back in the not-so-distant past and analyse two, apparently, unrelated incidents and the aftermath of those.

The first incident happened about nine months ago. A ‘mysterious disease’ started taking the lives of innocent people in Lahore. Nine months later, we still do not have any clear answers, no policy outcome and certainly no clear strategy to ensure that this does not happen again. While it is generally accepted that it was some sort of contamination in essential life-saving drugs that caused one of the worst public health incidents to unfold, it remains unclear who shares the blame. We may never know how the custodians of national security looked over a gaping hole in drug quality control and did nothing about it. Looking back, I consider the society divided into three groups. There are those who have forgotten about it, and there are those who still believe it is ‘bairooni saazish’ (foreign conspiracy) and then there are those who lost everything. We should ask ourselves, which of these three groups deserves our support ?

Fast forward about six months, another piece of news, this time a supposedly positive one, grips the nation. Promoted by federal and provincial cabinets ministers, endorsed by the media and immediately absorbed the people, we are told that a car, that runs on water, has been ‘invented’ by a Pakistani. With water aplenty and petrol scarce, we were told to believe that all tried and tested laws of thermodynamics are worthless when it comes to desi innovation. Get ready, Kelvin, Gibbs, Clausius and other pioneers of thermodynamics, here comes the water car to bamboozle you and all those who contributed to our understanding of how cars work, what engines do and what physics has to say about it. Again, there are three groups.

Those who still believe that this can happen and that elitist groups are stopping Pakistan from changing the world, the group that doesn’t remember anything about the water car and the group that considers it a sorry chapter in our collective intellect.

Apparently, the two stories have nothing to do with each other, but I believe both of them point to a fundamentally similar problem. At the very core, it is the breakdown of quality control. Now, I know that there will always be contamination of medicines, in every country, through complacency, incompetence or malicious intent. The point is to ensure that the system catches it and ensure that if it ever happens once, it never happens again. The real point here is to share with all, why did it happen and whatever happened to safety checks that are supposed to be in place?

The same can be said about contamination of intellect and common sense. Every now and then, we will be duped, but we have to have means to catch it and ensure that it does not proliferate at a national level. Charlatans who promise the moon and some more will always be there. What is unfortunate is that they are promoted as national heroes by the government ministers and the media alike. Again, we should insist on why we allowed this to happen and what have we done to make sure that next time someone claims to convert lead into gold, we don’t allow the government to call him the next national hero.

A quick scan of these, and many other similar events peppered throughout the year, has just one message: a little bit of rigour goes a long way. Insist on a little bit of quality control and we might be able to save ourselves and our intellect from contamination.

Published in The Express Tribune, October 4th, 2012.]]>
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			<title>Drug regulatory body: As PPMA strives to have its input included, govt considers two drafts</title>
			<link>https://tribune.com.pk/story/404245/drug-regulatory-body-as-ppma-strives-to-have-its-input-included-govt-considers-two-drafts</link>
			<comments>https://tribune.com.pk/story/404245/drug-regulatory-body-as-ppma-strives-to-have-its-input-included-govt-considers-two-drafts#comments</comments>
			<pubDate>Fri, 06 Jul 12 02:21:12 +0500</pubDate>
			<dc:creator>
				<![CDATA[sehrish.wasif]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=404245</guid>
			<description>
				<![CDATA[Committee will prepare a new draft incorporating the older versions; asks PPMA to submit its recommendations.]]>
			</description>
			<content:encoded>
				<![CDATA[The government is considering two drafts of a bill to make the Drug Regulatory Agency of Pakistan (DRAP), neither of which has had input from the Pakistan Pharmaceutical Manufacturers Association (PPMA).


The association has expressed concern over not being taken on board for the preparation of the bill. PPMA Chairman Muhammad Asad Khawaja told The Express Tribune that the government should have invited them for consultation while drafting the bill.

“It is strange that PPMA, the main stakeholder for whom this bill is being prepared, has been ignored in the process,” he said.

The draft of the bill was to be finalised in the meeting of National Assembly Standing Committee on National Regulations and Services held recently but PPMA chairman was not invited to attend the meeting.

Senator Abdul Haseeb from the Muttahida Qaumi Movement, who is also convener of the Senate Special Committee on Formation of Drug Regulatory Authority, said that “it is strange” that the PPMA was hoping that the government would invite it for consultation. Instead, he suggested, the association should present a separate draft of the bill or recommendations for the government to incorporate into its own drafts.

He said two drafts, one prepared by Nargis Sethi, the cabinet secretary and the other drafted by the Senate Special Committee on Formation of Drug Regulatory Authority, are under discussion.

“The bill prepared by Nargis Sethi will be of no benefit to the country as she wants to involve the bureaucracy in this sector. However, the committee wants to make this drug regulatory agency an autonomous authority,” he said. He added that Sethi is not authorised to formulate the draft.

However, Hasseb said, recommendations from both drafts have been incorporated in the revised bill, which will be finalised in the upcoming meeting. “The bill should be finalised, approved and implemented within 100 days, otherwise the ordinance will lapse,” he added.

Published in The Express Tribune, July 6th, 2012.]]>
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			<title>Can we say never again?</title>
			<link>https://tribune.com.pk/story/402523/can-we-say-never-again</link>
			<comments>https://tribune.com.pk/story/402523/can-we-say-never-again#comments</comments>
			<pubDate>Mon, 02 Jul 12 18:01:53 +0500</pubDate>
			<dc:creator>
				<![CDATA[Muhammad Hamid Zaman]]>
			</dc:creator>
			<category><![CDATA[Opinion]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=402523</guid>
			<description>
				<![CDATA[Working on counterfeit, sub-standard drug related challenges, I have yet to see action making drugs safer.]]>
			</description>
			<content:encoded>
				<![CDATA[Lahore, January 2012. Does it remind us of something unusual or out of the ordinary? Given the many political tremors we experience every day, January of this year may not ring any special bells. We hear so many bells and sirens that they all seem the same. But January of this year was different. In the era of short-term memories becoming even shorter, it is hard to believe that only six months ago, Pakistan was in the midst of its worst public health crisis. Nearly 200 people had died in Lahore in a matter of mere days due to a mysterious drug reaction. Common folks, who desperately needed medicines for their cardiovascular conditions were served a deadly cocktail that evaded all checks and balances, supposedly put in place for their safety. The standard conspiracy engines were working at full steam and our favourite domestic and foreign scapegoats were once again the centre of all conversation.

Within days of promises of inquiry and bringing ‘all those responsible to the might of justice’, the memory faded to the same annals of history where such incidents belong. A place also known as oblivion. While there was some discussion about an anti-malarial mixing with a cardiovascular ailment drug, many questions continue to haunt us to this day. The obvious ones are why did it happen, who was responsible and where were our so-called quality control mechanisms? What is the status of the so-called ‘thorough investigation’ that was promised at all levels? Perhaps, a more important question that I am waiting to hear the answer to is, what have we done since? How do we ensure that a similar crisis of this magnitude, or worse, will not unfold in Lahore, Karachi, Islamabad or any other city? At this juncture, I would also dare to ask how do we know a similar incident of smaller magnitude is not unfolding, right now, in some city where people are given ‘jaali dawaaein’?

While every single life that was lost or affected in any way during this public health crisis was one too many, the problem could have been much worse. While we were somewhat fortunate in January of this year, we may not even be this lucky the next time around. Closing down a single pharmacy, a couple of factories and giving a bunch of politically-charged statements creates headlines, not solutions.

Just as the chain of command responsible for this tragedy of enormous proportions remains elusive, so does the chain of command investigating the incident. How do we ensure that our quality control mechanisms are now better informed and better prepared than they were six months ago? What have we done that was different in June compared with January? What, if any, lessons have we learned since?

As someone who works on counterfeit and sub-standard drug related challenges in developing societies, I have yet to see a robust approach put in place to ensure that our drugs are safer today than they were in January. We can either blame the federal and provincial governments or make the Eighteenth Amendment a scapegoat. Or we can demand that enough safeguards be provided to us so that we can be confident about the life-saving drugs we use.

A detailed public report analysing both the causes of this incident and the propagation of the problem at this well-reputed cardiology centre would be a good start. But that cannot be the only comfort that we should seek from this incident. We cannot, and must not, deny that the problem of counterfeit, sub-standard and inactive drugs is a real threat. Let us take this seriously and ensure that our children and adults, the poor and the rich and particularly those who are at the fringes of society, will not be given life-losing drugs disguised as life-saving ones.

I do not think that we are incapable of learning. I hope a strategy will be implemented that enables us to look squarely in the eyes of the family members of those hundreds of people who were affected and say, ‘never again’.

Published in The Express Tribune, July 3rd, 2012.]]>
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			<title>PIC tragedy: Four months on, spurious drugs case remains in cold storage</title>
			<link>https://tribune.com.pk/story/388031/pic-tragedy-four-months-on-spurious-drugs-case-remains-in-cold-storage</link>
			<comments>https://tribune.com.pk/story/388031/pic-tragedy-four-months-on-spurious-drugs-case-remains-in-cold-storage#comments</comments>
			<pubDate>Sun, 03 Jun 12 04:13:09 +0500</pubDate>
			<dc:creator>
				<![CDATA[ali.usman]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=388031</guid>
			<description>
				<![CDATA[Drug Regulatory Authority yet to become functional.]]>
			</description>
			<content:encoded>
				<![CDATA[Four months have passed since spurious medicines at the Punjab Institute of Cardiology (PIC) claimed the lives of 165 patients and affected another 700 in Lahore – yet not a single person has been indicted in what was arguably the greatest medical tragedy in the country’s history.


Data available with The Express Tribune shows that the compensation process is still pending. While compensation cheques for Rs500,000 were distributed to the relatives of 116 deceased patients, cases of 38 patients are still being verified, and the addresses of the remaining 11 are said to be incomplete.

The unofficial death toll is said to be around 200; and more than 1,500 patients are said to have been affected by the faulty medicines distributed free of cost by PIC to poor patients.

In January 2012, heart patients approached different hospitals with similar symptoms of low platelet count, darkening complexion and bleeding. Health authorities tried to downplay the matter at first, but the issue later escalated to a major health crisis. Preliminary investigations showed that a drug named Isotab, contaminated with anti-malarial chemical Pyrimethamine, had caused the deaths.

However, authorities have little to show in way of preventive measures taken to avert any such crisis in the future. A senior doctor at the PIC admits that “it seems everybody has forgotten about the PIC drug-related deaths.”

Of efforts taken in wake of the incident, the doctor, requesting anonymity, says: “A lot has changed since then, but only on paper. The on-ground situation remains the same. The judicial inquiry report is yet to be released and no mechanism has been put in place to check that medicines are not contaminated with hazardous chemicals.”

PIC’s chief executive Dr Bilal Zakaria, who was appointed after the drug fiasco, claims to have taken some precautionary steps. “It is now mandatory for PIC to purchase medicines only from pharmacies that have at least three branches in a city. We have also asked the companies to submit a report of all the non-active ingredients in the medicines.”

Dr Zakaria maintains that a Drug Regulatory Authority (DRA) has a major role to play in keeping a check on pharmaceutical companies. However, though the president has issued an ordinance in this regard, a regulatory authority is yet to be established.

PIC’s former head Dr Muhammad Azhar, who was removed from his post after the tragedy, differs in opinion from Dr Zakaria. Dr Azhar feels the conditions at PIC have deteriorated further. “If the government cannot make a unique system, it should copy the mechanisms put in place by the USA and the UK.”

“In Pakistan, there are above 55,000 registered medicines while in the USA there are just 5,000 and in the UK only 2,200. The government should just copy their lists to avoid any such catastrophe in the future.”

Pakistan Pharmaceutical Manufacturer’s Association (PPMA) Chairman Dr Riaz Ahmad said the issue of giving licenses to manufacturers will now be decided by the DRA after the passage of the 18th Amendment.

The Punjab chief minister’s special assistant on health Khwaja Salman Rafique is quick to evade the blame. He says the provincial administration has given its consent and it is now up to the federal government to make the DRA functional.

A senior official at the health department expressed his dissatisfaction over the inaction against Efroze Chemical Industries, the company that manufactured Isotab. “The company has been sealed but hasn’t paid any damages to the families of those who died due to the faulty drug.”

Advocate Azhar Siddiq, who filed a petition in the Lahore High Court regarding the case, said: “The report of the judicial inquiry is expected soon. I am hopeful that the inquiry, headed by Justice Ijazul Ahsan, will hold the perpetrators responsible.”

A young boy who lost his father due to the faulty medicine doesn’t know who to blame. “If the culprits in this case are not brought to justice, I will believe the government killed my father.”

Published in The Express Tribune, June 3rd, 2012. ]]>
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			<title>PIC deaths: Govt told to suggest steps to avoid repetition</title>
			<link>https://tribune.com.pk/story/375281/pic-deaths-govt-told-to-suggest-steps-to-avoid-repetition</link>
			<comments>https://tribune.com.pk/story/375281/pic-deaths-govt-told-to-suggest-steps-to-avoid-repetition#comments</comments>
			<pubDate>Mon, 07 May 12 14:57:22 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=375281</guid>
			<description>
				<![CDATA[Justice Umar Ata Bandial directed the government to file its reply by June 12.]]>
			</description>
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				<![CDATA[The Lahore High Court on Monday sought reply from the Punjab government about steps that can be taken to avoid reoccurrence of an incident like the fatal poisoning of Punjab Institute of Cardiology patients by substandard medicine.

The judge directed the government to file its reply by June 12.

Justice Umar Ata Bandial issued this order on a petition seeking a transparent policy to purchase medicines for public hospitals and action against those responsible for the deaths caused by substandard medicine.

The petitioner alleged that quality medicines were not provided at public hospitals. He said government officials, including the drug inspectors and chief executives of the hospitals, were complicit in this.

He regretted that the government was keeping no check on the hospitals to ensure proper medicines at these hospitals.]]>
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			<title>Spurious drugs case: SC seeks report on young doctors’ service structure</title>
			<link>https://tribune.com.pk/story/340487/spurious-drugs-case-sc-seeks-report-on-young-doctors%e2%80%99-service-structure</link>
			<comments>https://tribune.com.pk/story/340487/spurious-drugs-case-sc-seeks-report-on-young-doctors%e2%80%99-service-structure#comments</comments>
			<pubDate>Thu, 23 Feb 12 05:12:27 +0500</pubDate>
			<dc:creator>
				<![CDATA[rana.tanveer]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=340487</guid>
			<description>
				<![CDATA[Summons health secretaries; describes YDA strikes as ‘cruel’ and ‘unprofessional’.]]>
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				<![CDATA[A two member bench of the Supreme Court summoned the provincial health secretaries of all four provinces on Wednesday and sought detailed reports on healthcare facilities and service structures for young doctors.


Justice Tassaduq Hussain Jilani and Justice Mian Saqib Nisar were hearing a suo motu case into the deaths of cardiac patients due to spurious medicines handed out by the Punjab Institute of Cardiology.

During the course of hearing, Justice Nisar strongly criticised the Young Doctors Association, telling its representatives that going on strike and stopping other doctors from working was cruel and unprofessional.

The court directed the Punjab government to submit a report on the genuine grievances of young doctors and on how the government is going to redress them.

Meanwhile, the court also sought a report from the cabinet division secretary over measures being taken to control polio and Hepatitis-C. The bench also asked them to give their proposals to make hospitals’ system as well as the Drug Regulatory Authority effective.

Representatives of the Sheikh Zayad Hospital requested the court to stop the handing over of the hospital to the Punjab government. They said that the hospital was running on the federal government’s grant, which will end after it is handed over.

The Punjab advocate general told the court that 48,000 people were affected by reaction of spurious medicines but due to the timely action of Punjab government only 150 people died, which, he added, is a very small number as compared to those affected.

He assured the court that appropriate steps would be taken regarding autonomy of the Shaikh Zayad Hospital.

Published in The Express Tribune, February 23rd, 2012.]]>
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			<title>Tainted ISOTab: Statement of former MS recorded</title>
			<link>https://tribune.com.pk/story/340182/tainted-isotab-statement-of-former-ms-recorded</link>
			<comments>https://tribune.com.pk/story/340182/tainted-isotab-statement-of-former-ms-recorded#comments</comments>
			<pubDate>Wed, 22 Feb 12 15:42:41 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=340182</guid>
			<description>
				<![CDATA[The PIC store keeper, Zulfiqar Ali,&amp;amp; Muhammad Yousaf, a pharmacist, will appear before the tribunal today (Thursday).]]>
			</description>
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				<![CDATA[Jaffar Salem, the former Punjab Institute of Cardiology medical superintendent and Dr Syed Ali Hassan, the former deputy medical superintendent (Stores) at the hospital appeared, on Wednesday, before the inquiry tribunal of the Lahore High Court to record their statements.

The PIC store keeper, Zulfiqar Ali, and Muhammad Yousaf, a pharmacist, will appear before the tribunal today (Thursday). Our Correspondent]]>
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			<title>PIC suo motu: SC summons provincial chief secretaries</title>
			<link>https://tribune.com.pk/story/340112/pic-suo-motu-sc-summons-provincial-chief-secretaries</link>
			<comments>https://tribune.com.pk/story/340112/pic-suo-motu-sc-summons-provincial-chief-secretaries#comments</comments>
			<pubDate>Wed, 22 Feb 12 07:11:03 +0500</pubDate>
			<dc:creator>
				<![CDATA[web.desk]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=340112</guid>
			<description>
				<![CDATA[The officials have been directed to appear before the court on February 28.]]>
			</description>
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				<![CDATA[The Supreme Court has summoned all provincial chief secretaries in the Punjab Institute of Cardiology medicine disaster case.

The court resumed hearing in the suo motu case on Wednesday, and has directed the chief secretaries to appear on February 28.

A full bench of the SC, in its last hearing on Monday, had raised six health issues and sought the assistance of five senior doctors by on Wednesday (today).

As many as 130 people died in Punjab as a result of a fatal reaction from adulterated medicine, which investigators found was Isotab, that was provided free of cost at the PIC.]]>
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			<title>PIC medicine case: Apex court looks at lessons from killer pill tragedy</title>
			<link>https://tribune.com.pk/story/339513/pic-medicine-case-apex-court-looks-at-lessons-from-killer-pill-tragedy</link>
			<comments>https://tribune.com.pk/story/339513/pic-medicine-case-apex-court-looks-at-lessons-from-killer-pill-tragedy#comments</comments>
			<pubDate>Tue, 21 Feb 12 00:05:21 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=339513</guid>
			<description>
				<![CDATA[Bench expresses concern over rising rate of polio and hepatitis C.]]>
			</description>
			<content:encoded>
				<![CDATA[A full bench of the Supreme Court (SC) holding suo motu proceedings in the Punjab Institute of Cardiology (PIC) medicine disaster raised six health issues and sought the assistance of five senior doctors by February 22.


One of the issues includes how best to regulate licences and the manufacturing of drugs in Pakistan in order to ensure quality  control, specifically with regard to the composition and working of the Federal Drug Regulatory Authority. It also includes investigating the factors which have led to the resurgence of polio and the rise of hepatitis C in the country and measures to combat this challenge, compensating the families who lost their loved ones after treatment at the PIC, ensuring that the Sheikh Zayed Hospital works along professional lines, streamlining the work of government-run hospitals to ensure better health care, and working on how best to impose the service structure of doctors in government service to ensure their genuine grievances are addressed.

The bench also issued a notice to Tariq Ikram, the acting chief of the Pakistan Pharmaceutical Manufacturers Association (PPMA).

The SC also chided the Young Doctors Association (YDA) for protesting and going on strike, although the strike was called off earlier last week. Justice Saqib Nisar observed, “A strike is unjustifiable in your profession. What will a father feel if a doctor declines to treat his child?”

The bench also directed the health secretary to produce a list of those who died on account of consuming the fatal pill, Isotab, at the PIC. Earlier on Monday, Punjab Advocate General Ashtar Ausaf Ali informed the court that doctors and pharmacists who were suspended have been reinstated.

In response to a court query, the health secretary submitted that the provincial government was conscious of the need that Sheikh Zayed Hospital, now entrusted to the Punjab government on account of devolution, be run along professional lines and given autonomy to achieve this objective.

Regarding the statement issued by PPMA acting chief Tariq Ikram saying that there has been a massive increase in licence issuances to drug manufacturers over the last couple of years and that 40 per cent of the drugs in the market are spurious, the health secretary submitted that he is not in a position to give an exact figure on faulty medicines in the market.

He said that while the PIC medicine tragedy was unfolding, suspect medicines were sent to laboratories of international repute and one out of five was found to be substandard. The health secretary was of the opinion that this figure indicated that local drug manufacturing is not as substandard as is presented to the public.

YDA General Secretary Syed Nasir Abbas also submitted that some of the organisation’s demands have still not been accepted by the Punjab government, which include that their services be regularised.

Advocate General Ali submitted that he would get in touch with the concerned people receive suggestions in regard to the issues raised in court.

The bench also observed that the rise of polio and hepatitis C could be caused due the malfunctioning of the drug regulatory authority mechanism.

It also appreciated the prompt action taken by the prime minister and three chief ministers which culminated in the constitution of a Federal Drug Regulatory Authority.

The senior doctors the bench sought assistance from to ensure the authority is run smoothly include Professor Dr Jawad Zaheer, Professor Dr Faisal Masood, Professor Dr Zafar Iqbal of Sheikh Zayed Hospital, former CEO of Sheikh Zaid Hospital Professor Dr Anwar A Khan and Professor Dr Javed Raza Gardezi.


Published in The Express Tribune, February 21st, 2012.]]>
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			<title>Cracks emerge in pharma manufacturers association</title>
			<link>https://tribune.com.pk/story/339296/cracks-emerge-in-pharma-manufacturers-association</link>
			<comments>https://tribune.com.pk/story/339296/cracks-emerge-in-pharma-manufacturers-association#comments</comments>
			<pubDate>Mon, 20 Feb 12 21:47:36 +0500</pubDate>
			<dc:creator>
				<![CDATA[farooq.baloch]]>
			</dc:creator>
			<category><![CDATA[Business]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=339296</guid>
			<description>
				<![CDATA[PPMA vice chairman’s exit expected to be the first of many.]]>
			</description>
			<content:encoded>
				<![CDATA[Yet to recover from a recent shock, Pakistan Pharmaceutical Manufacturers Association (PPMA) may face another blow as some of its key members are expected to leave the association over growing differences. PPMA’s chief, however, denied there was any group within the association that can split it.

Last week, PPMA’s former vice chairman Tariq Ikram backfired at the association by announcing his resignation at an important press conference meant for expressing the association’s concerns over judicial probe into the incident of Punjab Institute of Cardiology (PIC) case. Ikram resigned in protest as he was asked not to share some of his thoughts on the industry and the defunct regulator.

His decision not only surprised fellow members but also exacerbated existing cracks within the lobby.

Confirming there were subdivisions within the pharma lobby, a pharma official – who requested not to be named – said the association may lose some key members if it is not restructured.

With difference of opinion over a majority of issues, the official said, it is hard to have a united stance on a given issue – something that was apparent in PPMA’s press conference last week. The official also expressed displeasure over some of the information that Ikram wanted to share with the media. Ikram should not have talked about the investment capability of pharmaceuticals because each company has its own limitations, he said.

While differences of opinion existed among all PPMA members contacted by The Express Tribune, they maintained that the entire association had a uniform opinion about judicial investigation into the PIC incident that claimed over 130 lives in Punjab.

Some members, therefore, want restructuring of PPMA, the source said. There should be one representative from each sector or group within the body to defend their interests, he said, which will make it easier to reach a uniform opinion over important issues. If it is not restructured, some members will dissociate from this body; the source said, and might break it.

On the contrary, PPMA Chairman Muhammad Asad categorically denied if the lobby would split or restructure. He said that PPMA is a democratic body and difference of opinion does exist among members at times but it is always resolved within the forum.

There may be a few members who want to form a separate group and no one can stop them, Asad said. However, the only representative body registered with the commerce ministry is PPMA and no other group or lobby will have legal mandate to represent the national pharma industry, he said.

PPMA covers about 300 pharmaceuticals; if some members dissociate them from this umbrella, Asad said, it doesn’t represent the majority’s view – which indeed represent the whole industry.

Published in The Express Tribune, February 21st, 2012.]]>
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			<title>DRA details: President issues ordinance to form drug regulatory body</title>
			<link>https://tribune.com.pk/story/338000/ordinance-promulgated-pakistan-gets-new-federal-drug-regulatory-body</link>
			<comments>https://tribune.com.pk/story/338000/ordinance-promulgated-pakistan-gets-new-federal-drug-regulatory-body#comments</comments>
			<pubDate>Fri, 17 Feb 12 16:50:02 +0500</pubDate>
			<dc:creator>
				<![CDATA[sehrish.wasif]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=338000</guid>
			<description>
				<![CDATA[Ordinance faces immediate opposition.]]>
			</description>
			<content:encoded>
				<![CDATA[President Asif Ali Zardari on Friday issued a much awaited ordinance to set up a centralised regulation body of the pharmaceutical industry. 

The cabinet division issued notification for the consideration of the establishment of the agency on Friday under the Drug Regulatory Agency Ordinance (DRAO) 2012.

The notification has not been confirmed by the Presidency, but a cabinet division official confirmed to The Express Tribune on condition of anonymity that the notification has been issued.

The agency is to control pricing of drugs, quality assurance, import/export and issuing licences to drug manufacturers among other details.

According to official sources working closely with DRA, the head office of the agency will be based in Islamabad. It will work under the cabinet secretary and will be made up of 13 members, including all provincial health secretaries. The head of the agency will be a chief executive officer who should hold a postgraduate degree and 20 years experience. His tenure will be for three years and would be extended for another year if required. Besides this, one technical member will be taken from the federation, doctors, pharmacists and pharma industry.

The main hurdle behind the establishment of DRA was the Punjab government, which was initially reluctant to issue a no-objection certificate (NOC).

But the agency faces more opposition.

“The DRA has been established on the draft formulated by Nargis Sethi, not on the draft given by the special committee or the Parliament,” said Senator Abdul Haseeb from the Muttahida Qaumi Movement (MQM) while talking to The Express Tribune.

Haseeb, who has been the convener of the Senate special committee on formation of Drug Regulatory authority said, “The newly-introduced ordinance does not contain even a single thing proposed by the committee in its draft.” He added that the committee will not approve the DRA.

A senior official working closely with the Drug Registration Board (DRB) on condition of anonymity said that the newly-established agency will not operate for the purpose that it has been created.

He explained that this is because there are currently about 400 pharmaceutical units and about 70,000 drugs registered in the country.  There is a huge shortage of staff available to keep a check on all these drugs.  The staff in DRA would not be enough to look after all of these.

Also, the drug inspectors who are working under the Executive District Officer Health (EDOs),  District Health Officer (DHOs) and hospital pharmacies working under  the Medical Superintendent (MS) should work under  the DRA and report to it directly.

This will give them authority and power to take action against illegal work as currently they are working under a lot of pressure, which usually stops them from taking any action.

He said that the government has violated the orders of the chief justice who in 2007 directed the government to give separate offices to the drug inspectors and also to provide them with a transport facility. He added that currently there are only 478 drug inspectors across the country, which is not enough. The drug inspector lacks staff with whom he can conduct raids. He goes alone without security or any protection.

Lack of facilities forces these employees to engage in corrupt activities, according to the official.

Published in The Express Tribune, February 18th, 2012.]]>
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			<title>PIC drug fiasco: Punjab govt looks to pin blame on pharma company</title>
			<link>https://tribune.com.pk/story/337670/pic-drug-fiasco-punjab-govt-looks-to-pin-blame-on-pharma-company</link>
			<comments>https://tribune.com.pk/story/337670/pic-drug-fiasco-punjab-govt-looks-to-pin-blame-on-pharma-company#comments</comments>
			<pubDate>Fri, 17 Feb 12 04:56:46 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=337670</guid>
			<description>
				<![CDATA[AG Punjab Ashtar Ausaf says investigation report reveals pharma company’s officials were aware of toxicity of Isotab.]]>
			</description>
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				<![CDATA[The Punjab government has prepared a report for the registration of a fresh case against the owners of Efroze Chemical Industries, The Express Tribune has learnt.


The Advocate General (AG) Punjab Ashtar Ausaf, talking to The Express Tribune, said that the investigation report, which will be submitted before the Supreme Court, has revealed that the pharma company’s officials were aware of the toxicity of Isotab. The company showed negligence and continued the supply of toxic medicine, he further stated.

It is recommended, in the Punjab Government’s report, that a murder case should be registered against the owners of pharma company in lieu of the deaths caused by the toxic medicines, the AG Punjab elaborated.

Meanwhile a Federal Investigation Agency (FIA) report quashed cases registered against two pharmaceutical laboratories while confirming charges against a third lab.

The FIA’s 15-page report exonerated Mega Pharmaceuticals and Pharmawise Laboratories. A charge sheet, however, has been prepared against Alfalah Pharma by the FIA and handed over for presentation to the drug court. Alfalah Pharma was found involved in the manufacturing of drugs with an invalid licence. The report further revealed that their tablet Alfagril, which was supplied to the PIC, has been declared substandard in an analysis conducted by the central drugs testing laboratory in Karachi.

Published in The Express Tribune, February 17th, 2012.]]>
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			<title>Spurious drugs case: Pharma association’s acting chief blasts industry, regulator</title>
			<link>https://tribune.com.pk/story/337738/spurious-drugs-case-pharma-association%e2%80%99s-acting-chief-blasts-industry-regulator</link>
			<comments>https://tribune.com.pk/story/337738/spurious-drugs-case-pharma-association%e2%80%99s-acting-chief-blasts-industry-regulator#comments</comments>
			<pubDate>Fri, 17 Feb 12 00:59:31 +0500</pubDate>
			<dc:creator>
				<![CDATA[farooq.baloch]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=337738</guid>
			<description>
				<![CDATA[Says exponential, unchecked growth responsible for the debacle]]>
			</description>
			<content:encoded>
				<![CDATA[The spurious drugs debacle claimed another victim on Thursday – the pharmaceutical association.

In a dramatic about-turn, the acting chief of the association turned rogue at an official press conference, and blamed the industry itself, and the licensing authority, for the spurious drugs debacle that claimed over 130 lives in Punjab.

After reading the Pakistan Pharmaceutical Manufacturers Association’s (PPMA) official statement, acting chief Tariq Ikram crumpled it up, trashed it, and resigned from his position as the body’s vice chairman.

“I was pressurised to read this statement, which does not include my input,” Ikram said.

“I am done with PPMA. We have to answer to Allah,” he added.

Ikram, whose family has been among the founding members of the PPMA, and associated with it for the last 25 years, also withdrew his company Opal Laboratories’ membership from the body.

As baffled panelists wondered what had happened, former chairman PPMA Dr Qaiser Waheed attempted some damage control.

Waheed said Ikram was hurt for not being allowed to share certain information at a time when the entire industry is being defamed, and has therefore resigned in anger.

Ikram attempted to speak again, but left after the audience suggested he hold a separate press conference.

He later sent his statement to The Express Tribune via email. More factories, less inspectors.

Between 1947 and 1988, the health ministry issued three manufacturing licences for pharmaceutical firms per year – 126 in total – but between 1988 and 2011, a total of 580 licences were issued, at a rate of 26 per year, Ikram’s statement said.

While manufacturing units have increased from 129 in 1988 to 709 in 2011 – an increase of 450% - the number of drug inspectors monitoring these units has barely inched up.

In 1988, the number of provincial drug inspectors across Pakistan was approximately 91 – one inspector per 1.4 factories – while it increased to 263 in 2011 – with one inspector for 2.6 factories.

With the drug regulatory authority being defunct, inspectors cannot enter factories or inspect the quality of manufacturing there.

Pharmacy at every corner

Ikram also blamed the government for registering thousands of pharmacies, majority of whom do not comply with the Drug Act 1976.

There were 20,000 registered pharmacies in 1988 and that number exceeds 78,000 today, the statement said.

The Drug Act 1976 states that each pharmacy must have a licensed pharmacist duly registered with the Pharmacy Council of Pakistan (PCP). Interestingly, only 6,142 pharmacists are duly registered with the PCP.

Meanwhile, several hospitals, including public facilities, do not have registered and qualified pharmacists for managing prescriptions and issuance of medication to patients, the statement said.

Cutting corners

Ikram’s statement said that the cost of setting up a new pharmaceutical factory ranges between Rs500 million and Rs1 billion at present, depending on the plant’s size.

In the past 22 years, hundreds of licences were issued to applicants whose investment may not have even exceeded Rs50 million, the statement added.

To meet operational costs, these factories – with limited capital – cut corners, compromising on quality and standards, Ikram said.

How do regulators expect such companies to cope with the cost of manufacturing and sales in these inflationary years, he added rhetorically.

Training and resources

Inadequate training of drug inspectors and meagre salaries are other areas that need attemtion, the statement said. No trainings were imparted to federal or provincial drug inspectors in 2012, it added.

While the average salary of a federal drug inspector ranges between Rs50,000 and Rs70,000, that of a production and quality control manager at a private manufacturing unit ranges between Rs200,000 and Rs300,000.

A provincial drug inspector in Sindh requires a monthly expense budget of Rs100,000 to Rs200,000 but actually receives between Rs10,000 and Rs15,000, it added.

Spurious drugs

The biggest challenge to the industry is not foreign competition – it is spurious drugs that account for 40% of the total drugs circulating in the market, the statement said.

A host of substandard plants are operating from small cities such as Sukkur and Hyderabad, manufacturing spurious drugs and replicating drugs of the multinational companies, it added.

These black sheep have to be identified and punished, Ikram said, adding that it is difficult due to bureaucratic influences.

He cited an example where a PPMA delegation and Pakistan Chemists and Druggists Association, along with a drug inspector, raided a pharmacy and caught a handful of spurious drugs.

“No action could be taken against the manufacture due to political intervention,” he said.

Ministry’s pressure

When asked why he was pressurised by his association to not reveal this information publicly, Ikram said it feared a government backlash.

The PPMA fears that the health ministry can victimise it, and could even shut down the entire industry in a day by generating fake cases against them.

Talking about PPMA’s role in the entire episode, Ikram said the association cannot audit any manufacturing unit nor can it stop any pharmaceutical factory from becoming a PPMA member.

According to a Peshawar High Court ruling, the association cannot audit any factory at the time of launch.

Additionally, the health ministry has allowed new factories to become PPMA member saying if it has given the licence, how can the PPMA stop it from becoming part of the body.

Published in The Express Tribune, February 17th, 2012.]]>
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			<title>PIC suo motu: SC reminds protesting doctors of patient rights, orders them to resume duties</title>
			<link>https://tribune.com.pk/story/337420/pic-suo-motu-sc-tells-protesting-doctors-of-patient-rights-orders-them-to-resume-duties</link>
			<comments>https://tribune.com.pk/story/337420/pic-suo-motu-sc-tells-protesting-doctors-of-patient-rights-orders-them-to-resume-duties#comments</comments>
			<pubDate>Thu, 16 Feb 12 14:16:19 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=337420</guid>
			<description>
				<![CDATA[Directs Punjab chief secretary to present fresh report into conflict between doctors, provincial administration.]]>
			</description>
			<content:encoded>
				<![CDATA[The Supreme Court has ordered protesting doctors at the Punjab Institute of Cardiology to resume their duties while seeking a fresh report from the Punjab chief secretary into the issues that have developed between PIC’s doctors and the provincial administration.

Directing the doctors to return to work, the court said that boycotting their duties was undermining a fundamental right of patients, which is the right to live.

About 150 members of the Young Doctors Association protested outside the PIC on Wednesday, demanding that senior doctors who had been removed from their positions following the PIC drugs tragedy be restored.

A three-member bench of the SC, headed by Justice Shakirullah Jan, resumed hearing on Thursday of a suo motu case on deaths of heart patients from spurious medicines provided free by the PIC. Dr Faqir Hussain Khokar, the registrar at the SC, conveyed a copy of the court’s January 30 order in the case and asked Punjab Chief Secretary Nasir Khosa to submit details of names and designations of doctors who were on strike. He has also been asked to inform which doctors have been suspended and why.

Referring to media reports of the strike, the court also directed the province’s health secretary and advocate-general to appear before the court on Friday.

A letter by the registrar conveyed the court’s message to the doctors, which read that medicine is a noble profession and ailing patients need the care and attention of doctors. “It is not in consonance with the spirit of their noble calling to go on strike and leave patients unattended,” the letter said.

In the January 30 order, the court had said that the responsible authority must conduct a transparent inquiry according to the law, fix responsibility and propose action on matters that had risen after the PIC medicine disaster. “All doctors/officers/manufacturers of the relevant drugs shall fully cooperate with the inquiry which shall be concluded expeditiously. However, no such doctor or a person required in such investigation or inquiry shall be arrested and any doctor arrested in this regard shall be released forthwith subject to his personal bonds to the satisfaction of the deputy registrar (judicial) of the Lahore High Court,” the order said.

LHC inquiry tribunal appoints commission, interviews officers

The Inquiry Tribunal of the Lahore High Court probing into the deaths in the Punjab Institute of Cardiology (PIC) tragedy on Thursday recorded statements of World Health Organisation (WHO) representatives. WHO Medicine Anti-Counterfeiting Programme and Quality Assurance and Safety Medicines technical officer Syed Khalid Saeed was interviewed by the tribunal. The tribunal comprising Justice Ijazul Ahsan also appointed a commission to visit Efroz Chemical Industries in Karachi to inspect the premises, production and storage facilities and examine the relevant records of procurement, manufacture, sale and dispatch of medicines produced in the factory. The commission will also visit the Drug Testing Laboratory, meet the federal drug inspector and collect information from the investigating officer in Karachi. It will then submit its report to the tribunal. The tribunal has summoned former health secretary Jahanzeb Khan, chairman of the procurement committee and the PIC chief executive officer for February 20.]]>
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			<title>Tainted IsoTab: Judicial tribunal starts inquiry</title>
			<link>https://tribune.com.pk/story/336338/tainted-isotab-judicial-tribunal-starts-inquiry</link>
			<comments>https://tribune.com.pk/story/336338/tainted-isotab-judicial-tribunal-starts-inquiry#comments</comments>
			<pubDate>Tue, 14 Feb 12 16:06:54 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=336338</guid>
			<description>
				<![CDATA[Secretary Nasir Khosa is scheduled to appear before the tribunal on Wednesday.]]>
			</description>
			<content:encoded>
				<![CDATA[Former Punjab Institute of Cardiology (PIC) chief executive Prof Dr Muhammad Azhar and former health secretary Muhammad Jahanzeb Khan appeared before the judicial tribunal on Tuesday and recorded their statements.

Justice Ijazul Ahsan is conducting the inquiry into the deaths of over 100 heart patients who died from a batch of IsoTab tainted with an anti-malarial drug.

According to a press release issued by Lahore High Court Azhar and Khan also submitted some documents to the tribunal. Home Secretary Nasir Khosa is scheduled to appear before the tribunal on Wednesday.

The proceedings are held in-camera.]]>
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			<title>The value of quality control</title>
			<link>https://tribune.com.pk/story/335889/the-value-of-quality-control</link>
			<comments>https://tribune.com.pk/story/335889/the-value-of-quality-control#comments</comments>
			<pubDate>Mon, 13 Feb 12 19:02:41 +0500</pubDate>
			<dc:creator>
				<![CDATA[Muhammad Hamid Zaman]]>
			</dc:creator>
			<category><![CDATA[Opinion]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=335889</guid>
			<description>
				<![CDATA[In our passionate moments, as we start searching for who to blame, we often ignore the need to strengthen the system.]]>
			</description>
			<content:encoded>
				<![CDATA[Who would have thought that the cause of death of the patients at the Punjab Institute of Cardiology (PIC) would be large amounts of an anti-malarial? This is not only unfortunate, but also absurd. On a broader note, it also says a lot about the breakdown of the drug testing mechanisms that should be in place to safeguard society. It also says something about the health of our society’s general quality control mechanisms at large, but I will come to that a little bit later.

First, it is important to note that the PIC tragedy is the manifestation of a system-level problem. While one or more individuals may have triggered this catastrophe, the magnitude of the tragedy is amplified by the failure of the system as a whole. It is also important to note that as a society, we are developing a tendency of personalising the tragedies. Blaming one individual for the miscarriage of the system is not going to stop it from happening the next time. In our passionate moments, as we start searching for who to blame, we often ignore the need to strengthen the system itself.

The fact that one of the tainted drugs given to the patients was contaminated is incredibly perplexing. The realisation that no one responsible for quality control — within the various levels of manufacturing or the distribution — was unable to catch it, is even scarier. If this can happen once, in a manufacturing plant, what controls do we have in place to make checks for the next time around? If it can happen in one city, what makes us think that it won’t happen in another? If it can happen with cardiology patients, why are patients of another ailment safe? Going after the perpetrators of this tragedy is one of the many things that we need to do, but not the only thing. Strengthening quality control, at the systems-level, through human resources and technological tools is even more important.

Yet, I have not seen a clear change in policy or even an indication of the new safeguards that will be put in place to create multiple layers of safety nets. Like everyone else, I am still not sure if we have the means to test drugs or not. If we do, as some experts and bureaucrats claim, then why were the drugs sent abroad? And even if we had to wait for results from outside labs, did our own testing labs corroborate those results? If the problem of contamination of an anti-malarial was with Isotab, what about the three other drugs that were supposedly tainted as well? What were they contaminated with? And finally, what mechanism do we have in place not only to test the drugs, but also test the facilities that test the drugs? Are those facilities up to date and functioning? Are people in charge of the industry competent? These are just some of the many questions we should ask if we are to strengthen our system and have any faith in the drugs that come into the market.

Now let us come to the bigger issue, of quality control in the society itself. The issue of quality control and proper checks within the system goes beyond medicines or health. The culture of sifarshis that are able to go through various levels of the system is no different from a bad drug going through various levels of quality control. Whether it is complacency, criminal intent or a combination of both, this complacency leads to gaping holes in our system that benefit sifarshis and bad drugs. The sifarshi himself or herself is only part of the problem, like the bad drug, but the system that enables him or her to get through is the bigger problem. The PIC tragedy is a clear symptom of a bigger disease. Let’s hope we don’t treat it with a substandard drug.

Published in The Express Tribune, February 14th, 2012.]]>
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			<title>PIC had bought substandard medicines, court told</title>
			<link>https://tribune.com.pk/story/335842/pic-had-bought-substandard-medicines-court-told</link>
			<comments>https://tribune.com.pk/story/335842/pic-had-bought-substandard-medicines-court-told#comments</comments>
			<pubDate>Mon, 13 Feb 12 15:26:05 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=335842</guid>
			<description>
				<![CDATA[The tablets purchased at cheaper rates were not sent for tests at the lab before being issued.]]>
			</description>
			<content:encoded>
				<![CDATA[Justice Umar Ata Bandial of the Lahore High Court (LHC) on Monday directed the Punjab Government to inform the court on steps taken regarding policy for purchasing medicines.

The judge was hearing a petition filed by Advocate Muhammad Azhar Siddique seeking formation of a judicial commission to investigate the deaths of Punjab Institute of Cardiology (PIC) patients due to the use of adulterated medicines.

During today’s hearing, Additional Inspector General (AIG) Zulfiqar Hameed appeared before the court and submitted that investigations into the matter revealed irregularities in medicine purchases made by the PIC.

Hameed said instead of purchasing quality medicines, PIC had purchased medicines of low quality at cheap rates.

“A tablet which is available in market for Rs20 was purchased by the PIC for just Rs0.75,” Hameed added.

The AIG also informed the court that the medicines of lower quality were manufactured by two factories including Efroze Chemical Company, Karachi. However, he added, none of the owners could be arrested since they have obtained protective bails from the Sindh High Court.

Hameed also stated that the PIC record showed that the medicines purchased by the institute were never re-checked by drug test laboratory.

The judge ordered the investigation team to inform the court about those responsible for the sale of the inferior drugs by February 22, the next date of hearing.

Following the court directions, Punjab Health Secretary Arif Nadeem submitted a detailed report regarding the present situation of the patients affected by the spurious drugs.

Nadeem said from December 23, 2011 to February 11, 2012, a total of 929 patients were affected by the adulterated medicines. These patients were then admitted to different hospitals across the Punjab. Out of this, 707 patients were discharged after recovery, while 103 patients are still under treatment, the Health Secretary stated.

According to the Punjab Health Secretary report, 120 patients had died. Nadeem added that 70 patients died in Lahore alone.

The judge also enquired about the payment of compensation money worth of Rs500,000 each to the bereaved families by the Punjab government, to which Additional Advocate General gave assurance to the court that payments would be made by the next date of hearing.

On the other hand, the inquiry tribunal of the Lahore High Court headed by Justice Ijazul Ahsan on Monday summoned former secretary health and former chief executive of PIC to appear before the tribunal on February 14.]]>
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			<title>PIC medicine disaster: Punjab government unbans 4 drugs</title>
			<link>https://tribune.com.pk/story/334532/pic-medicine-disaster-punjab-government-unbans-4-drugs</link>
			<comments>https://tribune.com.pk/story/334532/pic-medicine-disaster-punjab-government-unbans-4-drugs#comments</comments>
			<pubDate>Fri, 10 Feb 12 16:23:27 +0500</pubDate>
			<dc:creator>
				<![CDATA[owais.jafri]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=334532</guid>
			<description>
				<![CDATA[Patients have been told to use the medicines, which were cleared by labs in Lahore, London and Switzerland.]]>
			</description>
			<content:encoded>
				<![CDATA[The Punjab government has removed a ban on four of five medicines that patients were prohibited from using following the deaths by fatal reactions from free medicines distributed by the Punjab Institute of Cardiology.

After investigations showed that a medicine named Isotab was the culprit in the hundreds of tragic deaths, the other four proscribed drugs (Alenolol, Solprin, Concort, Cardiovastein) were cleared for use.

The Punjab health department issued a notification on Friday, allowing not only usage but also storage and procurement of the four medicines.

Samples of all five medicines, including Isotab, were sent to drug-testing labs in Lahore, London and Switzerland. All three reports confirmed that Isotab samples contained a higher anti-malarial component than permitted. Patients had died due to this anti-malarial medicine named Pyrimethamine.]]>
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			<title>Spurious medicines</title>
			<link>https://tribune.com.pk/story/333560/spurious-medicines</link>
			<comments>https://tribune.com.pk/story/333560/spurious-medicines#comments</comments>
			<pubDate>Wed, 08 Feb 12 19:21:24 +0500</pubDate>
			<dc:creator>
				<![CDATA[Syed Mohammad Ali .]]>
			</dc:creator>
			<category><![CDATA[Opinion]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=333560</guid>
			<description>
				<![CDATA[The production of counterfeit drugs is in fact emerging as a worldwide dilemma.]]>
			</description>
			<content:encoded>
				<![CDATA[While Pakistan has to address a range of human development related indicators to catch up with neighbouring countries, the health situation in the country is particularly alarming even in comparison to the rest of South Asia. The latest adulterated medicines fiasco, which has claimed scores of lives, mostly in Lahore, needs to be understood in this broader context rather than as a stand-alone incident.

Given the dearth of public health financing and the absence of a national health insurance programme, the average citizen in our country is compelled to buy medicines out of their own pockets. Poor Pakistanis are estimated to spend about 77 per cent of their household’s health budgets on medicines alone and nearly half are fake or unfit for human consumption.

The interior minister recognised the extent of this problem when this issue was taken up in the National Assembly, two years ago. Our parliamentarians have passed a resolution to take action against those selling substandard or spurious medicine. Besides the Drug Court, a Drug Control Organisation has also been set up in the Federal Ministry of Health. Yet, in spite of all these seemingly reassuring measures, the ground realities provide ample cause for concern. How else could a pharmaceutical company with an expired license have been found to supply medicines in the open market and specialised medical facilities like the Punjab Institute of Cardiology (PIC)?

Subsequent to the deaths caused by a free drug provided by the PIC, the Punjab chief minister reactively formed a committee to look into the problem. The Supreme Court has taken notice of the matter but the various stakeholders are still trying to shift blame. But only a handful of cases have been registered and even lesser are being effectively prosecuted. This means that when the FIA seizes raw material and drugs during sporadic raids, many of the culprits are still able to get away scot-free.

The production of counterfeit drugs is in fact emerging as a worldwide dilemma. According to the World Health Organisation, fake drugs account for between 7-15 per cent of the total quantity of medicines in circulation in the market in developed countries and 25 per cent in developing ones. Counterfeiting is partially a reaction to the high drug prices imposed by pharmaceutical companies, as well as high taxes on medicines. Sri Lanka is scrutinising medicines from Pakistan and more countries may follow suit. If this happens it could hurt growth of our exports of medicines, which was around 400 million dollars over the last two years alone.

One hopes that policymakers pay more attention to curbing the proliferation of fake medicines. They also need to take to task those multinational and national pharmaceutical companies found involved in unethical marketing of medicines or who don’t have stringent quality standards.

Published in The Express Tribune, February 9th, 2012. ]]>
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			<title>PIC suo motu: FIA submits 'incomplete' report to Supreme Court</title>
			<link>https://tribune.com.pk/story/333427/pic-suo-motu-fia-submits-incomplete-report-to-supreme-court</link>
			<comments>https://tribune.com.pk/story/333427/pic-suo-motu-fia-submits-incomplete-report-to-supreme-court#comments</comments>
			<pubDate>Wed, 08 Feb 12 07:43:50 +0500</pubDate>
			<dc:creator>
				<![CDATA[web.desk]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=333427</guid>
			<description>
				<![CDATA[FIA says the Punjab government has sealed records and is not providing the necessary information.]]>
			</description>
			<content:encoded>
				<![CDATA[The Federal Investigative Agency (FIA) submitted its report to the Supreme Court in the Punjab Institute of Cardiology (PIC) medicine case on Wednesday, Express News reported.

The FIA said that the investigation report was submitted ‘incomplete’ as the Punjab government has not corresponded well and neither have government officials submitted their replies to the agency.

FIA officials told the court that the record of the PIC was sealed by the Punjab government and the court would have to order the government to provide it.

Major Mubashir, leading the team constituted by the Punjab government, met with the FIA and assured them of providing the records, but did not comply.

The medicine – IsoTab – was recently found to have a large amount of an anti-bacterial which triggered an unknown disease in heart patients who consumed it and caused the death of hundreds of people in Punjab.

With the death toll constantly rising, the Federal Investigative Agency (FIA) and the Punjab government took several steps, including sealing factories which manufactured them to control the matter.

The Supreme Court is also hearing a suo moto case of the incident.]]>
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			<title>Free Medicine: Mega Pharmaceuticals unsealed</title>
			<link>https://tribune.com.pk/story/333276/free-medicine-mega-pharmaceuticals-unsealed</link>
			<comments>https://tribune.com.pk/story/333276/free-medicine-mega-pharmaceuticals-unsealed#comments</comments>
			<pubDate>Tue, 07 Feb 12 20:59:53 +0500</pubDate>
			<dc:creator>
				<![CDATA[]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=333276</guid>
			<description>
				<![CDATA[Medicines manufactured at the Lahore based company yielded results devoid of contamination and up to the mark.]]>
			</description>
			<content:encoded>
				<![CDATA[Authorities in Lahore have reopened the tablet manufacturing section of Mega Pharmaceuticals after tests on its medicines returned clear, Express News reported late on Tuesday night.

Mega Pharmaceuticals, one of the drug manufacturers who had supplied medicines to the Punjab Institute of Cardiology where apparently a contaminated batch of prescription medicines caused adverse reaction among the patients causing as many as 700 people to fall severely ill while claiming the lives of at least 107 patients.

Investigating the deaths, the Punjab health department and the Federal Investigation Authority – on orders from the Ministry of Interior, had sealed the manufacturing units of three pharmaceutical companies including Mega Pharmaceuticals on January 23.

Samples of medicine collected were sent to labs in Pakistan as well as abroad. However, when these results came back with an all clear, the health department issued directives for the the manufacturing unit of Mega Pharmaceuticals to be unsealed.]]>
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			</item><item>
			<title>The dark side of cheap drugs</title>
			<link>https://tribune.com.pk/story/333013/the-dark-side-of-cheap-drugs</link>
			<comments>https://tribune.com.pk/story/333013/the-dark-side-of-cheap-drugs#comments</comments>
			<pubDate>Tue, 07 Feb 12 20:00:55 +0500</pubDate>
			<dc:creator>
				<![CDATA[editorial]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Editorial]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=333013</guid>
			<description>
				<![CDATA[The pharmaceutical industry must be put under closer scrutiny so that those working honestly can be rewarded.]]>
			</description>
			<content:encoded>
				<![CDATA[The Punjab Institute of Cardiology (PIC) scandal is still unfolding after nearly a fortnight: the death toll is now around 140. Three hundred more people, admitted to various hospitals of Lahore, are threatened with death because they took adulterated medicines. All of them are heart patients who could not afford to buy their pills and leaned on the free drugs of the PIC to survive. Fifty of them are in a serious condition and are expected not to survive. The PIC had bought the drugs from a number of pharmacies who made their products presumably under licence from foreign manufacturers. One factory in Karachi was found to have issued the contaminated pills which killed the patients in Lahore. And this was discovered only after drug samples were sent to Europe for examination.

The politicians extracted a lot of mileage from this incident in the Punjab Assembly where our leaders took their discourse to the lowest level witnessed so far. The Punjab High Court took notice and set up a commission; the Supreme Court too wants to know what happened and why so many people — all of them poor and exposed — died. Meanwhile, Chief Minister Punjab Shahbaz Sharif has followed up with tough action, suspending officials and instituting inquiries against those who should have ensured the purity of the drugs in the province, despite the fact that authority in this regard is bifurcated between the province the federal government, making it easy to arouse passions on the basis of ‘conspiracy’ theories. Mercifully, so far, no one has named the US, India and Israel as the ‘real culprits’.

As if nature wanted to focus our mind on the real source of trouble, a veterinary drug factory in Lahore’s Multan Road area blew up after a gas leak, killing 14 people, including seven women and three children, with dozens crippled and trapped under the debris of a ramshackle building. At the time of writing nearly half the factory workers out of nearly 60 who had reported to work were still buried under the rubble.

What comes to the fore are a number of factors: 1) the compulsion of providing cheap drugs to an impoverished population; 2) governance that is shot through with corruption, regardless of how dangerous certain jurisdictions may become; 3) a poor lower judicial system where a stay order can be obtained against any serious violation of rules through graft; 4) a low-quality pharmaceutical industry run by non-experts looking to make a quick fortune; 5) poor quality of manpower; 6) the predominance of an illiterate population and its compulsion to find employment; 7) the tyranny of keeping the prices low to make them affordable by the poor, which compels the hiring of mazdoor workers rather than those trained in drugs manufacturing; and 8) a poor and ineffective drug inspection regime in an ambience of federal-province rivalry.

Most but not all drug factories employ illiterate labour who can’t read labels as they handle machines that mix and manufacture medicines of extremely sensitive nature. It is said that the pharmaceutical factory in Karachi that issued the fatal pill could have been the victim of the negligence of workers who simply could not distinguish between ingredients and had kept the machines in a poor state of cleanliness. The factory that blew up in Lahore has revealed a number of worrying facts: it was illegally established in a residential area and had been sealed by the authorities a number of times, each time given leave to function through a stay order from the court. It employed illiterate men and women and also indulged in the practice of child labour. Simply no one looked at the quality of the building and probably no one went there to inspect the conditions in which the labour survived.

Conclusion: given its margins of profit, the pharmaceutical industry must be put under closer scrutiny so that those working honestly can be rewarded. Drug testing capacity of the state must be overhauled and bureaucratic complications removed. The manufacturers must be made to employ literate workers for the sake of security of life of poor patients. This could prevent future traumas of the sort experienced in Lahore.

Published in The Express Tribune, February 8th, 2012.]]>
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			<title>Shahbaz Sharif acts like a dictator: Javed Hashmi</title>
			<link>https://tribune.com.pk/story/332982/shahbaz-sharif-acts-like-a-dictator-javed-hashmi</link>
			<comments>https://tribune.com.pk/story/332982/shahbaz-sharif-acts-like-a-dictator-javed-hashmi#comments</comments>
			<pubDate>Tue, 07 Feb 12 16:47:08 +0500</pubDate>
			<dc:creator>
				<![CDATA[owais.jaffery]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332982</guid>
			<description>
				<![CDATA[The veteran politician says MQM's clout and importance cannot be denied.]]>
			</description>
			<content:encoded>
				<![CDATA[Pakistan Tehreek-i-Insaf  (PTI) leader Javed Hashmi took a potshot at Punjab Chief Minister Shahbaz Sharif, calling him a dictator, who never answered questions directed towards him in the Assembly.

Talking to the media in Multan on Tuesday, the former Pakistan Muslim League-Nawaz (PML-N) senior leader said that parties blaming dictators for the country’s woes, should also view Shahbaz’s behaviour in the same light, whose vision and ideology is akin to that of a dictator, who felt that he was not answerable in the assembly.

“His vision and ideology is completely based on dictatorship and he acts like a dictator as he never answers anyone in the assembly. You can verify this by asking anyone if Shahbaz has ever replied to questions in the assembly.”

Talking about the Punjab Institute of Cardiology contaminated medicines tragedy in Punjab, Hashmi said that Shahbaz should be held responsible and then the Punjab government, adding that if the Punjab Chief Minister denied responsibility then he was as responsible as the Health Minister.

Shahbaz had retained the Health Ministry, despite relinquishing eight out of the 15 ministries, recently.

“Neither has he resigned as chief minister nor as health minister,” Hashmi said.

‘MQM clout and importance cannot be ignored’

Amidst rumours regarding reconciliatory talks between the PTI and Muttahida Qaumi Movement (MQM), Hashmi spoke about the importance of the MQM as a political force and how their clout, importance could not be ignored.

“The political importance and power of MQM cannot be ignored,” the veteran politician said, adding that negotiations and reconciliation was the beauty of politics.

Hashmi promised that the country would see major breakthroughs in the political scenario of Pakistan, brought about by the PTI.

“Before any political ideology or political party, PTI is first the voice of the people of Pakistan,” the senior leader reiterated.

‘Resolve Kashmir and water issue first’

On relations with India, the veteran politician said that trade and relations with the neighbouring country could only continue if the latter seriously resolved issues, including that of Kashmir and the water dispute.]]>
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			<title>SC gives govt 10 days to set up drugs watchdog</title>
			<link>https://tribune.com.pk/story/332785/sc-gives-govt-10-days-to-set-up-drugs-watchdog</link>
			<comments>https://tribune.com.pk/story/332785/sc-gives-govt-10-days-to-set-up-drugs-watchdog#comments</comments>
			<pubDate>Tue, 07 Feb 12 05:02:23 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332785</guid>
			<description>
				<![CDATA[Apex court told that another medicine, Alfagril, also declared substandard; Lahore labs cleared of offence.]]>
			</description>
			<content:encoded>
				<![CDATA[Following the death of over a hundred patients of the Punjab Institute of Cardiology (PIC) due to contaminated medicines, the Supreme Court on Monday directed the relevant authorities to ensure the establishment of a drug regulatory body within 10 days.


A three-member bench of the apex court, headed by Justice Tassaduq Jilani, resumed the hearing of the suo motu case on Monday. The court was told that contaminated IsoTab tablets were responsible for the loss of lives. The court was also told that a laboratory test had determined that IsoTab – a medicine manufactured by Efroze Chemical Industries – caused the reaction.

Federal Investigation Agency (FIA) Director Azam Khan said that three cases were registered by his agency after a letter was received from Director of the Interior Ministry’s Crisis Management Cell Farid Ahmed Khan. In the letter, the FIA was asked to conduct an investigation into the medicine disaster. As a result, a team comprising federal drug inspectors and FIA officials was constituted, he added.

The chemicals factory was closed after a raid which included inspecting the premises and staff. The three pharmaceutical laboratories in Lahore which were originally suspected of foul-play have been cleared of any criminal offence. However, a medicine called Alfagril produced by one of the laboratories has been declared substandard.

Justice Jilani also said that the production department of Mega Pharma had been unlawfully sealed. Punjab Advocate General Ashtar Ausaf, however, clarified that the department was closed only to obtain samples, adding that production would not be disallowed.

In response to a court query, the FIA director submitted that the investigation officer in the case would recommend cancellation of cases against pharmaceutical companies who are declared to be in the clear. Justice Jilani asked the government to take steps to ensure that the reputation of these companies, damaged by the scandal, is restored.

During the hearing, the court observed that the FIA report indicates that cases were lodged based on newspaper reports, as the agency was not aware of which medicines caused the deaths at the time of case registrations. FIA officials informed the court that there had been pressure from the interior ministry to pursue the cases.

The court also directed that a copy of the court order be sent to all four provincial chief secretaries and adjourned the hearing till February 17.

Published in The Express Tribune, February 7th, 2012.]]>
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			<title>Sri Lanka inquires about faulty pills</title>
			<link>https://tribune.com.pk/story/332789/cascading-effects-sri-lanka-inquires-about-faulty-pills</link>
			<comments>https://tribune.com.pk/story/332789/cascading-effects-sri-lanka-inquires-about-faulty-pills#comments</comments>
			<pubDate>Tue, 07 Feb 12 04:57:25 +0500</pubDate>
			<dc:creator>
				<![CDATA[jaffer.bilgrami]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332789</guid>
			<description>
				<![CDATA[Tries to find out whethe­r the faulty medici­ne has been import­ed by or sold in the Sri Lankan market.]]>
			</description>
			<content:encoded>
				<![CDATA[Sri Lanka’s leading pharmaceutical regulatory watchdog body Saneka Bible Memorial Committee has sought clarification from the country’s health ministry to find out whether the faulty medicine Isosorbide-Mononirtate has been imported by or sold in the Sri Lankan market.


Committee Chairman Dr Jayanatha Bandara, in a letter sent to Sri Lanka Health Minister Maithripala Sirisena, expressed concern over the medical debacle and inquired if the health ministry of Sri Lanka had been officially informed about the drug poisoning cases by Pakistan. Dr Bandara also asked the Sri Lanka Department of Health to initiate an awareness programme for all health personnel, pharmacists and the general public at large about the correct use of the medicine.

The Sri Lanka Health Services Director General Dr Mendis had earlier announced that a warning had been issued to all concerned parties regarding the use of spurious medicine which was imported from Pakistan. He, however, clarified that investigations have revealed that there was no import or stock of the faulty medicine in the country.

A representative of the Sri Lanka Pharmaceutical Manufacturers Association Sudesh Jayalaktane said: “We are taking precautions on a country-wide level so that the faulty medicine is not supplied or imported into the country.”

Published in The Express Tribune, February 7th, 2012.]]>
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			</item><item>
			<title>Travel curbs slapped on pharma company owners</title>
			<link>https://tribune.com.pk/story/332787/travel-curbs-slapped-on-pharma-company-owners</link>
			<comments>https://tribune.com.pk/story/332787/travel-curbs-slapped-on-pharma-company-owners#comments</comments>
			<pubDate>Tue, 07 Feb 12 04:28:14 +0500</pubDate>
			<dc:creator>
				<![CDATA[rana.tanveer]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category><category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332787</guid>
			<description>
				<![CDATA[Health secretary submits report to LHC on the medicine tragedy.]]>
			</description>
			<content:encoded>
				<![CDATA[The Lahore High Court on Monday was told that the names of the owners of the pharmaceutical company Efroze Chemicals Ltd, involved in the faulty medicine debacle, had been placed on the Exit Control List (ECL).


A report submitted on behalf of the Punjab health secretary was placed before Justice Umar Ata Bandial elucidating the efforts made by the government in the aftermath of the medical disaster that left over a 100 dead.

In his report, the health secretary revealed that up to February 3, 2012, out of 890 affected patients, 315 were undergoing treatment in various hospitals, 369 had been discharged after complete recovery, while 107 had died.

The high court bench was told that the use of five suspected medicines was suspended immediately at all teaching and DHQ hospitals. The matter was also placed before the Provincial Quality Control Board (PQCB) and the federal government suspended all available stock of the suspected medicines from manufacturing companies, cancelling their licenses.

The health secretary further revealed that the Punjab government had formally requested Sindh chief secretary and the Federal Investigation Agency (FIA) director general to take necessary legal action against Efroze Chemicals including sealing of their production premises.

He said the Supreme Court also took suo motu notice of the issue and a comprehensive report had been submitted there.

Justice Bandial, after going through the report, adjourned the hearing till February 13 and directed the Punjab health department to file a comprehensive report about the remedial steps being taken to provide relief to the affected patients.

Compensation

Meanwhile, the Pakistan Pharmaceuticals Manufacturers Association (PPMA) announced the provision of jobs for two persons from each family that has lost a member to fake medicines used in the Punjab Institute of Cardiology (PIC), Lahore. According to a press release, PPMA Chairman Mohammad Asad said that in order to share the miseries and sorrows with the bereaved families, the PPMA has decided to provide jobs to two persons from each victim family and these jobs would be provided as per their qualifications.

Published in The Express Tribune, February 7th, 2012.]]>
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			</item><item>
			<title>Drug monitoring: We need a central drug regulatory authority, says PMA</title>
			<link>https://tribune.com.pk/story/332682/drug-monitoring-we-need-a-central-drug-regulatory-authority-says-pma</link>
			<comments>https://tribune.com.pk/story/332682/drug-monitoring-we-need-a-central-drug-regulatory-authority-says-pma#comments</comments>
			<pubDate>Mon, 06 Feb 12 21:39:21 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Sindh]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332682</guid>
			<description>
				<![CDATA[Doctors see over-the-counter empty capsules, badly stored biological drugs as a part of the problem.]]>
			</description>
			<content:encoded>
				<![CDATA[The Pakistan Medical Association (PMA) expressed concern over the loopholes in the process of registering medicines in the country and has demanded that a federal or central drug regulatory authority be set up immediately.


They want the government to withdraw all those drugs that do not meet the criteria set by the WHO and develop a mechanism to deal with emergencies like the one caused by IsoTab in Lahore in which 107 patients died. They warned that this will continue to take place if the Drug Act of 1976 and the laws are not updated, according to the standards of World Health Organisation (WHO), said the honorary secretary general of the PMA, Dr Mirza Ali Azhar, at a press conference on Monday.

“It is shameful that our laboratories are not even competent enough to find out what was wrong with IsoTab and we had to seek foreign help,” he said referring to testing in the UK.

Dr Qazi Wasiq of the PMA in Karachi said that the government was waiting for a no-objection certificate (NoC) from the Punjab government, which said that it would issue one once Lahore’s Sheikh Zayed Hospital was devolved. Sindh, Balochistan and Khyber-Pakhtunkhwa have already have already issued NoCs. “This politicisation of the matter needs to be done away with,” he said.

Dr Qaiser Sajjad of the PMA in Karachi said that drug regulation was so absent that anyone could buy empty capsules over the counter, fill them with anything and sell them without being stopped at any point.

Biological drugs are not stored in cold storage, as advised by the WHO, either. “Hence, diabetes and hepatitis patients are a high risk of developing adverse reactions to these drugs,” he said. “I am a doctor but even I would not take responsibility for any drug now.”

Another serious problem besides counterfeit drugs, said the president of PMA Central, Dr Tipu Sultan, was the registration of biological drugs, such as insulin, interferon (immunity regulators), vaccines and growth hormones. He said that these drugs need expert handling and are sensitive to environmental changes.

Reporters at the press conference suggested that with a federal authority, the country might end up with multiple regulatory authorities because of devolution. But the president of the PMA, Dr Idrees Adhi, insisted that the matter needed to be governed from a central body. He gave the example of the Pakistan Medical and Dental Council, which was still a federal authority and was not devolved.

He explained the logic behind the demand put forward by the doctors. Having a separate regulatory authority for every province will cause confusion and increase corruption because drug manufacturers supply nationally and not to individual authorities. Having many drug-regulatory authorities will mean that each drug is tested separately in every province. “Had this been an effective method, then India and America would have as many drug regulatory authorities as the number of states,” said Adhi. “There should be a central authority while the provinces can have their own food and drug inspectors.”

Dr Aziz Khan Tank, the secretary general of College of Family Medicine of Pakistan, stressed that there should be a state-of-the-art testing lab. “Pakistani medicines, which constitute 80 per cent of total consumption, should be monitored, along with the 20 per cent medicines which are imported,” he said.

Published in The Express Tribune, February 7th, 2012.]]>
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			<title>PIC deaths in reaction to medicines, LHC told</title>
			<link>https://tribune.com.pk/story/332521/pic-deaths-from-reaction-to-medicines-lhc-told</link>
			<comments>https://tribune.com.pk/story/332521/pic-deaths-from-reaction-to-medicines-lhc-told#comments</comments>
			<pubDate>Mon, 06 Feb 12 17:10:19 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332521</guid>
			<description>
				<![CDATA[Report sugges­ts that 315 people are under treatm­ent, while 369 have been discha­rged. 107 died from the...]]>
			</description>
			<content:encoded>
				<![CDATA[A report by the Secretary Health looking into the Punjab Institute of Cardiology scandal, submitted to the Lahore High Court on Monday, said that the cause of deaths was due to an adverse reaction to one or more medicines given to patients. 

The LHC has also directed Punjab health department to file a comprehensive report on remedial steps being taken for the victims of contaminated medicines who hailed from rural areas of the province.

A report on behalf of Secretary Health was submitted to Justice Umar Ata Bandial highlighting government efforts against the manufacturers of the suspected medicines and steps taken for the treatment of affected patients.

The report said that when the possible, cause of patients’ deaths was confirmed, and could have been caused from reaction to one or more drugs supplied by Punjab Institute of Cardiology (PIC). The institute was thereafter directed to immediately to stop disbursement of the suspected medicines.

The report pointed towards the use of five suspected medicines which were immediately stopped at all teaching and DHQ hospitals.

The health department had sent drug samples to various international drug laboratories, including those of England, Switzerland, Belgium, France and the USA. The report said that the Medicine and Health Care Products Regulatory Agency (MHRA) confirmed that Isotab-20, of Efroze Chemicals, was contaminated with significant amounts of the anti-malarial drug (Pyrimethamine). The findings were also endorsed by another laboratory of Switzerland and the Drug Testing Laboratory Lahore, the secretary said in his report.

The matter was also placed before Provincial Quality Control Board (PQCB) and federal government cancelled all stock of the suspected medicines from the manufacturing companies and cancelled their licenses, the report said. It also revealed that the names of the companies directors had been placed on exit control list.

It further revealed that Punjab government had formally requested Chief Secretary Sindh and FIA Islamabad Director General to undertake necessary legal action against Efroze Chemicals including sealing of production premises.

It said many high level committees were holding inquiry of the unfortunate deaths of the patients and a judicial commission had also been constituted to hold inquiry. The secretary health mentioned in his report that up to February 3, 2012, out of 890 affected patients, 315 were still under treatment in various hospitals, 369 had been discharged after complete recovery while, unfortunately, 107 had died.

He said the government was extending all possible assistance, including adequate financial assistance, to the affected patients and their families. He said the Supreme Court also took suo motu notice of the matter and a comprehensive report had been submitted in the court.

Justice Bandial after going through the report adjourned hearing of a petition on the matter till February 13 and sought details about steps taken for the patients belonged to rural areas in the province.

Judicial Activism Panel chairman Muhammad Azhar Siddique filed the petition and sought constitution of a judicial commission to investigate about deaths of more than hundreds patients due to use of adulterated medicines of the PIC. He took a plea that it was a case of sheer negligence of the institute administration for which they should be taken to the task.]]>
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			<title>PIC medicine: SC wants recommendations for new drug regulatory body in 10 days</title>
			<link>https://tribune.com.pk/story/332454/pic-medicine-sc-wants-drug-regulatory-body-established-within-10-days</link>
			<comments>https://tribune.com.pk/story/332454/pic-medicine-sc-wants-drug-regulatory-body-established-within-10-days#comments</comments>
			<pubDate>Mon, 06 Feb 12 15:59:00 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332454</guid>
			<description>
				<![CDATA[Chief Secretaries of all four provinces asked to file recommendations for new drug regulatory body.]]>
			</description>
			<content:encoded>
				<![CDATA[Hearing the case of spurious medicines that took more than 100 lives in Punjab Institute of Cardiology (PIC), the Supreme Court on Monday directed relevant authorities to to establish a drug regulatory body within ten days.

The court also directed that the copy of the court order be sent to all four provincial chief secretaries so that they may file their recommendations before adjourning the hearing till February 17.

A three member bench of the apex court headed by Justice Tassaduq Jilani heard the case.

The court was told that contaminated Isotab tablets manufactured by Efroze Chemical Industries were the main reason behind losses of many lives, as proven by a laboratory test.

Director (Legal) Federal Investigation Agency (FIA) Azam Khan informed the court that three cases were registered by FIA as it was asked by the interior ministry to investigate the case. A joint team comprising federal drug inspectors and FIA officials was constituted, he said.

The team conducted raids and closed Efroze Chemical Industries, after inspecting the premises and meeting staff.

The three pharmaceutical laboratories in Lahore which were originally suspected of foul play were cleared of any criminal offence, however, a medicine called Alfagril, produced by one of the laboratories, has been declared substandard.

Justice Jilani also mentioned during the hearing that the production department of Mega Pharma was unlawfully sealed, to which Advocate General Punjab Ashtar Ausaf clarified that the department was closed only to get samples, adding that it can resume production now.

To a court query, Director FIA submitted that the team investigation officer will recommend cancelation of cases against pharmaceutical companies. Justice Jilani further asked the government to take such steps to restore the damaged reputation of the companies.

The court observed that the FIA report on the case indicated that cases were lodged against these companies on the basis of newspaper reports, as the agency was not aware of the exact cause of the deaths. The FIA officials told the court about that they were pressurised by the interior ministry to register cases but the court responded stating that no one was allowed to take law in their own hands.]]>
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			<title>IsoTab was the murderous tablet, AG Punjab confirms</title>
			<link>https://tribune.com.pk/story/332463/isotab-was-the-murderous-tablet-ag-punjab-confirms</link>
			<comments>https://tribune.com.pk/story/332463/isotab-was-the-murderous-tablet-ag-punjab-confirms#comments</comments>
			<pubDate>Mon, 06 Feb 12 15:55:04 +0500</pubDate>
			<dc:creator>
				<![CDATA[asad.kharal]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332463</guid>
			<description>
				<![CDATA[The conclusions were based on findings of the medico legal officer who conducted autopsy on PIC victims.]]>
			</description>
			<content:encoded>
				<![CDATA[Those consuming contaminated medicine distributed by the Punjab Institute of Cardiology (PIC), specifically ‘IsoTab’ suffered from bone marrow separation, the Advocate General of Punjab confirmed on Monday.

His conclusions were based on findings of the medico legal officer who conducted autopsy on PIC victims.

The AG Punjab said that the names of two directors of Efroze pharma had been placed in Exit Control List (ECL) on the request of the Punjab government. Meanwhile, the names of remaining Pharmaceutical Laboratories who supplied the medicines to PIC were situated in Punjab and had already been sent to the ministry of interior for placing their names in ECL.]]>
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			<title>PIC medicine: 890 people affected, Punjab government presents report to LHC</title>
			<link>https://tribune.com.pk/story/332426/pic-medicine-890-people-affected-punjab-government-presents-report-to-lhc</link>
			<comments>https://tribune.com.pk/story/332426/pic-medicine-890-people-affected-punjab-government-presents-report-to-lhc#comments</comments>
			<pubDate>Mon, 06 Feb 12 14:02:48 +0500</pubDate>
			<dc:creator>
				<![CDATA[web.desk]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332426</guid>
			<description>
				<![CDATA[Deputy heath secretary tells court that 107 people have died due to the adulterated medicine.]]>
			</description>
			<content:encoded>
				<![CDATA[A total of 890 people were affected by the adulterated Punjab Institute of Cardiology (PIC) medicine, according to the deputy health secretary who presented a report to the Lahore High Court on Monday, reported Express News.

The secretary on behalf of the Punjab government told the bench, headed by Justice Umar Ata Bandyal, that currently 330 people affected by the medicine were in critical condition, while 107 have died and 315 have been discharged from various hospitals across the province.

The bench inquired how the medicines reached the hospitals and ordered the secretary to present a report in the next hearing.

The hearing was adjourned till February 13.

Pharmacist investigating matter transferred

Pharmacist Bilal Yasin, who was investigating the matter of the PIC adulterated medicine, was transferred by the ministry of health on Monday.

Yasin had claimed that there was no record available on how the medicines were sent to various hospitals and neither was the affected batch of medicines tested from the Drug Testing Laboratory.

Meanwhile, two women lost their lives due to the drug reaction bringing the unofficial death toll to 137.

The dead include 70-year-old Bilquis Bibi who passed away at Jinnah Hospital and 59-year-old Rehana Bibi who passed away at the Services Hospital.]]>
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			<title>PIC drugs tragedy: Amidst rising toll, a new controversy brews</title>
			<link>https://tribune.com.pk/story/332134/pic-drugs-tragedy-amidst-rising-toll-a-new-controversy-brews</link>
			<comments>https://tribune.com.pk/story/332134/pic-drugs-tragedy-amidst-rising-toll-a-new-controversy-brews#comments</comments>
			<pubDate>Sun, 05 Feb 12 05:39:24 +0500</pubDate>
			<dc:creator>
				<![CDATA[ali.usman]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=332134</guid>
			<description>
				<![CDATA[YDA says it didn’t allow new MS to take charge – a claim rejected by Dr Javed.]]>
			</description>
			<content:encoded>
				<![CDATA[Controversies surrounding the Punjab Institute of Cardiology rage on, especially following the emergence of a debate over the appointment of the institute’s new medical superintendent (MS).


The Young Doctors’ Association (YDA) claimed on Saturday that it did not let Dr Muhammad Javed take charge as the new MS of the PIC.  Dr Javed, on the other hand, denied the claim and said he had, in fact, assumed charge of his office.

Meanwhile, three more people died in Lahore on Saturday after consuming adulterated medicines distributed by the PIC, increasing the unofficial death toll to 123.

The medicine – IsoTab – was recently found to have a large amount of anti-bacterial, which triggered an unknown disease in heart patients who consumed it.

With the death toll constantly rising, the Federal Investigation Agency (FIA) and the Punjab government have taken several steps to control the matter.

The young doctors said that the Punjab government had assured them of not taking action against any doctor until the findings of the judicial inquiry fixed the responsibility of deaths on a doctor from the PIC.

Dr Javed, who came to the PIC on Saturday to take charge as the new MS, had no choice but to leave. “We didn’t misbehave with Dr Javed. We just told him that he should go back to the health secretary’s office and inform him that the YDA did not let him assume charge of his new responsibilities,” Dr Amir Bandesha, the YDA office bearer of PIC, told The Express Tribune.

He said that on behalf of the Punjab government, Senator Pervaiz Rashid had assured the YDA during a meeting last Sunday that no new doctors would be appointed on the posts of those who have been suspended in connection with the drug reaction deaths. “Today, the government tried to breach its promise,” he added.

However, rejecting YDA’s claims, Dr Javed said he had assumed his new charge.

He said he would convert the PIC into a patient-friendly hospital by getting it out of the present crisis.  A health department spokesman also confirmed that Dr Javed has assumed the charge.

Published in The Express Tribune, February 5th, 2012.]]>
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			<title>Two more fall prey to lethal PIC medicine in Lahore</title>
			<link>https://tribune.com.pk/story/331831/two-more-fall-prey-to-lethal-pic-medicine-in-lahore</link>
			<comments>https://tribune.com.pk/story/331831/two-more-fall-prey-to-lethal-pic-medicine-in-lahore#comments</comments>
			<pubDate>Sat, 04 Feb 12 07:24:57 +0500</pubDate>
			<dc:creator>
				<![CDATA[web.desk]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=331831</guid>
			<description>
				<![CDATA[Unofficial death toll reaches 126.]]>
			</description>
			<content:encoded>
				<![CDATA[Two more people lost their lives in Lahore on Saturday on consuming adulterated medicines distributed at the Pakistan Institute of Cardiology (PIC), reported Express News.

The death toll reached 126 as 60-year-old Shahida, a resident of Rang Mehal, and 55-year-old Ghulam Ali, a resident of Qasur, lost their lives at the Services Hospital.

The medicine – IsoTab – was recently found to have a large amount of an anti-bacterial which triggered an unknown disease in heart patients who consumed it.

With the death toll constantly rising, the Federal Investigative Agency (FIA) and the Punjab government have taken several steps, including inquiring the medicines and sealing factories which manufactured them, to control the matter.]]>
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			<title>Off the hook: Three phrama firms get clean bill of health</title>
			<link>https://tribune.com.pk/story/331701/off-the-hook-three-phrama-firms-get-clean-bill-of-health</link>
			<comments>https://tribune.com.pk/story/331701/off-the-hook-three-phrama-firms-get-clean-bill-of-health#comments</comments>
			<pubDate>Sat, 04 Feb 12 04:51:53 +0500</pubDate>
			<dc:creator>
				<![CDATA[asad.kharal]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=331701</guid>
			<description>
				<![CDATA[FIA discharges cases against them as none of their drugs found ‘spurious’]]>
			</description>
			<content:encoded>
				<![CDATA[The Federal Investigation Agency Punjab has discharged cases against three pharmaceutical laboratories allegedly responsible for supplying contaminated medicines to the Punjab Institute of Cardiology (PIC) after they were cleared of criminal offence.

Reports received from laboratories in and outside the country have so far not declared any medicine manufactured by the three pharmaceutical firms as ‘spurious’, sources familiar with the matter revealed.

As a result, the FIA has been barred from carrying out further investigations into the pharmaceutical firms, which were suspected of supplying spurious drugs which caused the deaths of over 100 people.

The FIA has power to initiate legal action under the Drugs Act, 1976 (XXXI of 1976) in a case where drugs found are spurious, a senior member of the Joint Investigation Team (JIT) probing the matter told The Express Tribune.

According to the Drugs Act, spurious drug means “a drug which purports to be a drug but does not contain the active ingredient of that drug; or which purports to be the product of a manufacturer, place or country of whom or of which it is not truly a product; or which is imported or exported or sold or offered or exposed for sale under a particular name, while actually it is another drug; or the label of which bears the name of an individual or company purporting to be its manufacturer or producer, whereas the individual or company is fictitious or does not exist.”

During the course of investigations, it was revealed that all three suspected pharmaceutical laboratories were not found involved in any criminal offence, as lab reports did not declare any medicine spurious or injurious to health, The Express Tribune has learnt.

The FIA has decided to discharge cases earlier registered against theses pharmaceutical laboratories on charges of manufacturing as well as supplying spurious drugs to the PIC, a senior member of the probe team confirmed.

Of the three pharmaceutical laboratories, a tablet, Alfagril, of one pharmaceutical laboratory, has been declared substandard – but not spurious or injurious to health, sources said.

Earlier, a judicial magistrate sent Chief Executive of Alfalah Pharma Waseem Choudhary on a 14-day judicial remand for not renewing the licence of his company, which sold medicines to the PIC.

The FIA produced the accused before the magistrate’s court. FIA officials prayed the court that they had recovered some record of selling medicines, which had been sold to the PIC, but now neither the PIC nor the Drug Testing Laboratory were providing any record related to the accused.

(With additional reporting by Rana Yasif in Lahore)

Published in The Express Tribune, February 4th, 2012.]]>
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			<title>Shahbaz needs to step up to the plate</title>
			<link>https://tribune.com.pk/story/331604/shahbaz-needs-to-step-up-to-the-plate</link>
			<comments>https://tribune.com.pk/story/331604/shahbaz-needs-to-step-up-to-the-plate#comments</comments>
			<pubDate>Fri, 03 Feb 12 22:06:39 +0500</pubDate>
			<dc:creator>
				<![CDATA[mohammed.rizwan]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=331604</guid>
			<description>
				<![CDATA[Sharif brings up conspiracy theories at the drop of a hat.]]>
			</description>
			<content:encoded>
				<![CDATA[In a nation where the media, civil society and, to some extent, the intelligentsia lap up conspiracy theories readily, where every incident is attributed to the three As (Allah, Army and America), where an unsigned document threatens the stability of an elected government, the latest gaffe from Chief Minister Shahbaz Sharif takes the cake.

Sharif, under pressure from the Opposition, whilst brandishing a report from a UK laboratory laid the blame for the contaminated drugs being handed out at the PIC on a conspiracy hatched by some ‘aala shakhsiyat’ in Islamabad. No prizes for guessing who that would be.

Sharif brings up conspiracy theories at the drop of a hat. Remember when dengue fever was playing havoc in the province, the chief minister had hinted at a conspiracy against the Punjab.

Can a political opponent really alter the chemical composition of a drug to play games? Not a very convincing argument.

On Thursday, Leader of the Opposition Raja Riaz demanded that Sharif name the person who had hatched this conspiracy.

Will the failure of the countless schemes that have been initiated by the chief minister also be blamed on political opponents? And who is to blame for the 14 departments without ministers? Sharifs’ opponents again? To this date, the chief minister has not appointed a health minister.

On Monday, Sharif is to answer more questions about the PIC fiasco. We would like to know who contracted the drug company that supplied the contaminated drug? Why did the doctors take so long to figure out what was happening? Why does the province not have a single decent laboratory to detect contamination? Hopefully, Sharif will have answers and a clear timeline for action.

Published in The Express Tribune, February 4th, 2012.]]>
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			<title>Regulating medicines</title>
			<link>https://tribune.com.pk/story/331415/regulating-medicines</link>
			<comments>https://tribune.com.pk/story/331415/regulating-medicines#comments</comments>
			<pubDate>Fri, 03 Feb 12 17:18:05 +0500</pubDate>
			<dc:creator>
				<![CDATA[editorial]]>
			</dc:creator>
			<category><![CDATA[Editorial]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=331415</guid>
			<description>
				<![CDATA[In such cases, government should step in and help out because the idea is not to kill industry but to make it work.]]>
			</description>
			<content:encoded>
				<![CDATA[The discovery that the heart medication Isotab — manufactured by a Karachi-based company — was contaminated and had been responsible for dozens of deaths has caused understandable alarm amongst the public. Yet, we feel that had this crisis been managed better, much of what may soon become the economic fallout could have been avoided. The pharmaceutical industry in Pakistan is small, but growing at a healthy pace and even beginning to export some of its products now. The last thing they needed was a panic like this one. There had been rumours of cancelled export orders and countries reconsidering allowing Pakistani pharmaceutical exports into their markets. Pakistan’s reputation as a producer of reliable drugs is at stake. One bad batch of medicines does not mean that the whole industry is not worth saving and protecting. If we allow the present discourse to devolve into finger-pointing, we could potentially ruin what could be a strong export revenue generator for Pakistan. Each of the protagonists could have acted better. The pharmaceutical company which is now under scrutiny should have acted faster in determining what the problem was and should have recalled the entire stock of the drug as a gesture of proactive goodwill. In the pharmaceutical business, credibility is everything and worth paying for to protect. Meanwhile, the federal and Punjab governments should have acted more responsibly, instead of engaging in a blame game. They should have acted in concert to help prevent the further dissemination of the contaminated drugs.

The fact is that pharmaceutical manufacturing is a dangerous business. Accidents can and do happen and mistakes can and will be made. The most effective response is to be able to quickly determine exactly what went wrong in the manufacturing process or supply chain and fix it. This process requires the collaboration of both the manufacturer and the regulators. The US and the EU are generally good examples of this. There, incidents such as these, but on a smaller scale, have happened, but the industry wasn’t shut down. Rather, the government stepped in and helped out because the idea is not to kill the industry but to make it work and become a provider of safe and affordable medicines.

Published in The Express Tribune, February 4th, 2012.]]>
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			<title>Contaminated drugs debacle: Many a slip between the factory and the shelf</title>
			<link>https://tribune.com.pk/story/331188/contaminated-drugs-debacle-many-a-slip-between-the-factory-and-the-shelf</link>
			<comments>https://tribune.com.pk/story/331188/contaminated-drugs-debacle-many-a-slip-between-the-factory-and-the-shelf#comments</comments>
			<pubDate>Fri, 03 Feb 12 06:03:03 +0500</pubDate>
			<dc:creator>
				<![CDATA[mahnoor.sherazee]]>
			</dc:creator>
			<category><![CDATA[Sindh]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=331188</guid>
			<description>
				<![CDATA[Debacle indicative of systematic error, says PPMA chairman Muhammad Asad Khawaja while talking to The Express Tribune.]]>
			</description>
			<content:encoded>
				<![CDATA[Isotab may have been a  contaminated pill but drug manufacturers say the route from factory’s conveyor  belt to patients’ medicine cabinets is a long one – and responsibility lies all along it.


A day after Punjab Chief Minister Shahbaz Sharif revealed that a batch of Isotab tablets, meant for heart patients, had been contaminated with an anti-malarial chemical, the Pakistan Pharmaceutical Manufacturers Association (PPMA) claimed the real culprit is the lack of a drug regulatory authority.

The debacle is indicative of a systematic error, said PPMA chairman Muhammad Asad Khawaja while speaking to The Express Tribune.

Even if the company manufactured faulty medicine, what were the drug inspectors and the managers at the Punjab Institute of Cardiology doing after the drugs were distributed, he said.

Pending issue

Seven months after the Minis­try of Health was devolved under the 18th Amendment, health departments are still reeling from issues as a result of the unstructured transition. Topping the list is the lack of a drug regulatory authority (DRA) to monitor and conduct quality control checks on pharmaceutical companies and their products.

“The issue of the DRA is still with the Council of Common Interests and no decision has been taken on it as of yet,” said Sindh health secretary, Syed Hashim Raza Zaidi.

A decision may be expedited, given the contaminated drugs debacle, he said.

As a standard practice, Zaidi added, the provincial health department always sends medicines for tests at the laboratory whenever they are bought in large quantities for public sector hospitals.

Cost of panic

Panic over a batch of contaminated medicine threatens to upend a multi-million dollar industry. Economist Arshad Zaman says it poses a serious damage to “Pakistan as a brand” in the global market.

“There are over 400 [pharmaceutical] companies [in Pakistan],” said vice chairman for PPMA Tariq Ikram. “Each company produces an average of 100 products. Millions of units are produced. This is just one company and one product. Such instances happen once in a lifetime and the entire industry’s image should not be damaged because of it,” he said.

The association chairman said contaminated drugs and their recall is a global phenomenon that has affected giants like GlaxoSmithKline and Johnson &amp; Johnson.

Heparin, an anti-coagulant was recalled in March 2008 after a contaminated batch imported from China killed 81 people in the US.

Earlier, Tylenol, a popular American painkiller manufactured by Johnson &amp; Johnson killed seven in 1982 before the product was recalled across the United States.

Repercussions

But panic is spreading fast. The mounting death toll in Punjab and reports from a laboratory in London stating Efroze Pharmaceutical’s IsoTab contained high dosage of anti-malarial pyrimethamine, have led to at least five countries banning cardiology medicines from Pakistan, PPMA says.

Pakistan’s pharmaceutical industry has an estimated worth of $200 million, exports $100 million worth of medicines to over 60 countries, and an annual growth rate of around 30%, said Khawaja.

All that may be on the stake because of a single contaminated batch.

“For decades people have been taking Pakistani medicines and now one dispatch after another is being stopped,” says former PPMA chairman Kaiser Waheed. “The cancellations and bans have started but it will be six months before we can accurately quantify the impact.”

Waheed also defended the company, Efroze Pharmaceutical, which he said has been in the industry for around half a century and exports to 27 countries.

“They are a well-known family in the business. They are known as the ‘dawai walas’ because their forefathers were in the business in Calcutta before partition,” he said.

Edited by Gulraiz Khan

Published in The Express Tribune, February 3rd, 2012.]]>
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			<title>No ban on Pakistani medicines, says Sri Lanka</title>
			<link>https://tribune.com.pk/story/331173/no-ban-on-pakistani-medicines-says-sri-lanka</link>
			<comments>https://tribune.com.pk/story/331173/no-ban-on-pakistani-medicines-says-sri-lanka#comments</comments>
			<pubDate>Fri, 03 Feb 12 05:57:19 +0500</pubDate>
			<dc:creator>
				<![CDATA[jaffer.bilgrami]]>
			</dc:creator>
			<category><![CDATA[World]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=331173</guid>
			<description>
				<![CDATA[Alert warning issued to doctors, hospitals not to administer isosorbide-5-monoritrate 20 mg imported from Pakistan.]]>
			</description>
			<content:encoded>
				<![CDATA[The Sri Lankan Director General Health Services Dr UA Mendis clarified on Thursday that “so far, there is no ban on import of medicines from Pakistan.”

“An alert warning, however, has been issued to doctors and hospitals not to administer or prescribe isosorbide-5-monoritrate 20 mg imported from Pakistan,” he added.

“Presently we are carrying out a through investigation and checking the supply and stock position from the importers and stockists,” he said, adding that according to his information “no such stock is available in hospitals or drug stores.”

Earlier, head of the country’s drug regulatory authority Hemantha Beneragama had said that the isosorbide-5-mononitrate 20 mg drug manufactured in Pakistan cannot be used in Sri Lanka.

Beneragama had added that the same drug manufactured elsewhere was safe to use.

Published in The Express Tribune, February 3rd, 2012.]]>
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			<title>Sri Lanka bans import of Pakistani medicines</title>
			<link>https://tribune.com.pk/story/330774/and-the-world-reacts-sri-lanka-bans-import-of-pakistani-medicines</link>
			<comments>https://tribune.com.pk/story/330774/and-the-world-reacts-sri-lanka-bans-import-of-pakistani-medicines#comments</comments>
			<pubDate>Thu, 02 Feb 12 01:21:43 +0500</pubDate>
			<dc:creator>
				<![CDATA[zahid.gishkori]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330774</guid>
			<description>
				<![CDATA[Export of locally-manufactured medicines had surged to over $400 million over the last two years.]]>
			</description>
			<content:encoded>
				<![CDATA[Following the PIC medicine debacle, Sri Lanka has banned the import of medicines from Pakistan — a move that would badly hurt the export of locally-manufactured medicines, which had surged to over $400 million over the last two years.


The health ministry of Sri Lanka has taken the decision after over 100 people died due to alleged spurious medicines in Lahore. It was further revealed that more countries – including Vietnam, Burma, Philippines, and Yemen as well as countries from Africa and South America – are also considering reviewing their policies to import medicines from Pakistan.

Sri Lanka suspended the sale and use of Pakistani-manufactured Isosorbide Mononitrate 20 mg drug, used for chest pains, said a senior doctor of the National Cancer Institute of Sri Lanka.

“Isosorbide mononitrate, generally called ISMN, is a drug used principally in the treatment of angina pectoris in Sri Lanka,” he told The Express Tribune from Colombo. Government hospitals in Sri Lanka usually prescribe ISMN, which dilates blood vessels to reduce blood pressure, he explained.

“Our ministry took the decision for safety reasons following reports of the recent deaths from a heart-related drug in Pakistan,” he said, requesting not to be named.

Pakistan Pharmaceutical Manufacturers Association (PPMA) officials also expressed concern over the lingering of the spurious drugs issue, which could stagnate exports if the federal government does not take immediate steps to control the situation.

On the other hand, officials dealing with the issue revealed that the government was deliberating putting around 12 drugs on the import ban list. However, the final decision will be taken after taking into account the investigation reports received from abroad, added an official of the Punjab Health Ministry.

“The government should form a drug regulatory authority in pursuance of better and effective marketing strategies to improve the image and push the export figures up,” the PPMA chairman said.

Punjab Chief Minister Shahbaz Sharif’s senior advisor Senator Pervez Rashid criticised the federal government for its failure to constitute a drug regulatory authority at the centre. “An international laboratory should be built in Pakistan to test medicines,” Rashid said.

Islamabad is issuing 32 licences to pharmaceutical companies on a daily basis, the senator revealed. “So, this is the main reason which led to the use and distribution of substandard medicines.”


Published in The Express Tribune, February 2nd, 2012.]]>
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			<title>PIC medicine disaster: Isotab is the killer pill</title>
			<link>https://tribune.com.pk/story/330773/pic-medicine-disaster-isotab-is-the-killer-pill</link>
			<comments>https://tribune.com.pk/story/330773/pic-medicine-disaster-isotab-is-the-killer-pill#comments</comments>
			<pubDate>Wed, 01 Feb 12 23:12:34 +0500</pubDate>
			<dc:creator>
				<![CDATA[ali.usman]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330773</guid>
			<description>
				<![CDATA[London lab report says excess of anti-malarial chemical in drug caused deaths.]]>
			</description>
			<content:encoded>
				<![CDATA[A London laboratory has determined that Isotab, a medicine manufactured by Efroze Chemical Industries, caused the reaction that has so far cost 120 lives.

At a press conference on Wednesday, Chief Minister Shahbaz Sharif revealed that Isotab tablets, which are meant for heart patients, had been contaminated with an anti-malarial chemical, which resulted in fatalities to patients who used it daily. The medicine was given free of cost to patients of the Punjab Institute of Cardiology (PIC).

A doctor familiar with the investigation, who did not want to be named, told The Express Tribune that there were dangerous quantities of the chemical, Pyrimethamine, in Isotab.

Explaining the reaction to the body, the doctor said: “Pyrimenthamine is found in Fansidar, an anti-malarial drug. This chemical reduces folic acid, which is responsible for production of blood. Isotab is given to heart patients twice daily to lessen the burden on their heart. The chemical found in Isotab, however, was equal to 10 tablets of Fansidar, which means those who used this medicine twice a day were effectively taking 20 tablets of Fansidar, which suppressed the bone marrow, disturbed blood production, and ultimately caused death.”

The doctor said that the other four medicines under suspicion – Cardiovestin, Alfagril, Concort and Soloprin – were manufactured by lesser-known pharmaceutical companies. “We didn’t expect Isotab to be contaminated because it’s manufactured by Efroze Chemical Industries, who have around 80 registered medicines in Pakistan. We suspected the above four medicines, but Isotab has turned out to be the one with faults,” he said. He added that drug testing laboratories in Pakistan had previously cleared Isotab.

At the press conference, Shahbaz was in no mood to accept responsibility, claiming that the circulation of the faulty medicine was a conspiracy against Punjab.

“A high-ranking person in Islamabad is responsible for this,” he said, adding that official letters had been written to the federal government with these allegations. Referring to the treatment of patients, the chief minister said that folic acid was being used as an antidote.

Shahbaz also announced that the London laboratory’s report would be forwarded to the World Health Organisation.

Meanwhile, Governor Sardar Latif Khan Khosa took a different view to the chief minister. He announced that the federal government would compensate the families of those who died of the drug reaction. “This is an extreme form of criminal negligence. The Punjab government should accept its negligence. By raising fingers toward President House in Islamabad, the provincial government cannot beguile people,” the governor said.

The owner of Efroze Chemical Industries did admit on Wednesday that the batch of Isotab produced for the PIC containted Pyrimethamine. However, the owner told Express News that his factory should not be closed down, as it had been producing drugs for 35 years and exported them to over 20 countries.

Terming the disaster a ‘conspiracy’ to malign the factory’s name, the owner said that in September last year, some material was stolen from their warehouse, and this might have been used in adulterating the batch of medicines. He said that only this particular batch was spurious and that the rest of the medicines produced by the factory did not have any issues.

The Federal Investigation Agency, meanwhile, has closed the factory after inspecting the premises and meeting staff on Wednesday. The three pharmaceutical laboratories in Lahore which were originally suspected of foul play have been cleared of any criminal offence. However, a medicine called Alfagril, produced by one of the laboratories, has been declared substandard – though not spurious – a source with ties to the FIA said.

It’s obviously more serious for Isotab, which has been taken off the shelves in Pakistan and banned across the world.

(Read: Medicine crisis - who is to blame?)

(With additional reporting by Asad Kharal)

Published in The Express Tribune, February 2nd, 2012.]]>
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			<title>PIC staff, doctor, distributor arrested in contaminated medicine case</title>
			<link>https://tribune.com.pk/story/330769/pic-staff-doctor-distributor-arrested-in-contaminated-medicine-case</link>
			<comments>https://tribune.com.pk/story/330769/pic-staff-doctor-distributor-arrested-in-contaminated-medicine-case#comments</comments>
			<pubDate>Wed, 01 Feb 12 21:40:17 +0500</pubDate>
			<dc:creator>
				<![CDATA[]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330769</guid>
			<description>
				<![CDATA[Men declined having purchased IsoTab batch 093, however tampering in records, and medicine stock discovered.]]>
			</description>
			<content:encoded>
				<![CDATA[Police in Lahore has arrested six men including two doctors, and two medicine coordinators in connection with the Punjab Institute of Cardiology (PIC) contaminated medicine case, Express News reported on Wednesday.

Sources said that an investigative team took six men in to custody including two doctors on the panel of PIC medicine procurement committee, two distributors including Tariq and Musharraf, PIC store keeper Zulfiqar, and pharmacist yousuf.

The names of the two doctors arrested have not been revealed.

According to sources, the arrested men denied having bought IsoTab medicine of batch 093. However, investigations discovered that their records had been tampered. Some of the contaminated medicines too were recovered from their store.

An FIR under sections 468, 471, and 420 have been registered. Further deliberations are underway to on whether those arrested should also be charged under sections 319 and 302.]]>
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			<title>Tainted drugs: Efroze Chemicals shut down for 14 days as govt issues advisory</title>
			<link>https://tribune.com.pk/story/330594/tainted-drugs-efroze-chemicals-shut-down-for-14-days-as-govt-issues-advisory</link>
			<comments>https://tribune.com.pk/story/330594/tainted-drugs-efroze-chemicals-shut-down-for-14-days-as-govt-issues-advisory#comments</comments>
			<pubDate>Wed, 01 Feb 12 21:05:08 +0500</pubDate>
			<dc:creator>
				<![CDATA[mahnoor.sherazee]]>
			</dc:creator>
			<category><![CDATA[Sindh]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330594</guid>
			<description>
				<![CDATA[The company is being investigated for sending tainted medication with high quantities of the anti-malarial to Punjab.]]>
			</description>
			<content:encoded>
				<![CDATA[With the death toll in the Punjab due to contaminated medicines still on the rise the Sindh health department issued a notification alerting for certain suspected medicines to be removed from all public sector hospitals.


Clear instructions with the names of medicines, their dosage and batch numbers were issued after a meeting which was headed by Health Minister Dr Sagheer Ahmed on Wednesday.

The Express Tribune has learnt that some private hospitals have also issued internal communications advising practitioners not to prescribe certain medications. These private hospitals include Tabba Heart Institute.

Earlier in the day, the first decisive action in Karachi against chemical and pharmaceutical companies was taken as the FIA suspended the operations of Efroze Chemical Industries Private Limited in Korangi. Under the Drugs Act 1976, production has been suspended for 14 days and 49 kilogrammes of raw materials for the heart medication IsoTab were seized. The company is being investigated for sending tainted medication with high quantities of the anti-malarial, pyrimethamine, to the Punjab Institute of Cardiology (PIC) while one batch was sent to the Punjab Employees Social Security Hospital (PESSH).

About 9.2 million tablets or 23 batches of IsoTab produced by Efroze Chemicals were seized. Twenty-two batches of the medicine were supplied to the PIC while one batch was sent to PESSH, federal drug inspector Dr Shahid Hussain told The Express Tribune.

Crime Circle Deputy Director Akbar Baloch said several samples including IsoTab 20mg were sent to the Central Drug Testing Laboratory for verification on January 25 and 26. The Central Drug Lab is testing for the dosage of pyrimethamine in Isotab, after test results sent by the Punjab government to a laboratory in London were announced. The results for the tests from the Central Drug Lab are still awaited.

Speaking to the media after a few hours inside the factory on Wednesday, the Crime Circle’s Akbar Baloch said, “The raw materials and reports have been seized so that they cannot be tampered with.”

At the time when the FIA arrived at the factory, the senior most company representative present was senior executive supply chain manager Sabah Mohiuddin. In visible shock after FIA officials announced the 14-day lock-down Mohiuddin said, “The factory has not been sealed but production has been halted for now.” Close to 5pm, employees, most of who are on daily wages, quietly left the premises.

No arrests have been made yet as the drug inspectors first need to complete their tests and if they file a complaint report, the FIA will take action accordingly. “Arrests can only be made once the investigation is complete and the Central Drug Laboratory tests are available,” Baloch added.

Federal drug inspector Abdul Rasool Sheikh said, “Some return samples have been also taken and will be sent for testing.”

However, as an FIR was lodged in Punjab against the company, Baloch confirms that the director and CEO of Efroze Chemicals, Abdullah Feroz, and director for marketing and sales, Nadir Khan Firoz, as well as the director for technical operations, Khurram Munaf, have been put on the Exit Control List. “The interior ministry has also added Mr Mumtaz, Mr Shafi and Mr Sultan on the ECL,” Baloch said.

Speaking to Express News, Abdullah Feroz said he suspected foul play in order to malign the company. According to Feroz, the large quantities of pyrimethamine were stolen from the company in September. No FIR was filed over the incident.

The events unfolded as a follow-up to Punjab Chief Minister Shahbaz Sharif’s press conference where he announced Efroze Chemicals had been sealed. Journalists were surprised to discover, however, that work was progressing as usual on Wednesday.

Prescribing Isotab

Associate professor for Cardiology at Aga Khan University Hospital, Dr Khawar Kazmi says Efroze Chemicals is just one of the companies making the medicine Isotab. There are other brands as well. According to Kazmi, the problem is not with the actual molecule but only a particular company due to what he believes is a lack of quality control. However, he urges for other brands to be checked as well. “This event was inevitable. If it hadn’t happened now it would have certainly led to more problems.”

Cardiac surgeon at Tabba Heart Institute Dr Khalid Rasheed says IsoTab is “readily available and frequently prescribed”. However, there are many other options which may be used so there is no need for patients to panic.

Published in The Express Tribune, February 2nd, 2012.]]>
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			<title>Sindh health department cautions public about use of medicines</title>
			<link>https://tribune.com.pk/story/330550/sindh-health-department-cautions-public-about-use-of-medicines</link>
			<comments>https://tribune.com.pk/story/330550/sindh-health-department-cautions-public-about-use-of-medicines#comments</comments>
			<pubDate>Wed, 01 Feb 12 17:51:16 +0500</pubDate>
			<dc:creator>
				<![CDATA[express]]>
			</dc:creator>
			<category><![CDATA[Sindh]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330550</guid>
			<description>
				<![CDATA[Dr Sagheer Ahmed has advised the public to immediately stop using contaminated medicines, contrary to PMA statement.]]>
			</description>
			<content:encoded>
				<![CDATA[Contrary to a statement by the Pakistan Medical Association (PMA) on Wednesday about continuing the controversial medicines, the Health Department in Sindh has cautioned patients in the province on using them.

According to a notice issued by the health department on Wednesday, Sindh Health Minister Dr Sagheer Ahmed has advised the public to immediately stop using the contaminated medicines.

The medicines include, Solprin batch 535 (aspirin) 300mg, by Pharmawise Lahore Alfagril (clopidogril) 75 mg, by Alpha pharma Lahore, Cardiovastin (simvastatin) 20 mg, batch number 11E451 – 11L710 – 11L686 – 11G585, by Mega Pharmaceuticals, Atenolol 100 mg, batch number 110 by Zafa Pharmaceuticals, Corcont 5 mg, (amlopidipine by besylate) batch number 24-25-27-28 by Swiss pharma and Isotab (Isosorbide mono nitrate), batch numbers J098 – J100 – J101, by Efroze pharma Karachi.

Meanwhile the Pakistan Medical Association (PMA) Lahore appealed to patients operated at the Punjab Institute of Cardiology (PIC) to continue the use of those medicines, since a number of those medicines were required to keep their valves and stents potent and that patients should consult their doctor in case of a problem.]]>
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			</item><item>
			<title>Free medicine: PMA appeals patients to continue use of medicines</title>
			<link>https://tribune.com.pk/story/330377/free-medicine-pma-appeals-patients-to-continue-use-of-medicines</link>
			<comments>https://tribune.com.pk/story/330377/free-medicine-pma-appeals-patients-to-continue-use-of-medicines#comments</comments>
			<pubDate>Wed, 01 Feb 12 16:09:02 +0500</pubDate>
			<dc:creator>
				<![CDATA[our.correspondent]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330377</guid>
			<description>
				<![CDATA[Demands a drug regulatory body in the province, requests PM and CM Punjab to hold joint meeting in this regard.]]>
			</description>
			<content:encoded>
				<![CDATA[In the wake of contaminated medicine crises in Punjab, the Pakistan Medical Association Lahore (PMA) Lahore has appealed to patients, operated at the Punjab Institute of Cardiology (PIC), not to discontinue the medicines out of fear of a reaction.

The PMA, on Wednesday, said that a number of those medicines were required to keep their valves and stents potent and that patients should consult their doctor in case of a problem.

PMA Lahore office bearers have strongly protested on the unusual delay in the establishment a drug regulatory authority, adding that since the past 24 days, the federal and Punjab government were playing blame games instead of taking concrete steps.

The office bearers included Dr Tanveer Anwar, Dr Izhar Ahmed Chaudhry, Dr Ihsan ur Rehman, Dr Yasmin Ihsan, Dr Kamran, Dr Sabahat Habib Khan and Dr Salman Kazmi.

The association further said that besides a federal drug regulatory authority, a provincial regulatory authority was also mandatory to regulate the pharmaceutical industry, including the quality and prices of the medicines.

PMA demanded Prime Minister Yousaf Raza Gilani and Chief Minister Punjab Shahbaz Sharif to call a joint meeting for the establishment of a drug regulatory authority in the province.]]>
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			<title>Efroze Chemical Industries owner says PIC batch contaminated</title>
			<link>https://tribune.com.pk/story/330308/efroze-chemical-industries-owner-says-pic-batch-contaminated</link>
			<comments>https://tribune.com.pk/story/330308/efroze-chemical-industries-owner-says-pic-batch-contaminated#comments</comments>
			<pubDate>Wed, 01 Feb 12 10:32:48 +0500</pubDate>
			<dc:creator>
				<![CDATA[web.desk]]>
			</dc:creator>
			<category><![CDATA[Punjab]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330308</guid>
			<description>
				<![CDATA[Contra­ry to confes­sion, owner says factor­y should­n't be closed for this reason.]]>
			</description>
			<content:encoded>
				<![CDATA[Owner of Efroze Chemical Industries confessed on Wednesday that the batch of IsoTab produced for Punjab Institute of Cardiology (PIC) was tainted with Pyrimethamine, an anti-malarial.

Contrary to his confession, the owner, while speaking to Express News, said that his factory should not be closed down only for this reason as the factory had 35 years of experience in the market and that their drugs were exported to over 20 countries worldwide.

Terming it a “conspiracy” to malign the factory’s name, the owner said that last year in September, some material was stolen from their warehouse and said that it might have been used in adulterating the batch of medicines.

He said that only this particular batch was spurious and that the rest of the medicines produced by the factory did not have any issues.

The owner also said that an FIR will be lodged in this regard.

Earlier today, a team of Federal Investigation Agency along with officials of health department reached the factory.

FIA Deputy Director Akbar Baloch said that the team will go inside the factory to talk to the management and added that media was not allowed to enter the premises at the moment.

Express News' correspondent Farooq reported that there were chances that the company will be sealed after the discussion between FIA’s team and the management of Efroze Chemical Industries is ended.

Meanwhile, the Pakistan Pharmaceutical Manufacturers Association has expressed its shock at the incident. They say that a technical committee has been formed to look into the matter, and that they would be able to issue a statement tomorrow.]]>
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			<title>Medicine adulterated with large amounts of anti-malarial: Sharif</title>
			<link>https://tribune.com.pk/story/330278/medicine-adulterated-with-large-amounts-of-anti-malarial-sharif</link>
			<comments>https://tribune.com.pk/story/330278/medicine-adulterated-with-large-amounts-of-anti-malarial-sharif#comments</comments>
			<pubDate>Wed, 01 Feb 12 06:40:29 +0500</pubDate>
			<dc:creator>
				<![CDATA[sidrah.moiz]]>
			</dc:creator>
			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=330278</guid>
			<description>
				<![CDATA[CM says antido­te formul­ated, can revers­e the affect of the drug overdo­se.]]>
			</description>
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				<![CDATA[With over a hundred dead, Chief Minister Punjab Shahbaz Sharif finally revealed the cause behind the fatal drugs on Wednesday. “IsoTab was found to be adulterated with an anti-malarial.”

In a press conference held in Lahore, Sharif informed journalists that the drug – IsoTab – produced by Efroze Chemical Industries, was found to have 50mg of an anti-malaria content, which the patients were given every day.

“The dosage is 14-times greater than the prescribed dosage which is 25mg a week,” Sharif said.

He said that the Punjab government sent out samples to European labs in order to find out the cause of the deaths. “We not only sent out drug samples to European labs, but also sent human samples, including traces of bone marrow and skin.”

Sharif said an antidote was also formulated which could reverse the affect of the drug overdose. “Without wasting a second, doctors, paramedics, pharmacists and health secretary of Punjab started to work on the antidote.”

“Folinic Acid or Calcium Folinade has been found out to be the antidote, which is available in the form of injections,” said Sharif. “We have obtained this drug in large quantities and supplied it to the hospitals. And if necessary, we will even import this drug.”


He said that experts believed that this antidote will show a positive sign and will save a lot of lives. “Last night, the first dose of this antidote was given to the patients and now, the second dose is underway.”


The chief minister said that he sent out letters to the concerned officials of the federal government in this regard. “We stayed up all night long to make sure that we get a grip of the situation as soon as possible.”

“We have told them to seize the spurious drugs and get rid of them.”

Sharif said that the forensic results were also sent out to the World Health Organisation (WHO) by European labs and that it [WHO] would also do what it could in the situation.

The chief minister said that the forensic reports were submitted to the Supreme Court and the judicial commission investigating the matter. “There should be no doubts remaining now as we have cleared out everything. The matter should not be politicised.”

Sharif also called for an “unbiased” investigation in the matter.

He also informed the media that the factory in Karachi has been sealed by the inspector general of Sindh police.

On the other hand, Express News’ correspondent Aamir Farooq reported that the company has not been sealed yet. However, a team of Federal Investigation Agency along with officials of health department has reached there.

FIA Deputy Director Akbar Baloch said that the team will go inside the factory to talk to the management and added that media was not allowed to enter the premises at the moment.

Farooq reported that there were chances that the company will be sealed after the discussion between FIA’s team and the management of Efroze Chemical Industries is ended.]]>
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			<title>As death toll rises at home: PIC drugs samples sent abroad for testing</title>
			<link>https://tribune.com.pk/story/330143/as-death-toll-rises-at-home-pic-drugs-samples-sent-abroad-for-testing</link>
			<comments>https://tribune.com.pk/story/330143/as-death-toll-rises-at-home-pic-drugs-samples-sent-abroad-for-testing#comments</comments>
			<pubDate>Wed, 01 Feb 12 04:51:23 +0500</pubDate>
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				<![CDATA[ali.usman]]>
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			<category><![CDATA[Pakistan]]></category>
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				<![CDATA[Sales of Pakistani medicines plummet, causing severe damage to local industry.]]>
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				<![CDATA[As the authorities fumble to grasp what is going on, the Pakistani pharmaceutical industry is suffering severe financial losses, with claims that over two billion rupees has been lost so far.


Advocate General of Punjab Ashtar Ausaf, during a suo motu hearing of the Punjab Institute of Cardiology (PIC) free medicine case on Tuesday, told the Supreme Court that an interim report in the case will be submitted to the court on February 6.

The death toll, meanwhile, has reportedly reached 117.

Ausaf informed the court that samples of the drugs were sent out to Switzerland, Belgium and England for tests and they are awaiting results. He said that the move was necessary because there was no laboratory in Pakistan which could clearly determine the cause of the deaths by examining the samples.

On the other hand, a high-tech lab built by the Punjab government for Rs2.5 billion, with the latest equipment and highly qualified staff, has refused to conduct a chemical analysis of the body parts of three dead bodies, and referred task to an older lab, sources told The Express Tribune.

At the hearing, Ausaf added that, so far, nothing concrete has surfaced in the investigation and an autopsy of the victims’ bodies will be required to determine the actual cause of the deaths.

Heading a three-member bench, Justice Tassaduq Hussain Jillani asked the Lahore High Court inquiry tribunal to continue its probe into this issue, saying that the investigation report is inconclusive, as the people responsible for the deaths have not been specified in the report.

Justice Jillani also asked why the Federal Investigation Agency (FIA) arrested people reportedly involved in the case. The FIA officials present in the court informed him that, following the 18th Amendment, all health-related issues were transferred to the provincial governments and the FIA is authorised to arrest people who are involved in making the medicines.

Justice Jillani ordered the FIA to release the owners of pharmaceutical companies on personal bonds, which, it later emerged, the FIA did.

When Justice Saqib Nisar inquired about the steps taken by the Punjab government, Ausaf informed the court that the government had contacted the chief justice of the Lahore High Court to constitute a tribunal to investigate the case. The three-member bench also asked why Punjab Chief Minister Shahbaz Sharif had not taken any action regarding the issue.

People reluctant to use local drugs 

Pakistan’s pharmaceutical manufacturing industry has suffered losses of above Rs2.24 billion in the 15 days since the PIC disaster came to the public attention, Pakistan Pharmaceutical Manufacturer’s Association (PPMA) officials claim.

Multi-national drug companies, on the other hand, are doing a roaring trade, pocketing over Rs150 million every day, according to reports.

Health department officials have said, time and again, that the problem was with the specific batch of these medicines and other local medicines were safe to use. However, the trade of local medicines has been considerably reduced.

“The total business of pharmaceutical companies through manufacturing is estimated at around Rs200 billion annually,” PPMA Chairman Dr Riaz Ahmad told The Express Tribune.

“Recently, I had to fire some officials of my marketing team in Sri Lanka. Doctors over there are not prescribing Pakistani medicines and Indian manufacturers are going to every doctor they know or don’t know to convince him to replace Pakistani drugs with Indian drugs, as Pakistani drugs are not reliable,” he added.

“The situation in Pakistan is even worse. It took us 20 years to take the share of locally manufactured drugs to 60per cent in total consumption of medicines, and we fear now it might take us the next 10 years to maintain this,” Dr Riaz said, adding that “the media needs to play an important role in this regard. We should convey to people that Pakistani medicines are safe to use. The problem was just with a specific batch of PIC. Otherwise, hundreds of thousands of patients have been using same medicines and they are very effective.”

Meanwhile, recent investigations into the case hinted that more than 100,000 adulterated pills might have been handed out to heart patients in Lahore. The medicine, called Alfagril, had a manufacturing fault because of which the pills developed brown spots on them and consequently resulted in a disease in the bone marrow.

(With additional reporting by Asad Kharal in Lahore and Azam Khan in Islamabad)

Published in The Express Tribune, February 1st, 2012.]]>
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			<title>Free medicine: Kaira calls on Shahbaz Sharif to devolve additional portfolios</title>
			<link>https://tribune.com.pk/story/329851/free-medicine-kaira-calls-on-shahbaz-sharif-to-devolve-additional-portfolios</link>
			<comments>https://tribune.com.pk/story/329851/free-medicine-kaira-calls-on-shahbaz-sharif-to-devolve-additional-portfolios#comments</comments>
			<pubDate>Tue, 31 Jan 12 18:30:53 +0500</pubDate>
			<dc:creator>
				<![CDATA[abdul.manan]]>
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			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=329851</guid>
			<description>
				<![CDATA[Says Punjab government playing blame games, Shahbaz should take action against ill governance in the province.]]>
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				<![CDATA[Pakistan Peoples Party’s (PPP) Central Information Secretary Qamar Zaman Kaira said on Tuesday that the Punjab government was playing a blame game with the federal government in the Punjab Institute of Cardiology (PIC) scandal and that Punjab Chief Minister Shahbaz Sharif should devolve his additional portfolios.

Kaira was addressing a press conference in Lahore in a bid to share the PPP’s views on pertinent issues in the country. He lashed out at Shahbaz, that instead of playing a blame game, Shahbaz should instead devolve his additional portfolios and take concrete steps against ill governance in the province.

He added that according to the Drugs Act 1976, three provinces had expressed their consent over the establishment of a Drug Regulatory Authority but the Punjab province was yet to give its consent.

The PPP leader said that the federal government’s function was to issue licenses to pharmaceutical companies and has around 30 federal drug inspectors. Meanwhile, the Punjab government with 450 provincial drug inspectors had failed to check the contaminated medicines.

Early elections

Talking about early elections, Kaira said that the federal government would discuss early elections after presenting the fifth budget in May.

Regarding the appointment of the Election Commission of Pakistan chief, he said that as per the 18th Amendment, after consultation with the leader of the opposition, three names would be forwarded to the parliamentary committee. The committee, comprising of representatives from all political parties, would then decide upon the new commissioner.

In the event of a lack of consensus upon the names, they would separately forward three names, each, to the committee which would be later signed on by the President of Pakistan. Kaira, though, hoped that the federal government and opposition would appoint a new ECP chief with consensus.

Regarding the appointment of a defence secretary, he added that it was the Prime Minister’s prerogative and that this issue would also soon be resolved amicably. Kaira added that in the past both civilian and military personnel had occupied this post.

Memogate

Kaira called the Memogate case a useless issue which had diverted the government’s attention from the real issues facing the nation. While criticising the military with caution, he said that although it was the military’s duty to stop the May 2 incident and to probe the presence of Osama bin Laden in Abbottabad, instead, the incumbent civilian government had defended its intelligence agencies and the army on all forums.

Kaira added that prior to Memogate, the whole country was in consensus over the suspension of NATO supply routes after the Salala attack, but after this case garnered public attention, the nation got diverted, with certain quarters benefiting.

He added that the parliamentary committee on National Security and a judicial commission was probing into the case, hence the court should be allowed to decide.

Restoration of Nato supply routes

Speaking on the restoration of Nato supply routes, Kaira said that the government would soon call a joint session of the parliament in which recommendations of the committee regarding NATO supply and Pak US relations would be finalised.

Government’s achievements in the parliament

The PPP information secretary also mentioned the federal government’s achievements over the past four years, highlighting that 176 bills had been passed, six private members bills, four joint sessions, four presidential addresses to the parliament and four budgets presented in the house.

The defence committee on cabinet had convened 10 meetings, 73 Economic Coordination Committee meetings and 102 cabinet meetings.

During the press conference, Kaira said that the federal government would easily pass the 20th Amendment with two thirds majority.]]>
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			<title>PIC suo motu: With 117 dead, interim report to be submitted Feb 6</title>
			<link>https://tribune.com.pk/story/329793/pic-suo-motu-interim-report-to-be-submitted-on-feb-6-death-toll-reaches-117</link>
			<comments>https://tribune.com.pk/story/329793/pic-suo-motu-interim-report-to-be-submitted-on-feb-6-death-toll-reaches-117#comments</comments>
			<pubDate>Tue, 31 Jan 12 09:29:02 +0500</pubDate>
			<dc:creator>
				<![CDATA[asad.kharal]]>
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			<category><![CDATA[Pakistan]]></category>
			<guid isPermaLink="false">https://tribune.com.pk/?p=329793</guid>
			<description>
				<![CDATA[Owners of pharmaceutical company manufacturing fatal drug released.]]>
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				<![CDATA[Advocate General of Punjab Ashtar Ausaf, during a suo motu hearing of the Punjab Institute of Cardiology (PIC) free medicine case on Tuesday, told the Supreme Court that an interim report in the case will be submitted to the court on February 6.

Ausaf informed the court that samples of the drugs were sent out to Switzerland, Belgium and England for tests and the results are awaited.

He said that this step was taken because there was no laboratory in Pakistan which could clearly determine the cause of the deaths by examining the samples.

Ausaf told the court that so far, nothing concrete has surfaced in the investigation and an autopsy of the victims' bodies will be required to determine the actual cause of the deaths.

Heading a three-member bench, Justice Tassaduq Hussain Jillani, asked why the Federal Investigation Agency (FIA) arrested the people involved in the case.

The FIA officials present in the court informed him that after the 18th Amendment, all the health related issues were transferred to the provincial government and the FIA is supposed to arrest people who are involved in making the medicines.

Justice Jillani ordered the FIA to release the three arrested people. However, the FIA told the court that the reason of arresting MS of PIC will be explained to the court later.

When Justice Saqib Nisar inquired about the steps taken by the Punjab government, Ausaf informed the court that the government had contacted the chief justice of the Lahore High Court to constitute a tribunal to investigate the case.

The advocate general also told the court that the ministry of health in Punjab is headed by Chief Minister Shahbaz Sharif, when the court inquired.

The three-member bench observed why Sharif had not taken any action regarding the issue.

The court said that the tribunal will carry on with its investigations, but the FIA and Punjab government will have to submit their replies to the court in the next hearing scheduled for February 6.

Pharma owners released

The Federal Investigation Agency (FIA) Punjab chapter on Tuesday afternoon, on the orders of the Supreme Court has released the owners of three pharmaceutical laboratories who had been arrested after the PIC fatal medicines scandal came to light.

They had been arrested by the FIA on January 23, 2012 on charges of supplying the medicines to the Punjab institute of Cardiology (PIC) which reportedly caused the deaths of more than 100 cardiac patients following an adverse reaction to the drugs..

Earlier, on Tuesday the Punjab’s police investigation team had visited the FIA Punjab office and recorded the statements of the owners of pharmaceutical laboratories in FIA custody.

The FIA officials confirmed the release  of the owners of the all three pharmaceutical laboratories identified as Dr Tahir Azam, owner of Mega Pharmaceuticals (pvt) Ltd, Muhammad Waseem Chaudhry , owner of Alfalah Pharma (Pvt) Ltd  and  Chaudhry Nadir Khan, owner of Pharmawise Laboratories (Pvt) Ltd.

Death toll reaches 117

The death toll due to the fake medicines reached 117 on Tuesday as three people lost their lives in the Services Hospital and the Mayo Hospital.

Two of the dead were identified as 51-year-old Mumtaz Ibrahim and 55-year-old Rabia Bibi.

More than 400 people are admitted in various hospitals and are currently under treatment in Lahore.

Investigations reveal 100,000 adulterated pills handed out

Recent investigations into the PIC fake medicine case hinted on Tuesday that more than 100,000 adulterated pills might have been handed out to heart patients in Lahore.

The medicine, called Alfagril, had a manufacturing fault because of which the pills developed brown spots on them and consequently resulted in a disease in the bone marrow.

The Central Drug Laboratory issued a notice saying that one out of the seven pills that were being given out to heart patients in Lahore was substandard. The pill was identified as Alfagril.

An investigation team has been formed by the Federal Investigative Agency (FIA) to probe the case which has resulted in more than a 100 people in Punjab, while the Supreme Court has initiated a suo motu action.

Probe team visits Drug Testing Laboratory

The high-level inquiry committee constituted on the orders of Punjab Chief Minister Shahbaz Sharif visited the Drug Testing Laboratory (DTL) in Lahore to obtain updates regarding the test of the drugs.

The committee, led by DIG Major (retd) Mubasharullah, comprises DIG Elite Force Zulifqar Cheema, DIG Farooq Mazhar, SSP Zulifiqar Hameed, Incharge Investigation SP Shadman and other investigation officers.

Deputy Director DTL Jameel Anwar briefed the investigation team about receiving drug samples and the preparation of tests as well as issuing reports and analysis of the samples.]]>
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