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.