Can we say never again?

Working on counterfeit, sub-standard drug related challenges, I have yet to see action making drugs safer.

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 3^rd, 2012.