Ask a doctor or pharmacist before use: Another crisis waiting in the wings

Health Department officials say effective regulation impossible with so few drug inspectors.

LAHORE:

The Health Department lacks a proper system to monitor and check whether drug pharmacies are following standard operating procedures (SOPs) before selling medicines, Health Department officials said.

According to Health Department estimates, there are just 10 drug inspectors to monitor some 100,000 pharmacies in Lahore. This makes it virtually impossible for the department to monitor drug stores for any unethical or illegal practices.



“For the nine towns of Lahore, there are just 10 drug inspectors which means every town has around one drug inspector. How do you expect one inspector to monitor all the pharmacies in the area assigned to him,” said an official at the Director General (DG) of Health Office on the condition of anonymity.

“Drug inspectors are not only responsible for monitoring drug pharmacies but also keep an eye on pharmaceutical companies,” another official said on the condition of anonymity. “The raw material for cough syrups is imported from abroad. Some cough drugs are manufactured using controlled substances like ephedrine while others are manufactured using uncontrolled substances like dextromethorphan.”

“Pharmaceutical companies have to justify consumption of controlled substances. However, the consumption of uncontrolled substances is not shown. There should be a uniform policy. All substances that trigger dizziness and are used in cough syrups should be controlled substances,” he said.

Young Doctors Association Pakistan General Secretary Dr Salman Kazmi said 10 drug inspectors were not enough to check even Lohari Market, which is considered the hub of unregistered medicines.

“It is not possible for 10 drug inspectors to check pharmacies that cater to the needs of 10 million people,” he said. He added said that the existing drug inspectors were poorly trained and lacked technical knowledge.

“The government should unregister a large number of medicines, which are not available at pharmacy chains.People get medicine registered very easily and then start manufacturing them at their homes, which results in cases like the recent deaths after consuming Tyno syrup,” he said.

According to figures available with the Punjab Pharmaceutical Manufacturing Association, there are 60,000 registered medicines in Pakistan, which is much greater than the number of registered medicines in UK, USA and India.

Dr Muhammad Azhar, former chief executive of Punjab Institute of Cardiology, said the government should copy the UK and USA models. “Only medicines using the same salts should be allowed registration in Pakistan,” he said. Health Executive District Officer (EDO) Captain (retd) Inamul Haq confirmed there were 10 drug inspectors in Lahore. He said the number was too small for a city like Lahore and should be increased.

Facts and Figures 

12,000 bottles of Tyno syrup were confiscated by Health Department teams during raids on medical stores in Faisalabad

90%

of people who died after taking Tyno syrup were drug addicts, according to post-mortem reports, says Khawaja Salman Rafique, the adviser to the Punjab chief minister on health affairs

10,000

Dextromethorphan syrup bottles have been confiscated in Gujranwala and 3 people arrested for selling the syrup

Published in The Express Tribune, January 7^th, 2013.