A pharma famine

A moratorium on price increases which has been in place for 12 years, has driven vital drugs out of pharmacies.

Baseline medical services in Pakistan have never been good and any number of factors conspire together to produce a health system that staggers along on a good day, stumbles to a halt on a bad. A link in the medical chain is pharmaceuticals, the medicines that are prescribed either by the doctor or by the individual self-medicating, and some are in short supply. At the root of the problem is the failure to agree a pricing mechanism between the medicine manufacturers and successive governments, and this is not a new problem. Particular difficulties arise with vaccines, which are fragile, have a short shelf-life and most need to be kept at a constant temperature in a cold-chain. There is currently a shortage of an important childhood vaccination for typhoid. No vaccines are made locally and all are imported, with many becoming extremely expensive as the rupee has depreciated.



There is currently a moratorium on price increases which has been in place for 12 years. It has driven vital drugs out of pharmacies, with even over-the-counter medicines, such as Panadol, seeing shortages. Shortages inevitably create black markets and with winter almost upon us, with its harvest of respiratory and viral complaints imminent, we may be seeing more of these. Artificially depressed prices for any commodity spell trouble eventually and one only has to look at the subsidies on petroleum products to see that writ large. Raising prices to the market level and allowing retailers to make a fair profit is politically sensitive, but an interim price rise has been decided whilst the bureaucrats attempt to work out a pricing policy. Again. Theoretically, the Drug Regulatory Authority of Pakistan, created last year, fixes prices, but it has not. The size of the pharmaceutical market in Pakistan is estimated at two billion dollars annually, ill-health is endemic especially among the poor and an unresolved dispute between vested interests feeds through into the national cycle of deprivation. Talks between industry and the government have failed to produce a solution and another self-inflicted wound bleeds into the dust. And who is to blame? Why nobody; of course, it’s the others.

Published in The Express Tribune, October 21^st, 2013.

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