Enforced drug list

The debate on the National Medicinal Drug Policy is never ending. Full credit for this must certainly be given to the People’s Movement for the Rights of Patients (PMRP), for keeping the subject alive in the media.

I am compelled to make some comment on this campaign carried out by the PMRP, because of its repetitious nature and the impracticality of their one and only argument: Their claim that there are 9,000 varieties of medicines in Sri Lanka out of which only 352 are essential drugs. 

It is the PMRP’s view that somehow, through the National Medicinal Drug Policy, they could bring this number down from 9,000 to 352. First, I think that it must be made clear from what I know from my sources that there aren’t 9,000 drug products floating in the Sri Lankan pharmaceutical marketplace. However, there is the possibility that there are 9,000 drugs registered by the Government for importation into the country.

Whatever the number may be, what is scary in my view is that there is a body in this country which has taken it upon itself to propose a control system which is going to limit our choice when it comes to the use of pharmaceuticals. Not in any of their writings do I see the PMRP making any suggestions as to a method on how and who will control this limited drug list of 350 drug products.

When all is said and done, the manufacture and supply of pharmaceuticals is not a philanthropic effort. What it actually boils down to is business, where expensive research and development is necessary to create cutting edge pharmaceuticals and medicinal care for a world that has newer and newer diseases appearing by the drove and pandemics fast becoming a part of our lives. 

A mere 352 drug products as a choice for the varied ailments we have in this modern day seems awfully small. But I’m no medical practitioner and am not in any way qualified to take a call on this. But if one has to move from the so called 9,000 figure to the magical 352 number, I am sure there will be a great deal of pressure placed on the entire system.

I would think the forces of demand and supply within the open market system that Sri Lanka currently operates in will have a natural selection process which will marginalise drugs that are not effective, making them eventually drop out. But the question is, what will happen if somebody is actually deciding which drug is in and which is out of the list? Who would be this single deciding factor? And one can only ask, would this not open the door to a great deal of corruption?

There have been allegations by various people that the doctors of our country are ill-used by pharmaceutical companies to prescribe particular drugs. I don’t know personally whether this happens or not. But I would think that if a doctor prescribes a drug that does not work and continues to do so because of an inducement by pharmaceutical companies, he/she may not have a practice for very long. Who wants to go to a doctor who doesn’t heal you? 

The intentions of the PMRP might be honourable, but the method which they are advocating as to the supply of pharmaceuticals appears to be quite naive. If their intentions are bona fide, they need to come out and tell everyone concerned what mechanism should be put in place to control this drug list and clearly outline how it can operate in a scenario where monopolies and cartels are not created.

This is a debate that can go on forever and yet not have an answer. Having said that, it is also an important issue which has the health of a nation is at its stake. The outcome of the National Medicinal Drug Policy, as the PMRP rightly points out, places a lot of responsibility on the media. The media has an important role to play in informing policy makers and more importantly, educating the public on the various aspects and nuances of the Medicinal Drug Policy, which can greatly impact lives either positively or negatively.

Let us hope that our lawmakers will be progressive and bring in legislation that will not set us back in a vastly unknown future where predictions are that many medicinal drugs such as antibiotics would become ineffective. The survival of the human race is expected to depend on newer medicine which will be discovered by global pharmaceutical companies in the future. How Sri Lanka will be ready for this with an enforced list of 352 drugs as the PMRP suggests is anybody’s guess.

As a matter of full disclosure, I would like to place on record that I handle public relations for the Sri Lanka Chamber of Pharmaceutical Industry (SLCPI). But the views expressed in this column are mine and have no connection to the SLCPI.

(The writer, a PR consultant and head of Media360, was previously a mainstream journalist in print and electronic media. He also edits a new media website.)