New investigations reveal an estimated US $150 million worth of spurious drugs are posing a risk to public health at Bangladesh. In its annual testing of 5000 drug samples this year, the Public Health and Drug Testing Laboratory (PHDTL) detected 300 drugs that are either counterfeit or of very poor quality.
Significantly, these include many popular antibiotics and lifesaving drugs. Jolted into action, the health ministry's Drug Administration authorities have launched a drive against illegal and fake drug vendors in the country. Preliminary findings reveal Bangladesh boasts a whopping 80,000 unlicensed drugstores.
Drug administration officials express their helplessness in combating the menace,"There are so many illegal operators that we cannot cope. Our 25 branches across the country are staffed with just 40 drug superintendents and inspectors. We act when we get specific complaints. But this set up is hopelessly inadequate."
They point out that smuggled drugs are the biggest threat, as this is a grey area which is totally unmonitored. In the absence of quality controls, any dishonest importer can smuggle in fake drugs at a takeaway price and sell them at a higher price, experts remark. The rampant growth of contraband drugs is blamed on the poor quality of health services and cutthroat competition between drug manufacturers. The 100,000 strong industry produces drugs worth over US $500 million.
Worse, the acute shortage of doctors and clinics in rural areas forces patients to purchase off-the-counter drugs sans a prescription. This helps fake drug vendors to thrive, stresses a pharmaceutical industry executive. A large percentage of patients also travel to neighboring India for treatment, returning with prescriptions of Indian drugs.
To cater to them, dozens of unauthorized pharmaceutical establishments have mushroomed on the Bangladesh border. These units either smuggle in Indian drugs or manufacture fake ones that threaten the lives of thousands of patients, experts observe. Although doctors warn these drugs could be causing deaths, no survey has so far been conducted to assess their negative impact on public health. Recently, the Drug Testing Laboratory found that a popular drug used for strokes and brain hemorrhages - Cavinton - was being marketed minus its main chemical ingredients. "It is obvious that patients who used this counterfeit drug have either died or suffered an ordeal," they say.
Ironically as the Bangladesh Pharmaceutical Industries Association remarks, "The presence of fake and illegal drugs in Bangladesh is itself surprising because we manufacture over 96 per cent of our requirements and even export drugs."
The value of fake and contraband drugs flooding the market is estimated to be between US $100 million and $150 million. According to him, these drugs are produced in hundreds of fly-by-night drug factories functioning along the borders of Bangladesh, India, Pakistan, China and Thailand.
Paradoxically though, the Chemist and Druggist Association points out, the pharmaceutical industry is Bangladesh's second largest foreign exchange earner, boasting exports to 52 countries. The industry comprises over 800 drug-manufacturing companies, 230 of which manufacture allopathic drugs, 255 producing traditional herbal drugs, 300 engaged in the manufacture of modern herbal drugs and 80 homeopathic drug producing outlets.
It alleges that apart from some three dozen leading allopathic drug manufacturers, the rest are involved in the production of fake and low quality drugs. The forum terms this cannibalistic marketing of competing companies. "Due to its high returns, businessmen with no commitment to health services have started investing in the pharmaceutical sector. Their companies thrive on faking popular brands and manufacturing drugs sans authentic ingredients. The low prices help their drugs to sell," it says.
Many companies manufacture fake post-operative antibiotics like cephradine and hydrocortisone. Fungus-coated saline fluids and used syringes are also commonly found. In addition, most drug manufacturers lack suitable storage facilities and enclose tablets and capsules in such low quality foil that it is impossible for them to retain their potency. Health ministry says the local pharmaceutical industry meets nearly 96 percent of the country's drug demands. According to the ministry, it has ordered a crackdown on illegal drug networks in the country. "We are preparing to sue some 15 illegal and fake drug vendors in the capital Dhaka. We are currently inspecting other towns and cities as well."