PART - II
The WHO estimated in 2017 that one-tenth of medicines sold in low- and middle-income countries were thought to be substandard or falsified. Independent modeling studies based on those numbers indicate that this could result in as many as 285,000 children dying every year from malaria or pneumonia. The W.H.O. has not released more recent numbers, and there is limited data on exactly how much of this comes from India. Though there are stringent laws to check this menace, yet the consumers are required to play pro-active role in protecting themselves and to help in reporting about various forms of fake/counterfeit drugs and other unwholesome regulated products available in market. These include drugs with no active ingredient(s) or drugs containing only lactose or even chalk in tablets or olive oil in capsules.
Others are drugs with insufficient active ingredients such as xxxx tablets containing 50 mg of the active ingredient instead of200mg, others are drugs with active ingredient(s) that are different from what is stated on the package such as Paracetamol tablets packaged and labeled as (xxxxx, yyyyy and zzzzz combination).There are also cloned drugs with the same quantity of active ingredients as the original drug. Cloning is hiding behind a fast moving registered product to rake up profits without the associated liabilities and it is solely driven by financial motives. What these fraudsters fail to understand is that minimal effective blood concentration, which determines the efficacy of the drug, is not only dependent on the quantity of active ingredient, but also on the quality, excipients, and formulation techniques. The big question, however, is: who takes responsibility when there are adverse effects of cloned drugs? Unfortunately, the Doctor is the target.
Fast moving cosmetics, food and drinks are also massively cloned. Others are drugs without the full name and address of the manufacturer, expired drugs or drugs without expiry dates, toxic herbal preparations mixed with orthodox medicine, and contaminated infusions and injectables. Other forms of substandard/unwholesome products include syringes with poor calibrations or blunt to semi-blunt tips, contaminated and/or pyrogenic syringes, needles, surgical blades, blood bags and infusion sets, non-sterile gloves, sutures and condoms, expired products and those products without expiry dates or best before dates, or relabelled with the intention of extending their shelf life, and contaminated chemicals.
Still others include food and drinks contaminated with bacteria, heavy metals, trace metals, radioactive materials, and banned chemicals, or those containing unapproved sweeteners, colours, flavours and other additives, or others with poor quality or internationally acceptable packaging. It is difficult to ascertain a precise effect of a spurious drug on the health of a person for the following reasons: a) It is not known at the time of consumption of medicine that it is a spurious drug.
Therefore, if the drug is not effective a patient usually thinks that the diagnosis is wrong and either he consults another physician or ends up having a series of diagnostic tests including blood, x-rays, ultrasound, CT scan, MRI etc. How effective is quality assurance and vigilance resulting in an increased medical expenses, mental agony and absence from work or studies. (b) If there are certain toxic effects of the medicine then it is usually assigned to an allergic reaction of the medicine and the physician might change the medicine. The toxic medicine is then completely forgotten and is not pursued anyfuther. (c). If the medicine is fatal then usually the death is assigned to the disease or the negligence of a doctor or the hospital Even when spurious drugs do not endanger life they can leave the patient seriously ill and those with inadequate potency can induce drug resistant bacteria i.e., they will not respond even when right medicine in right dosage is given.
All people deserve safe food, and medicines. We toil day and night for what? For that two morsel of wholesome nutritive food and safe Health. And if at the end of the day we are not sure of what we eat as food and medicine, then what are we toiling for? What can be done to check that? The only way to protect yourself and your child from this social evil and health hazard is by getting proper safety regulations for food, medicine and beverages in place and raising public awareness.
(Author is Certified Healthcare Quality professional on healthcare Quality improvement and Safety Standards. Feedback: email@example.com)