Spurious Drug Deaths of 100 Pakistanis- Zardari and Shahbaz Shariff Are Responsible

Integrity Indicators: Pakistan

2010

 

Overall Rating: Weak (68 of 100) 

Legal Framework: 91 of 100

Actual Implementation: 47 of 100

Implementation Gap: (45)

Source: Global Integrity Report 2010 *

Every educated Pakistani knows that there are “No. 1” and “No.2.”  The No.1 medicaments are for the wealthy or those who can afford, No.2 medicaments are for the 180 million “have-nots”
Pakistan’s Drug Industry is steeped in corruption, kick-backs, and malpractices.  Drug Manufacturers buy sub-standard low potency drug substances (raw materials) from dubious manufacturers in China and Korea. They combine them with off-specification and expired pharmaceutical binders, disintegrants, and diluents. Active drug chemicals and manufactured drug products are stored under fluctuating temperature and humidity conditions in warehouses, which could be better used as cattle sheds.  As a result, unstable drug products end-up being sold to government run pharmacy systems like PIC.
In Pakistan there are no Registered Pharmacists, any quack can set-up a Pharmacy Store.  Pakistan has a licensing system or  Registered Medical Practitioners (RMPs), which is a fig leaf provided to quacks to dispense medicine.  The qualifications are based on previous work experience in a pharmacy, hospital, herbal store, homeopathy, or dispensary. But, the main qualifier are bribes to the health department, fake degrees from diploma mills producing pharmacy degrees, pre-medical education, or just the right connections in the government.
One can buy any drug in Pakistan without a prescription, with few exceptions like Valium or drugs containing narcotics like codeine or opiates . Drug stores are generally congregated in the same area, so there is fierce price competition, and quality suffers.
Zardari, Gilani, and their  70 Cabinet Ministers buy their medicines in Dubai, US, and UK. They care two hoots if Pakistani people’s health goes to hell in a hand basket.  The Provincial Chief Minister, a scion of a Industral Empire, Shahbaz Shariff, carries the portfolio of the Minister of Health in Punjab, along with twenty others.  This control freak does not want any one else to share power, except his less mentally endowed brother, Nawaz Shariff. The rest of Punjab is ruled by the Kashmiri Biradari, whose progeny are the Shariff brothers.  They live in lavish lifestyles, even to the extent of world class highways leading to their lavish farms.  Corruption does nothing in Pakistan, except bring death of the lowest economic strata of society, the same malfeaseance pervades whole of South Asian, including India, Bengladesh, Burma, and to a lesser extent Sri Lanka.
Therefore, the responsibility for deaths of 100 Pakistanis lie at the door of Zardari and Shahbaz Shariff.  these happened on their watch, and as President Truman used to say, “the buck stops here.”
American Association of Pakistani Pharmaceutical Scientists (AAPPS) had offered several times to help guide Pakistan Drug Control Authority to implement ICH Guidelines and Good Manufacturing Practices (GMPs), but to no avail.  AAPPS comprises US Pharmaceutical scientists of Pakistani background, who have several hundred years of combined experience in drug development and manufacturing.  The only reason for stone walling by Pakistan Drug Manufacturers and the lack of support from the Federal and Provincial Governments is that industry profit margins will be reduced, Kick backs of millions of rupees or even dollars to Drug Controllers and Inspectors will vanish, if they implement  and comply with Globally Accepted Standards of Drug  Manufacturing. The Drug Czars are  bureaucrats, who sit in plush offices in Islamabad.  They hire drug inspectors, after receiving huge payments from the potential candidates. Getting a job as a drug inspector in Pakistan is like discovering a gold mine, kickbacks can range from thousands to millions of rupees. On 5 January, 2010, a drug inspector revealed the state corruption in Pakistan.

5 January 2010

Drug inspector reveals state corruption in Pakistan

A drug inspector in Pakistan has spilled the beans on corruption within the state department which is fuelling the trade in fake medicines.

IPN has long argued that state corruption and weak rule of law are leading factors in the dissemination of fakes.

The inspector revealed that cases often sit in the courts for up to a decade, while the criminals keep operating, or simply move elsewhere to escape conviction.

“Vested interests” in the government are blamed for deliberately stifling justice.

“Due to the vested interests of a few notorious people at the QCB [Quality Control Board], these cases are still pending and have been put off for special meetings — which may or may not take place,” added a police official in Karachi.

Meanwhile the inspector said: “Piles of cases have been filed in the Sindh Drugs Court, but all of it seems in vain as the court is busy dealing with cases that had been registered nine or 10 years ago”.

Another senior official at the department revealed that honest inspectors have been moved away from their work with no justification, policies which “highlighted that corruption that is rampant in the department”.

“The department has become a den for money makers and criminals, where good performances at work can be brought against you,” he said.

 

PIC free medicine: As deaths soar to 100, authorities still clueless

Published: January 25, 2012

Heart patients and their family members queue for their prescription medication from a pharmacy at the Punjab Institute of Cardiology in Lahore. PHOTO: AFP

LAHORE/KARACHI:

While the death toll of Punjab Institute of Cardiology (PIC) patients continues to rise, the federal government has sent samples of the suspected medicines to the Central Drug Testing Laboratory (CDTL) in Karachi for further investigation.

None of the eight different committees constituted by the Punjab government has so far prepared a satisfactory or comprehensive report probing the reasons why the PIC’s free medicine has now claimed over 100 lives. More damage is expected, as the total number of patients who might be at risk after taking free medicine from the hospital is about 46,000.

Dr Javed Akram, the principal of Allama Iqbal Medical College and head of a 22-member committee investigating the incident, had vowed to submit the report investigating the cause of the so-far-mystery disease within 48 hours, but has still to do so.

“Tests and investigations are under way and we are working on it,” Dr Akram told The Express Tribune on Tuesday. Dr Akram, however, feared more deaths, saying the death toll could reach an alarming figure of 100 to 150. He said his team had asked the pharmaceutical companies to provide a record of their medicine.

Chief Minister Shahbaz Sharif also visited Jinnah Hospital and told reporters he would take ‘stern action’ against those responsible. The CM also announced Rs500,000 in compensation for each of the victims’ families.

Sharif said the investigation was being carried out and the culprits would be brought to task soon. However, he did not give a timeframe for completion of the probe.

In Karachi, meanwhile, Dr Obaid Ali, analyst at the CDTL, confirmed he had received samples of the three drugs which were given to cardiac patients at the Punjab Institute of Cardiology (PIC). It is believed that one of the drugs, given to heart patients at the PIC, caused bone marrow suppression and aplastic anemia, resulting in the deaths of patients within a few days. Heart patients reached the hospitals with complains of non-stop bleeding from different parts of the body and dark spots all over.

Local experts in Karachi wondered how a medicine produced for the treatment of cardiac diseases could affect bone marrow.

Dr Tahir Shamsi, the medical director of the National Institute of Blood Disease & Bone Marrow Transplantation (NIBD), a pioneer of bone marrow transplantation in the country, said that the ill-effect caused by the tablets is still a mystery, because ingredients used in medicines for the treatment of cardiac illnesses do not contain generic drugs that cause bone marrow suppression.

Law enforcement has also been busy. The Federal Investigation Agency (FIA) seized a huge quantity of the suspected medicines during a raid on the warehouse of Pharmawise Lab (PVT) Limited, which included 29,400 tablets of one of the drugs, The Express Tribune has learned.

The investigation has revealed that three more pharmaceutical laboratories which supplied the suspected medicines to the PIC are situated in Karachi and the owners of these pharmaceuticals are likely to be arrested shortly by the FIA Sindh chapter, sources at the FIA further revealed.

A protest was held outside the PIC on Tuesday by relatives of patients who died of the mysterious disease, as well as those who are not now receiving sufficient medicines for free from the PIC since the scandal broke.

Muhammad Asghar, whose father died of the mysterious disease, said his father took medicines from the PIC and a week ago fell ill. “Bleeding started through vomiting and urination and caused his death,” he said.

Ali, who lives near MAO College, said his father and mother both were heart patients. “My father died after using medicines given by the PIC and now my mother isn’t taking any medicines. She says she wants to go to her husband and die. Our whole family has scattered and I have no idea what to do.”

Commenting on the possibility of the medicine reaching Karachi, the director of the National Institute of Cardiovascular Diseases (NICVD), Prof Dr Khan Shah Zaman, said that doctors are aware of the problem and have already taken preventive measures.

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