It is undeniable fact today that people owe drugs and medicines their good health and frequently their lives. Chemotherapy has certainly been one of the most important factors in extending our life expectancy. And medicines are an important part of health care, both to prevent and to cure diseases and illnesses. However it is true that the quality of life vastly differs in India as compared to advanced nations. In the last few months, significant media attention has been focused on the availability of fake, substandard and spurious medicines in Indian market. Some of the alarming statistics appeared in media are: 35% of the world's fake drugs are produced in India, nearly 20% of the medicines available in Indian market are either fake or substandard, one out of five strips sold is a spurious one, 16% of substandard medicines contain harmful ingredients. Incidentally many reports claim that substandard drugs come from the stable of reputed companies; and fake drugs are manufactured by underground units.
The facts reported as mentioned hitherto are very distressing and give an intriguing insight into availability of substandard medicines. Promotion of medicines by the industry through biased information is yet another menace. The access of a physician to objective information is very limited in India. Physicians are subjected to continuous pressure to prescribe drugs through industry's aggressive marketing. Though we are accustomed with consumer articles made in India of quality ranges from low to medium (including counterfeit design machines or electronics), the medicines, which are administered directly in the human body for therapy, should be of only one quality. A medicine administered to a patient of either developed or developing nations has to be same quality. Spurious and or fake drugs are not only failing to cure the intended ailments but also, sometimes, a major threat to human life. To be an effective medicine, even administered in Indian patients, it has to be of same international standard and quality. The personnel who produce, distribute or sale the medicines should have optimum knowledge and training. It is certainly true that a business of drugs must be a successful one. It is also obvious that unlike any other business scope of earning more and more money is prevailing in the drug business. However, it must be emphasized that in drug business money should not be the only motive force. On the top of it in our country where drug laws are either weak or not fully implemented, the high return spurious drug industry is bound to grow by leaps and bounds. What is ignored in business involving health and welfare of people is social responsibility. Hippocrates, almost 2400 years ago, put the practice of medicine on a high ethical plane. His thinking on ethics of medicines, concepts and precepts are embodied into now renowned Hippocratic Oath. This Oath exists from time immemorial and an essential spirit of medical field. What is needed in country is that the people responsible for production, distribution and sale of medicines should understand the importance of medicines and their actions to do well and harm. In spite of the deficiencies of regulations, laws and other rules that govern drug production and availability in the country, there remains much that can be done to improve the availability of standard drugs through practice of ethics. Apart from being a career for earning livelihood, the people should have attitude of caring and interest to alleviate suffering. They must understand their obligation to supply medicines for right purposes only. Socrates, the Greek philosopher, advocated ethics as being "governed by principles of universal validity, so that what was good was good for all, and what was my neighbour's duty was my duty also". Recently, I came across a quote from a poster at a railway station, "When there is no law, there is consciousness". In relation to drugs and their availability for care of sufferers, no moral could offer better than the quote. Today the only way to make standard drugs available for citizen is the true adherence to moral and ethical principles. Otherwise people may follow the advice of Dr. Bidhan Chandra Roy, former Chief Minister of West Bengal and well known physician, was once reportedly said to his patients, "You have to go to doctor because doctor has to survive; you have to buy medicines also against prescription of doctor because the medicine shop owner has to survive; and while crossing the Hooghly river your should throw the medicines deep in the river because you have to survive".
-- The author is Selection Grade Lecturer in Pharmacy Annamalai University, Annamalainagar, Tamil Nadu