The World Health Organisation (WHO) has asked the Union chemicals ministry to make the proposed generic drug stores project a 'health initiative', rather than an industry initiative. It has also asked the government to start the project, which is aiming to provide affordable medicines to the poor sections of the society, with a simple list of oral preparations of around 70 to 100 medicines in the first phase.
"This initiative should be seen as a 'health initiative' and therefore, the crucial importance of the ministry of health and family welfare. It should not be seen as an industry effort to provide medicines. This would make the prescribers (who are the key actors in this) be suspicious," WHO in its draft concept paper on generic drug stores said.
WHO also suggested to the government to start the project with around 70-100 medicines in the first phase. "While this may look a small number for the large population of India, it must be remembered that the majority of health problems could be dealt with by less than 100 drugs globally."
As per the proposal of the union chemicals ministry, over 300 drugs in 16 therapeutic areas will be made available through these generic stores in the first phase of this ambitious project.
WHO said that the list of drugs seems to serve a dual purpose of promoting medicines that are being manufactured and may also be useful in health. Unfortunately, such dual purpose lists tend to get ignored as there is no clear focus. If the objective is to provide affordable generic medicines relevant to healthcare in India, the one and only focus should be 'health' rather than an industrial component. Therefore, all decisions on which drug should be on the list should be made on health grounds. Profits can be made from generic medicines useful to health if this is a large enough market, this initiative will create that market.
Giving an example in the duplicates and redundancies in the proposed list of drugs of the ministry, WHO said that in the section for drugs for nausea and vomiting, cinnarazine, domperidone, metoclopramide and ondansetron have been listed. Of these, two can easily be excluded. Cinnarazine has no particular value and can be covered by both domperidone and metoclopramide. Ondansetron is used for highly specialised purposes such as vomiting after cancer chemotherapy and should not be included in this list. In addition, there are very highly specialised drugs such as erythropoietin beta which would need to be used only in very specialised hospitals.