The issue of Adverse Drug Reactions (ADR) is more of an urban issue for a developing country like India, which is still struggling to ensure adequate supply of essential medicines to majority of its population, said Dr B Ekbal, renowned health activist and National Convener of the Jan Swasthya Abhiyan (JSA), the Indian arm of the People's Health Movement.

In an exclusive interview to Pharmabiz at Kottayam in Kerala, last week, he noted the country is yet to seriously consider ADRs as a serious concern related to health of its public. Many of the states lack adequate public or private healthcare infrastructure to ensure adequate availability of medicines, mainly among the rural public. Right to Health is not even guaranteed by our constitution and establishment of a comprehensive primary health care infrastructure is still a dream for India. In this context, a country like India should regard ADR as an issue associated with urban healthcare.

The NGOs working in the field are yet to seriously take up ADR as an issue, considering other major issues plagued with our health care system that promotes the interests of corporate healthcare structure and ignoring the fundamental problems associated with our public healthcare infrastructure. Though the issue of ADR is seriously discussed among medico-friends circles, the reach of such NGOs are limited to make it an issue among the public and decision makers. Unlike most of the old generation doctors, the new breed of doctors show less interest in social issues like ADRs, noted Ekbal, also former vice chancellor of the Kerala University.

In Kerala, the Government had tried to bring in an ADR monitoring mechanism during 1996, and had spent about Rs One crore. However, the system failed to take off, said Ekbal, who was then the state planning board member, and added he was in the process of writing a book 'problem drugs and essential drugs'.

Dr Ekbal noted that 90 per cent of the R&D expenditure for developing new molecules is for developing drugs for the developed world. Out of the 1223 novel molecules patented in the last 25 years, only 13 are helpful for the developing nations like India, experts have pointed out, noted Ekbal.

JSA has set up two committees like the All India drug Action Network and the National Campaign Committee on Drugs, to look exclusively into the issues related to drugs. JSA played a crucial role in suggesting comprehensive changes to the recently announced Rural Health Mission, said Ekbal.

The Jan Swasthya Abhiyan is the Indian circle of the People's Health Movement, a worldwide movement to establish health and equitable development as top priorities through comprehensive primary health care and action on the social determinants of health. About 18 networks of 1000 odd NGOs are working in co-ordination with JSA.