At one point two decades ago,the talk in Kashmir was about a leading pharmaceutical stockist who had apparently been caught selling capsules that contained flour instead of amoxicillin,an antibiotic prescribed for respiratory,abdominal and various other infections. No police case was ever registered against the stockist,but the fear generated by the reported tinkering lingered for some time,with people wary of buying any capsule or tablet with that antibiotic.
A generation later,amoxicillin is again at the centre of a spurious drugs scandal,this time more extensively investigated,in wider public focus,and in a medicine market that has grown manifold since that first scare.
Tests by the drug control department have found zero per cent amoxicillin in 625 mg tablets branded as Maximizin and supplied to the states hospitals. By the time health authorities stopped the tablets supply,thousands of fake ones had already been consumed. In Jammu alone,70,000 tablets had been delivered last year,though not all of these were consumed.
Maximizin is manufactured by Affy Parenterals Vill of Himachal Pradesh,which has issued a statement saying it is not connected to the fake drugs,and that these were supplied by an unknown company that used Maximizin labels.
The state medical health education minister and the drug controller say the distributor is Lifeline Pharmaceuticals and Surgical Company,based in Jammu. The company,which could not be independently contacted,had a contract for supply of several antibiotics to state-run hospitals. The health department has registered cases against the manufacturer as well as the distributor,apart from stopping their supplies.
When the market is flourishing,manufacturers and suppliers can provide drugs with any companys brand after getting analytical reports and the labels, said Dr Mir Mushtaq,medical health officer,who is now spearheading the campaign against the supply . We want verification of all drugs,whether supplied to hospitals or the market.
The drug control department says 25 to 30 companies have set up manufacturing units in the state. Drugs worth Rs 600 to 700 crore are consumed annually,not counting those that are sold without prescriptions. If those were to be taken into account,estimate sources connected to the pharmaceutical industry,the annual consumption would be worth Rs 1,000 to 1,200 crore.
Minister vs minister
The campaign against the racket involves government officers,doctors and separatists besides two ministers targeting each other.
Shyam Lal Sharma and Taj Mohidin,both with the Congress,recently had their portfolios changed,with Mohidin taking over medical health education,and Sharma replacing him in public health engineering. Shortly after taking over,Sharma surprised the assembly by accusing Mohidin of scandals in the PHE department. A few days later,the drug scandal broke,and Mohidin promptly said there is no record of how many people might have died after taking the spurious drugs. The drugs had been bought during Sharmas tenure as heallth minister,and protesting doctors are now seeking his resignation.
Mohidin called it a failure of the system. Orders to the tune of Rs 20 crore have been placed before the company. All these orders are on hold, he said,adding the case will be handed to the crime branch.
Sharma,meanwhile,has accused Mohidin of spreading rumours against him because he had exposed scandals in PHE. Calling for strict action against the racketeers,Sharma told The Indian Express it was he who had introduced mandatory tests on a random 10 per cent of drug supplies. He had also set up two drug test labs,and it was one of these that found the drug spurious,he said.
He said the Central Purchasing Committee had been in place for 30 years and he,as health minister,had no role in the purchase of medicines for hospitals.
The Doctors Association of Kashmir has targeted the state drug controller,Satish Gupta,for the purchase. Gupta had been part of the central purchase committee that had procured the drug. He now heads the government probe.
How can we trust a person who is himself part of the scam? said Dr Nisar-ul Hassan,the associations president. We want an independent committee.
Mohidin said he has brought this up with the government,pointing out that someone who had been part of the purchase committee should not be asked to head the probe,and demanding a special investigating team.
Gupta refused to discuss this aspect. He confirmed that a routine check and analysis had found a brand of antibiotics supplied to government hospitals contained zero quantity of antibiotics. We have written to health authorities and asked them to lift all stocks of the company, he said.
Tests and protests
The Doctors Association of Kashmir says a fake injection,Curecef 1000 containing ceftiaxone,which was tested in October 2011 and declared as containing particulate matter,remains in use and the reports were never made public. Curecef injection was declared as fake by the drug department in 2011 but was still in use in 2012 and the report had not been exposed, says a report by the association.
Last year,at GB Pant Childrens Hospital,hundreds of infants had died,leading to the suspension of its medical superintendent who had apparently been insisting that doctors prescribe one companys medicines.
The government was forced to revamp the hospital administration and also initiated a probe. The probe revealed that the doctor heading the hospital was forcing junior doctors to prescribe medicine,especially antibiotics,from a particular pharmaceutical company, said a senior doctor at G B Pant.
In the absence of proper accountability and checks,fake drugs are easily available in the market and government hospitals, the doctor said.
Doctors association president Hassan said many more drugs are lying untested in government hospitals. Hundreds of people might have died after consuming these fake drugs, he said.
Doctors have threatened an indefinite strike that will close down all hospitals.
Among separatists,Hurriyat chairman Syed Ali Shah Geelani has alleged genocide and called for a shutdown.