Despite a series of well-publicised and highly visible crackdowns, the production and sale of fake, adulterated and falsely branded medical drugs continue unabated across the country.
Experts say the situation has changed very little despite several years of attempts by the Directorate General of Drug Administration (DGDA), which regulates the pharmaceutical industry, and law enforcement agencies to put down the deadly trade.
Cancelling the licences of offending factories, suing unlicensed traders and their financiers and raiding warehouses and retailers have failed to stem the supply of adulterated drugs.
Market insiders and public health experts say dodgy drug makers “manage” the administration and law enforcers with payments, in order to protect their businesses at a time when the public is willing and able to spend unprecedented amounts of money on health care.
“We have ordered regular drives to combat the appalling situation. We will listen to field-level experiences from the authorities today and will decide what to do next,” health minister Mohammed Nasim told the Dhaka Tribune over the phone.
The cost to consumers of being cheated by medicine makers is very high. Ingesting adulterated medicines can cause cancer, skin and heart diseases, experts said. Drugs that do not have the correct amount of therapeutic ingredient are ineffective, letting patients’ illnesses progress.
On August 11, a mobile court of the Directorate of Drug Administration (DDA) sealed off three homeopathic drugstores and fined two pharmacies for selling unapproved medicines and operating without licences.
On August 25, a Rapid Action Battalion mobile court sealed off a homeopathic and biochemical company in Shantibagh in the capital’s Demra area and fined its owner Tk2 lakh.
During the raid, RAB found drugs being produced from dead trees in an unhygienic environment, although the company did have a licence from the Drug Administration to produce medicines.
An anti-adulteration mobile court on August 27 fined four drug stores in Chittagong for selling expired medicines and for operating without proper licences. It also sealed two medicine shops and penalised the owners.
According to DGDA sources, there are about 250,000 drug stores across the country, of which just 120,000 are licensed.
Sources at the Bangladesh Association of Pharmaceutical Industries (BAPI) said at least 50,000 shops involved in selling adulterated medicine and food supplements, were operating without valid licences.
To respond to the glut of fake medicines in circulation, the Health Ministry will hold a meeting with representatives from the Cabinet Division, Home Ministry, Fisheries and Livestock Ministry, Science and Technology Ministry, Shipping Ministry, Directorate General of Family Planning, Directorate General of Health Services and Directorate General of Drug Administration.
Representatives of the law enforcement agencies, the customs department, the Dhaka divisional commissioner and deputy commissioner office, medicinal drug importers, manufacturers and traders will also join in the discussions on measures to combat the trade in adulterated and fake medicines.
“You cannot blame traders alone. Some manufacturers and drug administration officials are responsible this situation. Non-transparency in providing licences to pharmaceutical companies is a problem. Some companies that have licences are not really qualified for the licences,” said ABM Faroque, a professor of pharmaceutical technology at Dhaka University.
“Many companies have obtained licences despite not fulfilling the eligibility criteria … now there are more than 200 medicine manufacturers in the country,” he said.
During a visit to the country’s largest drug wholesale market near Mitford Hospital, it was found that traders face mobile court drives from time to time, but the effect on the fake drug trade is minimal.
The Mitford market is home to 2,400 wholesale and retail drug stores.
“If you want to buy a medicine from a well-known company, it costs much more than one from a rogue company. Some traders choose the cheap version because it is profitable,” said a leader of the Bangladesh Chemists’ and Druggists’ Samity (BCDS), asking not to be named.
He said traders should not be be held responsible for this because they did not manufacture the illegal product.
He said there are at least 50 drug manufacturers whose main business consists of producing and selling adulterated and fake medicines.
“They are succeeding at this trade by managing a section of BCDS leaders,” he added.
On July 10, drug administration officials, with assistance from the police conducted a day-long raid in the Mitford medicine market and seized about five trucks of adulterated medicines valued at Tk5 crore.
During the drive, a massive amount of adulterated and fake medicine, including drugs that had expired as long ago as 1993, were found in a warehouse belonging to former BCDS leader Milon Khan. He is now on the run.
When asked about it, the current BCDS general secretary, Monir Hossain, declined to comment.
Local traders said fake medicine traders must pay monthly fees to the DGDA, law enforcers, and even the BCDS, in order to run their businesses smoothly.
“The number of reported incidents are very small, but the coverage of the crime is very large. Dirty drug administration officials, law enforcers, manufacturing companies, wholesalers and retailers all benefit from the money consumers spend on adulterated medicine. The adulterated drug business betrays the public trust and profits by cheating the sick,” said ABM Faroque.
The drug administration has so far cancelled the licences of at least 25 factories for manufacturing substandard medicines, but 12 of them have resumed production of the same drugs after being granted stay orders from the High Court, officials said.
The censured manufacturers were either involved in using low cost ingredients or falsely branding their products in the packaging of high-end companies to sell their drugs at higher prices, officials said.
Weaknesses in monitoring and enforcement have allowed drug manufacturers with poor quality control records and evidence of committing fraudulent business practices to stay in business.
DGDA Director Ruhul Amin said drives were conducted regularly, but they cannot continue continuously due to a lack of manpower.
Public health experts termed the explanation a “lame excuse.”
“They are responsible for monitoring the manufacturing and marketing of these medicines. They can increase their regulatory measures, but they always say they suffer from a lack of manpower which is nothing but a lame excuse,” said former Bangladesh Medical Association president professor Rashid-e-Mahbub.
“The DGDA can prevent irregularities that imperil human lives, but the question is whether or not they are willing to do so,” he said.
Bangladesh Association of Pharmaceutical Industries (BAPI) Secretary General SM Shafiuzzaman declined to comment when asked about the involvement of manufacturers in the illegal medicine trade.
Public health expert Mahbub said: “There must be legal flaws. Otherwise how do these criminals secure bail and continue to run factories through stay orders? The government should look into legal loopholes and amend the law if necessary.”
