A tragic story as we commemorate the death anniversary of Prof. Senaka Bibile
inister Maithripala Sirisena, who initially made a genuine effort to introduce the NMDP in line with WHO ratified Professor Senaka Bibile’s proposals, recently presented a draft bill in a total deviation from the Bibile proposals. The World Health Assembly at its sittings in Geneva in May 1982, acknowledged Prof Bibile’s contribution widely and they seriously discussed the possibility of using the formula as a model in rationalizing the supplying systems in developing countries. Subsequently it was successfully launched in 37 third-world nations.
The People’s Movement for the Rights of Patients [PMRM] recently issued a statement condemning the proposed draft of the Health Ministry, and we have no alternative but to believe the pharmaceutical and health watchdog, PMRM, that this hoax-pas is nothing but a draft prepared by the Mafia itself. The miscreants succeed under public ignorance on the extremely harmful effects of the superfluous drugs they consume;loss of foreign exchange in terms of billions and also on the exceptional rewards that would befall the nation through planned restructure.
"They, in most instances are either misguided, ill-advised or tricked by the trader. Half of the practitioners fall into this category, while the other ‘mischievous’ half are lured into it by the unscrupulous marketer, who doles out lucrative ‘santhosams’, ranging from five-star family holidays, local or foreign, sponsorships of medical studies for their children, handsome monthly remuneration packages running into hundreds of thousands and many more in return for ‘prescription-habits’ spelled out by them"
Ms Margret Hamburg - Commissioner, US Food and Drug Administration, addressing the Annual Conference sponsored by WHO on December 10, 2013 said,“It is sad that we live in a world in which some ‘criminals’ are willing to maximize profits by placing poison in infant formula, and medically necessary drugs. It is a reality we must face. And more importantly it is a reality that we must become more proactive in dealing with.” - ‘Partnership for Safe Medicine’
History of NMDP
Responding to a call in 1966, the then pharmacologist and the Dean of Peradeniya University’s Medical Faculty, Prof Senaka Bibile 1920 –‘77, recommended a system called, ‘Ceylon Hospital Formulary’, where 600 drugs were selected under their Generic names for exclusive use, but it never saw the light of day. Again in the 1970s, during the foreign exchange crises, the then Health Minister appointed a committee headed by Prof Bibile to address the issues of sky-rocketing drug prices, which marked the birth and development of a National Policy with drastic changes. This policy, a viable low cost with no adverse change in the efficacy of a drug, guaranteed a rationalized structure for manufacture, importation and marketing system, was successfully launched on an experimental basis. The 630 drugs selected under generic names by the National Formulary Committee (NFC) were provided with literature to the medical profession, indicating the therapeutic values and efficacy of the Generics in place of unlimited high cost brands, which was abruptly abandoned under the open economic policies of the JRJ Government in 1978.
The third attempt
The UPFA, in 2005, vowed to implement NMDP based on Professor Bibile’s, which was accepted in principle by the Cabinet in 2007 on the advice of a committee headed by the Regional Advisor to WHO, on Essential Medicines, Prof. KrishanthaWeerasooriya (Pharmocology). A National Standing Committee (NSC) was formed, that included representatives of ‘People’s Movement for Rights of Patients’, as well. The purpose was to monitor the progress and quickly expedite proposals. The Cabinet gave its nod and the NSC was entrusted with the task of co-operating with the Legal Draftsman for ensuring new legislation being drafted for a National medicinal Drugs Bill.
After a lapse of four years, Minister Maithripala Sirisena addressing a workshop on registration of drugs held on January 15, 2011, said that his Ministry was a bottomless pit of corruption; His dedication for the cause was amply demonstrated when he resolved to implement the NMDP,which had been delayed by years,before relinquishing office as Health Minister and cut the drug cost by 2/3.However, The papers were shuttling between Hulftdorf and Deans Road for a few years, like in a game of Badminton played on a Nursery Courts by ‘kids’; the file going missing a couple of times and exchange of fresh drafts, re-doing and repeating the process, prompting the Minister to declare, “Don’t ask me, I do not know when”, in reply to a scribe.
Corrupt practices by ‘Big Pharma’
The unique feature of pharmaceutical marketing is that the ultimate consumer or the ‘customer’ for a product, is not the patient who pays for it, but the medical pracitioner who prescribes it. They, in most instances are either misguided, ill-advised or tricked by the trader. Half of the practitioners fall into this category, while the other ‘mischievous’ half are lured into it by the unscrupulous marketer, who doles out lucrative ‘santhosams’, ranging from five-star family holidays, local or foreign, sponsorships of medical studies for their children, handsome monthly remuneration packages running into hundreds of thousands and many more in return for ‘prescription-habits’ spelled out by them. This process compels the poor patients not only to pay a high price for a poor quality superfluous product, but also bear the risk of exposing their physical organs to a heap of chemicals with numerous side-effects.
The true nature of the Big Pharma, their deceitful activities and the strength of the industry in terms of assets and income, which lies a close second to the Arms trade hasn’t received its deserved exposure. Wall Street statistics revealed that out of 500 Fortune companies, eleven Pharma giants in US made higher returns than the rest of the 489 firms together; $65 billion in 2010, compared to $52 billion by the rest in the same year. The multinational industry uses its wealth and power to neutralise every institution that stands in its way; they spread their tentacles to reach, invade, grasp and bring under their command, individuals involved in managing institutions, dealing with teaching, manufacturing, research, importing, testing and registering, quality guaranteeing, distributing, prescribing and dispensing of medicinal drugs in both the state and the corporate sectors. They cover a substantial section of the administrative, academic, legal, bureaucratic, political and every other contractible official in the field, attracting them into their payroll. The ‘Big Pharma’, facing serious consequences in promoting high-priced substandard products in their own regions, have chosen safe sanctuaries in developing nations, ‘complete’ with weak ineffective regulations and people with highly prejudiced minds that accept anything Western. It is a matter of naming a financier as local importer/distributor; while they plant their men to handle the tasks under the disguise of ‘health services in third world’.
Shocking revelations by world’s top medical Authors
Medical journalists, Dr Marcia Angell, and Jerome P Kasirir, both former chief editors, New England Journal of Medicine, and Ms Alison Bass, an award-winning investigative journalist, who covers Medicine for prestigious international media have published volumes of bestsellers, including, ‘The Truth about Drug Companies, How they deceive Us’ by Dr Angell and ‘Side Effects’, by Bass; they deal with the ‘crimes’ committed by Pharmaceuticals Mafia in US and Europe. Dr Marcia in her decades of involvement with the industry observes how the ‘Big Pharma’ shifted from their honourable duty of discovering and developing useful drugs, to disgraceful marketing methods. She reveals their strategies in gaining influence over medical research, education and doctors prescribing habits; and all myths related to so-called high spending on research and on their strategy for using publicly financed institutions for their ‘research’ and more, the grievous rigging on clinical trials to make their drugs look better. She provides details about bribing legal authorities for obtaining specially extended patent rights for a product, and depriving a competitor from ‘spoiling’ his lucrative market. She covers several areas of corruption and cheating of doctors, saying, “With profits soaring, the giants brazenly use their funds to push their agenda through US Congress, the FDA (Food and Drugs Authority US, the controlling arm), and academic medical centres”.
"‘Big Pharma’, or the transnational pharmaceuticals industry, is run by the second most powerful and vicious mafia in the western corporate world; it is a business of trillions of dollars and billions in deals. Through a network of agents, they target the lucrative markets in the third world, buying over segments of the Medical profession;men in certain Health and Legal authorities and even top politicians."
Dr Angell uses her experience and first-hand knowledge gained during her tenure as Editor in Chief of The New England Journal of Medicine on the awful practices of the industry, their shifting from the original sacred mission of researching for useful new molecules and instead changes to vast marketing devices. She explains in detail their strategies in gaining influence over medical research. In her hard-hitting text, she exposes the pharmaceutical mafia proposing quick action. Dr Angell scotches the claim that high prices are due to huge disbursement on research and development, saying drug giants divert large sums to marketing of dubious brands and use profits for pushing their programme through Legislature, and other state authorities as FDA and also for advertising purposes. She observes that most of the research and development work is done at university affiliated hospitals at state cost. The so-called ‘new’ products, she says, are nothing but ‘me-too’ products or slightly altered old products. A New York Times review on her book, says, “The publication is a searing indictment of an industry that has got out of control”
The writer has
40 years corporate experience including in the pharmaceutical industry.