Meghalaya is lately entrenched in the expired drugs fiasco and the report of the Government Fact Finding Committee which was constituted following the alleged disposing of expired medicines worth up to Rs 4 crores is still awaited. These medicines were also allegedly purchased under the funds of the National Health Rural Mission. On the other hand, according to surveys by the Central Drug Standard Control Organisation (CDSCO), the official regulatory authority, about 4.5 percent of the drugs in the Indian market are substandard.
One can imagine the standard of health care the people from Meghalaya are receiving under such a situation. The finding stated that: Substandard drugs work less effectively, causing disease to run a longer course and can even require a new prescription during treatment. Substandard drugs also contribute to antibacterial resistance, a threat that has doubled in the last five years in India.
Experts believe that more lucrative routinely prescribed drugs are at higher risk of failing quality standards, as this new study, published in the December 2015 Journal of Applied Pharmaceutical Science concluded after testing 32 samples of diclofenac sodium, a popular pain killer.
A second study, published in 2016 in the International Journal of Pharmacy and Pharmaceutical Sciences evaluated 46 samples of amoxicillin trihydrate, a fast-moving antibiotic, found a substandard medicine incidence of 15.62% for diclofenac sodium and 13.04% for amoxicillin trihydrate.
It is found that one in every seven Indian drugs is sub-standard yet there is no authority to check the same. This not only applies to drugs and also includes various antiseptic creams and ointment which are available both from pharmacies and other vendors.
Assistant Professor, Ahmed Nawaz Khan, Department of Pharmacy, Jaypee University of Information Technology, Solan said that to make the grade, a tablet must contain between 90 percent and 110 percent of the active ingredient named on the label, according to the Indian Pharmacopoeia Commission, an autonomous Indian health ministry institution. However, the CDSCO offers a five percent grace margin on that lower limit.
In normal practices, manufacturers of drug samples that fail CDSCO tests for ingredients, dissolution, sterility, toxicity, among others, are served notice. But due to lack of manpower and testing laboratories, most of the drugs are being pushed into the Indian market.
This data has serious implications on health in a country where 58.2 percent of the total health expenditure is an out-of-pocket cost burden on people, according to the World Health Organization, and where medicines alone account for between 70 percent and 77 percent of health spending.
India, since Independence, has achieved modest success when it comes to some aspects of public health while at the same time more people are being diagnosed with lifestyle diseases. The changing disease patterns as well as lesser expenditures on health as a percentage of total expenditures by the central government, followed by state governments raise serious concerns about the viability of meeting the healthcare challenge. In most cases, access to proper treatments is only for the affluent while the rest have to resort to self-medication or home remedies.
In such circumstances, the hospitals have their own pharmacy where the medicines and drugs sold too are not at all checked by any competent authority.
According to a study, the government has around 20,000 hospitals that serve both the rural and urban populations. Added to this is the private healthcare system that ranges from quacks to hospitals with world class facilities. The private system is fragmented and largely present within and in the vicinity of urban agglomerations. In the future, access to these facilities will have to be re-looked at. These utilize the usage of technology for low penetration areas as well as newer access options in cities.
India is also home to 270 million people living below the poverty line, this section finds it difficult to link between Water, Sanitation And Health (WASH). Almost 60 percent of the people who do not have access to toilets in the world live in India. This is a matter of grave concern. It is because this that problems of public safety and public health arise. And it is mainly this section of the population that is being exposed to such substandard drugs.
There is a total absence of health security or insurance for the individual and the poor saving habits of almost all working professionals renders it difficult to meet the immediate high cost of medical expenses especially in the private hospitals. Above this, the patients is not at all aware that they have been forced to over spend on such substandard drugs, which work less effectively, causing diseases to run a longer course and can even require a new prescription during treatment.
In case of any emergency, plague or viral diseases, there will be a total breakdown in health services in the state unless the state government streamlines the functioning of the Health Department and also checks on the quality and standard of the drugs being sold in the state and being given through private and government hospitals. It is in this light that the healthcare challenge in Meghalaya is a humongous one.