E-drug: Multinational Pharmaceutical Companies in Pakistan
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[Note from moderator: this long sumission contained 3 different topics:
1. a drug prices discussion (which belongs to E-drug)
2. a debate whether Hepatitis-B vaccine is safe (which belongs to
INDICES)
3. a description of a sexual harassment case (which has been censored as
E-drug is not the right forum to discuss such items)
Individual E-drug subscribers who want this part can send an email
to the author directly: Zeba Ali at email <zeba@cyber.net.pk>
Wilbert Bannenberg. co-moderator E-drug
Email: WilbertBannenberg@compuserve.com]
The pharmaceutical multinationals in Pakistan are putting pressure on
the Health Ministry to increase medicine prices (as though they were not
high enough already). The Director General of Health, Prof. Ghayur H. Ayub
told APP (Dawn newspaper 11 October, 1998) that the Pharma Bureau and
Pakistan Pharmaceutical Manufacturers Association representatives had a
number of meetings with the health minister on the issue. "They pressed for
increase on the ground of devaluation of the currency, enhancement in
customs and different taxes which was creating enormous problems for the
manufactures," he explained. He also mentioned that the Pharma Bureau
and PPMA also met Hafiz Pasha, Prime Minister's Adviser on Finance and
raised the issue of "rupee devaluation, raw material price hike in
international markets and different duties which necessitated the increase
in drug prices."
This price hike campaign also comprises 'inspired' stories in the
Pakistani press. One such recent story in a section of the press (Every
10th Person Suffers from Hepatitis B, The News, 15 October, 1998) urged the
inclusion of Engerix B, the Hepatitis vaccine produced by SmithKline
Beecham in the Expanded Programme of Immunization (EPI) of the Government
of Pakistan. The story lamented that , "In Pakistan… no tangible
steps have been taken despite assurances of the federal health minister
regarding inclusion of Engerix-B in the EPI programme in the national
health …." Soon after the story was printed the govt announced that
it would buy Engerix B in large quantities.
The writer of the story conveniently omitted to mention that Hepatitis B
vaccines are highly controversial and there is enough scientific evidence
to prove that they do harm. Neither does it reveal that approximately 15000
people belonging to 15 associations will be represented in a Paris
court in a hearing against the people responsible for manufacturing and
marketing Hepatitis B vaccines. The plaintiffs who were administered
Hepatitis B vaccines now find themselves facing severe risks. The side
effects of the vaccines can be very serious, notably neurological problems
which can lead to multiple sclerosis .
These people, doctors or private individuals, in company with certain
associations concerned mainly with issues of health, believe themselves to
be the victims of the Health Authorities and laboratories who have wilfully
dramatised the spread of Hepatitis B in France in distributing false
information about how it is transmitted and about its actual incidence.
SmithKline Beecham in Pakistan spends a large amount of money on sending
reminders in the form of expensive literature printed in four colours,
posters for clinics and hospitals and gifts (water-coolers, car-sunshields
and refrigerators etc) to doctors for its vaccine Engerix B throughout
Pakistan.
Malam claims on its website that through its letters to pharmaceuticals
it has led to withdrawal or refomulation of drugs or modification in their
ads. But SmithKline Beecham's anti-diarrhoeal (generic name:
furazolidone/metronidazole) and Halfan the anti-malaria drug, have been
aggressively promoted. It goes without saying that SmithKline Beecham
spends monumental amounts of money on its promotional campaigns every year
in the form of expensive print material, gifts (calendars which have high
production costs, stationery, lamps, wall clocks, coasters, high quality
leather products, make-up kits, lipstick holders, keychains, umbrellas etc)
and promotional meetings each quarter which are always held in five star
hotels.
Profit, and more profit is the only guiding principle of the multinational
pharmaceutical companies yet, is their price hike demand justified? The
Pharma Bureau and PPMA base their demands on rupee devaluation and rise in
the price of raw materials in international markets. They claim that since
the manufacturing cost of medicines has risen, the sale price should also
rise.
To begin with, the very basis of their production costing is suspect as
they often buy the raw material from allied companies overseas at inflated
prices. In other words, they buy from allied sources at more than the
international market rates thereby inflating their cost which is then used
as a basis for determining the price of the medicines they produce. It may
be useful for the health ministry to investigate the prices of raw material
imported by the multinational pharmaceutical companies to
determine a fair cost of production.
Moreover, one would like to know in public interest, how many times have
they pressed for a reduction in prices when the prices of raw material have
fallen in the international markets. Have they passed on the benefits to
the consumers? Have they done the socially responsible thing?
But social responsibility is not one of the strong points of the
multinational pharmaceutical companies' culture. As a matter of fact it
plays no part in their business although some of them claim to be doing
a service to the Pakistani society by introducing international standards
and practices. However, they often fall below our own 'lowly native
standards'. The cutting down of unionised staff in the name of
efficiency in a labour surplus country can only be called a disservice
to our society. It is significant to note that such downsizing is often
undertaken where the unionised staff has been vocal about their
rights. So such measures are really an effort to get rid of troublesome
workers.
The practice is not restricted to unionised staff. Even higher level
staff not playing ball according to these companies' so called
international practices are summarily dismissed from service.
[... part skipped]
The multinational companies have proved neither good for the economy nor
the society in general. It may be argued that if these companies were not
present in the country, there may not be any medicines to be had. But with
the support from the people and the government, our local pharmaceutical
companies have the capability to manufacture essential medicines. It is
time we reconsidered our economic strategies according to the national
imperatives.
Zeba Ali
Email: zeba@cyber.net.pk
[Can E-druggers please also indicate from which academic/health background
they are speaking, and indicate tel/fax etc? Thx WB]
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