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Editorials Print edition: 2024-01-20

Insulin shortage

Published Updated

EDITORIAL: Is it any surprise that the country faces shortage of high-quality insulin, especially since the government was repeatedly warned that its own policies and bureaucratic red tape were forcing investors in the pharmaceutical sector to wind up operations in Pakistan and it still did nothing about it? More than six months ago, Eli Lilly – a multinational company that has been supplying the drug to the local market – scaled back its operations and requested a “source change”, because “supply chain issues” forced it to route production from a closer vicinity and it wanted to redirect shipments from its manufacturing facility in India.

But the government has been sitting on the request since then and permission has still not been granted, which means the company’s December shipment might be the last, and a severe shortage is now imminent. This would be appalling in the best of times. But since Pakistan has the world’s third highest number of diabetic patients, after India and China – 34 million people or 26.7 percent of the adult population, much higher than the global average of one out of 10 people – this neglect could well snowball into a national emergency.

It’s precisely because of this attitude that multinational presence in the pharmaceutical sector has shrunk from about 30 companies a few years ago to just four now. As long as there is uncertainty in policies, large size reputable companies will never take this country or its market seriously.

That is why so many of them have simply packed up and left. Now stakeholders are helpless as the industry is sure to regress even further. For, multinational presence drives growth and innovation, bringing new therapies and technologies to the market.

As pointed out before in this space, the makeup and job profile of DRAP (Drug Regulatory Authority of Pakistan) is major part of the problem. It is, at the same time, the drug registering authority and also the price fixer. That’s why it was also at the centre of the price fixing problem over the last couple of years when companies were driven to bankruptcy by not being allowed to adjust prices in proportion to increased input cost because of volatility in commodity and currency markets. As a result crucial medicines, including lifesaving ones, started disappearing from the shelves and ordinary people were left to suffer; which included paying many times the normal price in the black market.

Most countries have streamlined their pharma sectors by following the example of the American FDA, the international gold standard for the drug registration process, evaluating volumes of scientific data prior to approval.

Industry officials also give the example of Bangladesh, which designed investor-friendly policies and made the pharmaceutical sector self-reliant. It’s because of such policies that the country now boasts having two insulin manufacturing plants; one set up by Eli Lilly and the other by Novo Nordisk.

Pakistan can make a good start by dividing DRAP into two separate outfits. One that registers and accords approval for sale of medicines in the market and the other that fixes prices in keeping with international best practices. Otherwise, the entire sector’s decline will continue uninterrupted.

Copyright Business Recorder, 2024

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