[india-drug] Access to Essential drugs

[Jan.Arogya.Abhiyan@healthnet.org]

Access to Essential drugs
----------------------------

Dear all, 
It was decided in the Jan Arogya Abhiyan (JSA NCC) meeting on 12th
March in Delhi, that for the Health Rights Day (7th April) this year,
JSA would focus on the issue of ?Access to essential drugs? and
profiteering by the drug-industry. This would also help the Supreme
Court PIL being pursued by some JSA constituents. Attached herewith is
a suggested draft of a press release for 7th April. Please send your
suggestions in the track changes mode. As far as possible, the NCC
should circulate and release a consensus draft in English. State JSA
units can release a translated and modified version locally.
 
Warm Regards,
 
Anant Phadke, Abhay Shukla

Ensure People?s Right to Essential Drugs!
 
	On the occasion of the World Health Day, the Jan Swasthya Abhiyan (a
nation wide network of hundreds of organization committed to the goal
?Health For All?) draws attention to the need and distinct possibility
of realizing people?s right to ?essential drugs.?
 
	Growing Paucity Of Drugs In Public Health Services
	Drug-sales in India have now reached around Rs. 300/- per capita
annually. Research shows that this is more than sufficient to cater to
the needs of Primary Health Care of all the people, provided drug
production and use is scientifically managed.  In India, today, this
does not happen due to increased paucity of drug-supply to the public
health facilities on one hand (thanks to the privatization policy) and
on the other hand, in the private sector, mind boggling profiteering by
the drug-companies combined with huge wastage on account of production
of unscientific drugs and unscientific drug-combinations. 
	Only about 20% of patients go to the public health facilities for
outpatient care.  The government should allocate adequate funds so that
at least the set of patients approaching public health facilities does
not have to buy medicines from the market. But there are increasing
shortages of drugs in public health facilities due to the privatization
policy.  The WHO has recommended long back that public health
expenditure be 5% of the Gross Domestic Product. In India, it has been
a miserly 1.3% in 1985 and has further reduced to 0.9% by 2003. This
reduction is contrary to the declaration in the health policy 2002 that
it would be increased to 2% by 2010. It is both possible and necessary
to increase it to 2% immediately and to 5% by 2010. 
Research shows that if drug-supply to PHCs is doubled and used
properly, it can cater to all the drug-needs of the PHC-patients.  For
example to double the drug budget in all the PHCs in Maharashtra from
the current level of Rs. 60,000/- per PHC would require an additional
allocation of a mere Rs. 10 Crores annually. This is peanuts compared
to the huge concessions, grants given by the Maharashtra government to
the bigwigs. For example though it was clear that Mumbai-Pune Express
highway would be a financial disaster, it was built to favour certain
interests. It now incurs an annual loss or Rs. 130 Crores! (Other JSA
constituents can replace this example by one from their state)
 
Huge Profiteering by Drug Industry
Mind boggling profiteering by the drug industry is now evident. There
are many examples of a drug being sold by two reputed companies at
prices, which differ by a margin of 400% to 800%. LOCOST a ?not for
profit? enterprise, which manufactures high quality essential drugs for
the non-profit sector, sells drugs at prices, which are one half to one
tenth of the prices of the commercial brands. Tamil Nadu Medical
Corporation, a public body working for the Tamil Nadu government has
been buying quality tested drugs in huge quantities directly from the
drug companies at tender rates which are one tenth to one fiftieth of
the retail-market prices. These examples show the huge margins enjoyed
by the drug-companies. This excessive profiteering must stop and all
essential drugs must be brought under price-control.  A PIL in the
Supreme Court by some of the constituents of the JSA would hopefully
bring some justice on this issue to the hapless consumer.
 
Irrational, Wasteful Drug-Combinations
All the studies so far, which have analyzed the drug-combinations in
India, have  shown that most of these combinations are unscientific.
Cough mixtures, painkillers, tonics, haematinics all such mixtures
contain one or more inessential drugs which merely add to the cost and
side-effects of the drugs, leading to huge wastage of the buyer?s
money. If only scientific combinations of drugs are allowed, drug
prices would come down substantially. The JSA demands that this
long-standing demand be conceded immediately.
 
Demands
         Substantially increase public health expenditure and make drug
supply to all public health facilities adequate. Public health
facilities must guarantee access to essential drugs, by making these
available to all patients, based on rational prescriptions. If any
patient visiting a public health facility is made to purchase drugs for
a rational prescription, the drug-bill must be reimbursed by the state.

         Bring the entire list of essential drugs under the Drug Price
Control Order. 
         Ban all irrational drug-combinations.
 
 
Jan Arogya Abhiyan, Maharashtra.



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Access Essential Drugs Monitor #32 at http://www.who.int/medicines/mon/mon32.shtml

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