Events &
Issues
New Delhi, 28 May 2012
Health Administration
‘CORRUPT’ MAKING INDIA SICK
By Proloy Bagchi
All is not
well with the nation’s ‘health’. Two shocking revelations, which came to light
in the media recently, need special attention. One of these relates to corrupt
practices at the stage of approving and launching a drug in the market. The Parliamentary
Standing Committee on Health and Family Welfare detected serious irregularities
in respect of advices and letters of recommendations from some experts
submitted to the Drug Controller General of India (DCGI) regarding several
drugs. These recommendations, apparently, read the same, word-for-word, as
those submitted by the drug companies concerned. Experts’ endorsements are
crucial testimony for the country’s Central Drugs Standard Control Organisation
for allowing launch of drugs in the market.
The
disclosure revealed a nexus between some experts and a few drug companies
enabling unquestioned endorsement of the scientific recommendations of their
own products for onward transmission to the DGCI. These are required to be
submitted by the experts after due consideration of the drugs’ content and
their efficacy. Evidence, however, has been unearthed indicating that the
experts merely affixed their signatures to the recommendations submitted by the
companies concerned.
Worse, some
were submitted on the day of their receipt by the experts, obviously without
according to them due consideration. More alarming was the fact that the
experts are from a few iconic medical institutions of the country and some of
them happen to be working as professors in these institutions.
The
innocent, ignorant and unwary patients will be at the receiving end if drugs
are pushed in such a manner by the drug companies in collusion with highly
placed medical experts without being evaluated in regard to their therapeutic
potential. Suspect efficacy of drugs will hit all classes of people across the
board and with high drug prices it would be a sort of double whammy for them. Already,
people are suffering under the weight of their medical bills. A recent report
said that the “out-of-pocket” expenditure – the percentage of expenditure
incurred by households on medicines – has increased by 75% during the past
couple of years. High medical costs, along with rising prices of essentials,
are biting the common man.
According to
2011 World Health Organisation estimates about 70% Indians spend their entire
income on healthcare and purchase of drugs. With the prices of drugs for common
ailments like cardiac disease, hypertension, diabetes creeping up northwards,
market watchers are asking for State intervention. Poor are simply unable to
afford many drugs. Decrying the ineffectiveness of the National Pharmaceutical
Pricing Policy even ruling party politicians are concerned about common man’s
woes.
Such
improperly evaluated medicines can also adversely impact exports once they fail
to live up to their claims. India
is considered the pharmacy of the world. While the domestic retail market in
2008 was estimated to be valued at more than Rs 55,000 crores, exports were
worth around Rs 38,000 crores. Unless checked, corrupt practices at the stage
of approving and launching a drug in the market would amount to shooting
oneself in the foot.
Shockingly,
the health sector is somehow saturated with corruption, whether at the Centre
or in States. A former Central minister of Health & Family Welfare was
involved in several scandals during his tenure, including what is known as the
“vaccines scam”. He ordered the public sector units to discontinue manufacture
of various essential vaccines only to throw open the entire market to one of
his cronies for easy pickings. Ultimately, the other day he was charged by the
CBI in a Delhi
court for abusing his authority and permitting a medical college to admit
students without having necessary faculty and clinical facilities.
Establishment
of medical colleges has become a very paying proposition. Politicians, in
collusion with money bags, bribe their way into acquiring prime land for
establishing such colleges, the approval and later recognition for which is
easily obtained by pulling strings and money changing hands. The then President,
Indian Medical Council, Dr Ketan Desai, and two others were arrested last year
for taking hefty bribes for granting recognition to a medical college. No
wonder, the quality of medical education leaves much to be desired. Barring a
few reputed hospitals, medical institutions and (elderly) private physicians,
the general quality of medical attention to the patients is poor, more so to
those belonging to the economically weaker sections.
This
apart, the National Rural Health Mission (NRHM) appears to have become a
goldmine for corrupt politicians, doctors and administrations. The ambitious
goal of the Mission
is to “improve the availability of and access to
quality healthcare by people, especially for those residing in rural areas, the
poor, women and children”. The second news report was about the sleaze detected
in the NRHM in Madhya Pradesh where, one after the other, two directors of
health services have been caught with huge amounts of liquid and fixed assets -
all disproportionate to their respective incomes.
In the earlier case even the minister in-charge was involved along with
the principal secretary of the department of health, an IAS officer, who,
mercifully, is being prosecuted. The minister resigned but escaped prosecution.
In the recent case, the director was found to be in possession of assets worth
more than Rs. 100 crores. Serious irregularities were detected in the process
of tendering and procurement of medicines, mosquito-nets, etc. During the raid
at the director’s residence his wife reportedly advised the Lokayukta officials
to raid the houses of ministers to whom a crore of rupees was required to be
delivered every month!
One can imagine the astronomical sums that have been poured into the Mission from the fact
that in Uttar Pradesh alone Rs 10,000 crores are believed to have been siphoned
off. Two chief medical officers and three other officials were murdered and
scores of engineers, doctors, administrators and ministers have been
charge-sheeted by the CBI.
Conscious of the abysmal level of public expenditure on health (1.4% of
GDP) the Government has been allocating huge amounts of tax-payers’ money to
the States in an effort to achieve universal health coverage, including
cashless treatment. The
Centre’s resolve to boost Government spending can potentially make high-quality
care accessible to all. It has not shied away from making necessary allocations
as can be perceived by the way the system has been milked by the powers-that-be
at the Centre and in the States, especially, in MP and UP.
No
wonder, despite the (now waning) growth story India ranks below the Sub-Saharan
Africa in many international health-related indices. While the corrupt,
cannibalistic predators do not allow the benefits of outlays to reach the
needy, high drug prices and raging inflation prevent millions from buying
essential medicines because of pervasive poverty – a significant facet of the
Indian growth story. Clearly, the
corrupt hordes in the Government wouldn’t allow it to achieve its own “goal” of
building a healthy and strong India.
--- INFA
(Copyright,
India News and Feature Alliance)
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