Implementation Of National Drug Policy In Different Countries Economics Essay
In May 1975, the than manager general of World Health Organization ( WHO ) Dr Halfdan Mahler, strongly advocated at the World Health Assembly ( WHA ) for the development of national pharmaceutical policies based on the affordability, quality and handiness of drugs. A declaration was passed which urged the Secretariat of WHO to assist Member States to explicate national pharmaceutical policies that meet the existent wellness demands of the people. The declaration introduced the constructs of ‘essential drugs ‘ and ‘national drug policy ( NDP ) ‘ so far the planetary public wellness is concerned. Bangladesh is one of those states who responded early to that call and formulated their NDP in 1982.1 The 1982 policy enormously benefited the pharmaceutical industry of Bangladesh and helped the enterprisers to develop this sector with good quality and criterion. Bangladesh is now exporting drugs in more than 50 states of the universe with good repute after wholly extenuating the local demands. Not merely in Bangladesh, after execution of drug policy under WHO counsel, India now ranks 13th in universe production by value and ranks 4th in the volume of pharmaceuticals produced.2 Now there are 20 000 pharmaceutical makers in India.2 Most of the vaccinums are now produced in India. States like Brazil, Egypt, Turkey, Indonesia etc. are now bring forthing both active ingredients and finished merchandises. This is a great accomplishment for their pharmaceutical sector.2 By 1999, 66 states had formulated or updated a NDP within the old 10 old ages, compared with 14 states in 1989.2 To day of the month about 156 states have formulated their ain NDP.2 W.H.O guidelines suggest three wide aims of drug policy: handiness, quality, safety & A ; efficaciousness of drug and eventually rational usage. In this assessment the instance of Bangladesh which has 27 old ages experience of its drug policy will be used as an illustration to measure the booby traps of execution of those aims comparing some other developing states.
Handiness: The chief aim of the Bangladesh NDP was to guarantee that every people can acquire the indispensable and necessary drugs easy and with low-cost monetary value. With this terminal in position 150 ‘essential drugs ‘ were identified in the drug policy ( 1982 ) of Bangladesh with controlled pricing.3 This list has been reduced to 117 in the twelvemonth 1993.3 The maximal retail monetary value of the indispensable drugs was fixed by the drug disposal authorization though the existent scenario is different. Monetary values of indispensable medical specialties are non consistent with each other. There is broad fluctuation of the monetary value of same medical specialty within different trade names. For illustration the monetary value of each ‘Ciprofloxacin ( 500mg ) ‘ tablet ranges from taka 5 to taka 15 ( US $ 0.7-0.22 ) .2 It is said that the production cost of this drug is less than 2.5 taka per tablet.3 So some companies are doing an amazing net income of Tk.12 ( US $ 0.17 ) per table.. In Malayan drug policy, the Government relies on market forces to make up one’s mind the monetary value of the ‘essential drug ‘ , instead than commanding it. But this policy is now demoing some uncomfortableness excessively among aggregate people and public perceptual experience is now lifting towards control of drug monetary values in Malaysia though it seems unsuccessful in Bangladesh.4 Price of medical specialty straight related to the handiness. In Cameroon, a class of intervention for peptic ulcer costs about twice the monthly rewards of a authorities employee which is clearly unaffordable.2 A survey carried out in Ghana and Cambodia besides highlights the immense spread between monetary values of generic and trade name medicines.2 A good figure of states do non even try to command medicine prices.2 Over 40 % states have no ordinance of medical specialty monetary values which is a compulsory portion of WHO proposed effectual NDP. This is truly painful as drug is non like other commercial trade goods instead it has got human-centered value. Pharmaceutical concern should be more human-centered oriented. Pharmaceutical companies should maintain in head that medical specialties produced by them have direct impact on public wellness. They must non label inordinate high monetary value to their merchandises which will in bend adversely impact the public wellness. Poor people of course refrain themselves from purchasing really dearly-won medical specialties. So, the companies must follow a human-centered attack in puting their net income border. Over-pricing causes unequal entree to needed medical specialties in developing states. To heighten the handiness of drugs, companies should work manus in manus with the authoritiess.
Quality, safety and efficaciousness of Drugs: At nowadays more than 16000 different trade names of drugs are available in the market of Bangladesh and these are produced by every bit many as 300 pharmaceutical companies.1 Merely 4000 trade names are tested for quality and 12 1000s are come ining in the market without any trial for deficiency of proficient support and trained manpower.1 Financial solvency is an of import factor in this respect. This is a firing issue in many developing states excessively. The drug control authorization of these states should give permission really carefully for licencing a new drug. Furthermore in many instances these drugs may be useless or uneffective and of similar nature. This besides create a healthy environment for sham, specious, debased and harmful smuggled medical specialty to come in to the market. In 2004, Bangladesh drug proving research lab tried 5000 samples and detected 300 drugs which are either forgery or of really low quality.1 In 1998 it was 260 out of 5920.1 ‘No medical specialty without prescription ‘ is purely followed in about all developed states but unluckily this pattern is absent in the underdeveloped universe. As a consequence abuse of valuable drugs including antibiotics is really common. In drug policy of every developing state, there should be clear regulations and proviso of a definite list of drug to be prescribed by the traditional small town quacks or non-graduate practicians to minimise the abuse of medical specialty. A recent WHO report on medical specialty stated that an estimated two-thirds of planetary antibiotic gross revenues occur without any prescription, and surveies in Indonesia, Pakistan and India showed that over 70 % of patients were prescribed antibiotics without valid ground and among them the great bulk ( up to 90 % ) of injections are estimated to be unnecessary.2 Adverse drug reaction ( ADR ) and opposition to antibiotics are another two points of concern. Even in United States ADR rank among the top 10 causes of decease and are estimated to be between US $ 30 and US $ 130 billion each year.2 For the intervention of malaria, chloroquine opposition is now established in 81 of the 92 endemic countries.2 Resistance to common antibiotics besides established against gonorrhoea, pneumonia and bacterial meningitis. These drug resistances non merely put the person at much greater hazard of hapless intervention results but besides put enormous force per unit area over the national economic system of a state. At present there are 67 000 accredited drug shops in Bangladesh but practically it exceeds 0.2 million.1 There are no trained forces in these drug store and they do non waver to sell debased and low quality drugs for extortionate net income. This malpractice is rampant in the rural countries Bangladesh where illiterate hapless people are adversely affected. This is a common scenario for many developing states excessively. Recently Malaysia took decisive stairss to better the consciousness of drug usage among mass people by establishing different motive and consciousness plan which turn out to be effectual. They besides better post-marketing surveillance and monitoring.
Rational Use of Drug: Irrational and inappropriate usage of medical specialty is a planetary job. Recently in Bangladesh many pharmaceutical companies launched a group of multi vitamin- multi mineral tablets for taking lack without consideration of local demand and socio-economic status of the country.1 Bangladesh drug market now flooded with different vitamins and herbal merchandises imported by assorted distributer companies which are wholly unneeded and illegal to be marketed. Doctors have to play critical function and duties in this respect. They should be more cautious and wise in ordering drugs. For illustration, Oman have got betterment in ordering forms when the authorities established a board of directors of rational usage of drugs in 2000, besides national drug control authority.5 Recently in Iran, authorities believing for a drug prescription control commission in each state, with a computing machine nexus to a national commission, which will measure all prescriptions and send an one-year study to all respected physicians.6 Persian authorities late finished an experimental pilot undertaking in two states and found it really effectual. They are anticipating to cut down the entire drug cost around 10 % yearly by this way.6
Execution of a national drug policy has non been paid required attending by the authoritiess of most developing states. Notwithstanding the fact, Bangladesh as a developing state has registered several important advancement in the field of public sector. Particularly the national drug policy 1982 is a applaudable measure from the portion of Bangladesh Government. However, still there is immense range to do the drug policies of developing states more effectual. This paper has pointed out several facets of execution procedure of a national drug policy. Drugs regulators in developing states should see these facets in implementing their drug policies. Merely in this manner, public wellness in developing states will be ensured to a great extent.