COVID-19 is the only global health challenge. It leaves the world into a state of a medical emergency; one of the subsequent yet biggest challenges that COVID-19 brought to Pakistan is the extreme shortage of essential medicines.
If China and India are better off than developed countries in terms of medical capabilities, then why not Pakistan? Instead, they supply most of the pharmaceutical raw material to the world; even the global lockdown has not spared these pharmaceutical supply chains.
Pakistan, being blessed with a pharmaceutical hub, cannot produce raw materials that are needed to make medicines; sadly, we mainly import them.
In response to Covid-19 or any other global health emergency, do we have enough national pharmaceutical reserve for essential medicines? How long our reserves could last during this? Can we continue producing medicines if the foreign supply of raw material will be interrupted?
Unfortunately, the answer to most of these questions is not favorable. The reality is that over-reliance on imported raw materials will soon put the public health and entire industry in danger.
To understand our capability in terms of medicines, it’s sufficient. Sadly, Pakistan cannot even produce essential medication like paracetamol and ibuprofen tablets, a standard baseline treatment for Covid-19, and several other minor ailments. No matter how low cost it takes to produce such common flu and cough medicine, you will be surprised to know that we do not manufacture the active ingredients present in them; if the import stops, we won’t be able to produce such essential medicines.
Let’s talk about available reserves of the raw materials used to produce medicines like paracetamol and ibuprofen?
There are two types of materials needed to produce any medicine. The first is the active ingredient that helps to create a therapeutic effect. In contrast, the other ingredients are referred to as “excipients” that convert the active ingredient into a dosage form.
Unfortunately, Pakistan is unable to produce the active ingredients of most of the drugs, including life-saving ones; over-reliance on cheaper imports ruined our capacity to produce medicines.
The irony here is that even inactive ingredients are also imported in massive quantities.
We are importing many pharmaceutical and food additives, including plant-derived carbohydrate polymers extracted from vegetables and fruits.
Being one of the top 10 producers of agricultural commodities, we do not produce them locally.
You must be wondering, are we always so incapable and handicapped?
No, it was not the case a few decades ago, the situation was bad but not worse, we were good at manufacturing drugs like nicotinamide, aspirin, penicillin, and ephedrine.
Cheap imports kill local production.
But then, we stopped manufacturing medicinal substances. We didn’t just become insufficient but also killed the local produce over time; from that onwards, we didn’t make a single medicine without an imported ingredient.
Covid-19 has not only shaken the country emotionally and economically, but also challenged our public health system, and the real face of our medicine capabilities has also revealed.
This is the best wakeup call for Pakistan, and to realize the importance of self-reliance in this national emergency.
A pharmaceutical company recently stepped into the ground and obtained a license to locally produce Remdesivir, the widely-used antiviral drug to treat Covid-19 patients.
Though the medicine failed badly against Ebola and other viral outbreaks and its effectiveness against coronavirus is still in question. Still, all said and done, it is encouraging to see local producers coming forward and playing their roles.
Even if Remdesivir does not get approval, the technology can still be used to manufacture other antiviral drugs against other infections.
Pakistan needs a holistic approach to enhance the pharmaceutical capacity; institutions like NGOs, universities should play their role in fostering technology transfer and knowledge exchange from academia to industry.
Another positive contribution could be the revival of National Institute of Health, which has deteriorated over the years, mainly due to limited government support and funding, vision, and strategic direction.
To contain the COVID-19, all the developed nations are struggling to cope with it, which means reliance over them for anything, including pharmaceutical raw materials, would not be a wise move.
If we do not act now, a severe medical crisis will hit the nation, and more people would die due to emergencies and shortage of medicines than by the virus.
The lessons learned from the pandemic should be understood as soon as possible, and this way, we can potentially protect Pakistan in the event of another epidemic.