11-07-2025
Substandard drugs: A bitter pill to swallow
Late last month, a paper in The Lancet Global by a team of researchers led by Maximilian J Wilfinger of the University of Notre Dame, US, reported that several chemotherapy drugs administered in sub-Saharan Africa had failed quality tests. About 20 percent of the drugs were either ineffective or had dangerous side effects. The products of 17 manufacturers failed tests. All but one are Indian firms.
The Bureau of Investigative Journalism enlarged the story. Like earlier episodes in which paediatric syrups exported from India killed children overseas, this episode reminds us that merely having a volume lead in generics does not guarantee that India can be the 'world's pharmacy', as the government likes to advertise it.
These were the big picture stories, but the incident also has a personal, human angle. Personal stories are of course anecdotal, but that does not automatically devalue them, because we are not doing statistics here. So, to get personal, a couple of years ago, someone close to me was diagnosed with an aggressive paediatric cancer. We mostly hear of research successes, and the general impression is that cancers are becoming curable, or at least manageable. Indeed, they are, but for many cancers, treatment has not improved in 30 years. For perspective, it means that the treatment of the cancer we're talking about has not changed since V P Singh was prime minister.
A paediatric oncologist in Delhi told me a fundamental truth: 'Cancer doesn't affect only the patient, but the whole family.' That's especially true with difficult variants of the disease. The patient and family are suddenly cut off from normal life. It is as if an invisible wall stands between them and the majority who, thank heavens, have no experience of the disease. What divides these worlds is the idea that life is uncertain. Families with cancer know this; the rest of the world has gratefully forgotten it. Our legal wills still begin with the words, 'Since life is uncertain,' but we are fortunate. We take a course of pills to brush off diseases which were fearsome killers just two generations ago, like pleurisy and typhoid. After penicillin, we are no longer wired to think of untimely death as an everyday reality. Most of us feel it is unnatural to live with uncertainty.
