The Supreme Court in in its order on 23rd April 2024 has taken the Indian Medical Association (IMA) to task for its alleged unethical conduct over recommending overpriced drugs and line of treatment “for valuable consideration”. The apex court has pointed out that the IMA also needs to put its house in order as there are several complaints, a Bench of Justice Hima Kohli and Justice Ahsanuddin Amanullah said. The Hon’ble court showed concern over several misleading ads of FMCGs (fast-moving consumer goods) which effect health of the babies, school going children and senior citizens. The Court also asked the union of India and the state licensing authorities to activate themselves. It has also directed that the Ministry of Consumer Affairs, Ministry of Information and Broadcasting and the Ministry of Information Technology be made parties to the case, the top court asked the three ministries to file affidavits spelling out their respective stand on various issues raised in the matter.
The Supreme Court verdict has come immediately after the case of Patanjali for its fraudulent advertisements in medicine. It was after the persistent perusal of the issue by Dr Babu K.V from Kannur, Kerala who got the information on various related matter through the RTI. The IMA later filed a petition in the apex court on the plea that Ramdev and Balkrishan Acharya are misleading the people on their products and ridiculing the modern scientific methods of treatment even during the COVID pandemic. Ramdev projected his Coronil without any substantive evidence as a treatment for the disease. It is important to note that this was promoted by the then Health Minister Dr Harsh Vardhan, who is an ENT surgeon trained in modern medicine. Several health organisations had raised concern over the non-evidence based, even mythical methods of treatment being promoted by some of the higher functionaries in the BJP government.
The concerned citizens have been raising voice for the government to implement its commitment agreed upon in the Alma Ata declaration on health in 1978 to ensure health to all citizens. But contrary to what should have been done as per the Alma Ata declaration and state owning responsibility for the healthcare to the citizens, the market forces have taken over control of the healthcare. As a result there is entry of corporates in the health sector leading to conceptual change towards health. For the corporate the health is a business instead of service to the people. This was reflected during the COVID pandemic. Millions of people suffered and even lost their lives but the market forces in the health sector continued to reap huge profits. We have clear cut example of the vaccine making industry globally as well as in our country.
According to Dr Samir Malhotra, Professor of Pharmacology Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, COVID-19 scare forced many governments to enter into contracts with the companies developing vaccines. Many of these contracts had confidentiality clauses according to which the company was exempted “from any civil liability for serious side effects arising from the use of the vaccine, indefinitely”. Not only that, and this is shocking, these countries should “put up sovereign assets as collateral to guarantee indemnity”. Such assets could include embassy buildings, cultural assets, etc.
India has been no better. According to Aparna Gopalan ‘for each dose sold to private hospitals, Serum made profits of up to 2,000 % and Bharat Biotech up to 4,000 %, what might be considered as “super profits”. In India, 38 new billionaires were minted in the first year of the pandemic, while the combined wealth of the country’s 140 billionaires went up by 90.4 %’.
With the purpose to regulate the prices of drugs, National Pharmaceutical Pricing Authority (NPPA) was constituted in 1997 as an independent Regulator for pricing of drugs and to ensure availability and accessibility. Alliance of Doctors for Ethical Healthcare (ADEH) and the Indian Doctors for Peace and Development (IDPD) took up the matter of drug pricing with the NPPA in January 2017. Soon after the then chairman of the NPPA Shri Bhupendra Singh passed an order to reduce the prices of coronary stents. This was welcomed all around. But before he could take a decision on the other products and medical devices he was transferred to some other department. Initially there was some relief to the patients, but the private sector cleverly increased the hospital charges. Ultimately the benefit which should have gone to the patients did not materialise. The NPPA when approached to check the hospitals expressed its inability to intervene in this matter on the plea that this issue did not fall under its jurisdiction.
This clearly proves that under the existing system of private sector’s domination in the health it would not be possible to check their machinations. The Uniform Code of Pharmaceutical Marketing Practices (UCPMP) is being flouted with impunity. The government has ignored its own committee’s recommendations to cap the price of the pharmaceutical products. The committee on High Trade Margins in Prices of Drugs was formed in 2015 September and submitted its report in December. But it has been practically thrown into dustbin.
Nexus between these private companies and the government stands exposed as the pharma companies which were blacklisted for supplying sub-standard drugs were cleared after they purchased electoral bonds for the ruling dispensation at the centre.
Under the circumstances the medical organisations and the doctors fall prey to the existing ruthless market system which lacks empathy. The Hon’ble Apex Court should take into consideration this. Revival of the Public Sector is the only answer if we have to ensure health to all.
Dr Arun Mitra is a Practicing ENT Surgeon in Ludhiana, Punjab. He is also the President of Indian Doctors for Peace and Development (IDPD) www.idpd.org
