It may look the same but is completely different

Recently, environmentalists breathed a sigh of relief when the nation was informed that the government was not considering any easement of our laws and regulations as far as the Yida project is concerned. Now, health professionals are breathing their own sigh of relief after hearing that the reports that the Medical Benefits Scheme (MBS) was considering sourcing pharmaceuticals from India were unfounded (for now).
After OBSERVER media received a tip from a source close to the Ministry of Health that a plan was afoot for the country to drop out of the Pharmaceutical Procurement Services (PPS) of the Organisation of Eastern Caribbean States (OECS), and source its pharmaceuticals by other means and from suppliers or a supplier in India, we immediately reached out to Minister of Health Molwyn Joseph and other top health officials.
This possible move, after all, would be significant, not because we could save significant sums of money; rather, such a move could have serious health consequences. That is because India has a poor reputation as being a top producer of counterfeit drugs – drugs that have, for all intent and purposes, no active ingredients.
It is necessary for us to make the distinction between counterfeit and generic drugs. Generic drugs are drugs made with the same or very similar formulas as the original ‘brand-name’ drugs but are not sold under the original brand name. Counterfeit drugs, on the other hand, are really nothing more than fillers. Like counterfeit money, they may look the same but really, they have no value. India has done a good job of producing both.
For this piece, we are not even going to talk about the term “falsified” drugs which was recently adopted by the World Health Organization (WHO) after settling a long-standing dispute between India and the European Union (EU) by clarifying that ‘counterfeit’ will be used by member states with respect to protection of Intellectual Property Rights (IPR). In our bit of paradise, we could care less about the technical definitions used by big pharmaceutical companies as they battle with one another to save their billions of dollars in profits.
What we care about is access to affordable, safe medicines and the arrangement that we have with PPS seems to have served us well, as confirmed by the minister when he said, “PPS has served [Antigua & Barbuda] well” and that the government “does not intend to depart from our commitment to work with the programme”. Thank you Minister Joseph; that statement provides much needed relief to our minds and to anyone concerned about our health care services and supplies.
We would be lying if we did not admit that we are still a bit concerned because we did not receive a firm commitment that we will not sway from PPS. At the same time, we can understand that the government cannot tie our supply to a single entity forever but we must be honest and say that we are extremely cautious about sourcing pharmaceuticals from the Asian and South American continents.
We are not in the business of stereotyping but in this case, the risks are great and we fear that we do not have the resources to do the extreme vetting and testing of drugs coming out of those markets. And it does not necessarily have to be counterfeit drugs, it could simply be poorly manufactured drugs that do not have the desired or expected health benefits.
To put this into perspective, in a 2016, Special 301 Report, the Office of the United States Trade Representative stated: “While it is impossible to determine an exact figure, studies have suggested that up to 20 per cent of drugs sold in the Indian market are counterfeit and could represent a serious threat to patient health and safety” and “97 per cent of all counterfeit pharmaceuticals seized at the US border in Fiscal Year 2015 were shipped from four economies:  China, Hong Kong, India, and Singapore.”
So, while we can agree that “India is a major supplier of pharmaceuticals like the United States (US) and Cuba”, as the minister stated, it is also a major supplier of ‘unwanted’ pharmaceuticals that could have devastating effects if they were to slip into our health system.
How devastating? Let’s take India itself. A 2015 Newsweek article on the subject of counterfeit drugs entitled “The Fake Drug Industry Is Exploding, and We Can’t Do Anything About It”, authored by Alexandra Ossola, reported: “In 2013, officials in India discovered that 8,000 patients died over a five-year period in a remote Himalayan hospital because an antibiotic used to prevent infection after surgery had no active ingredient.”
It is not our intent to bad talk the Indian pharmaceutical industry but there is enough information out there and easily available from organisations like the WHO and the Centers for Disease Control (CDC), or even on the Internet, to cause our government to ‘err on the side of caution’. Countries like India have done immense good in reducing the cost of pharmaceuticals but it is unlikely that we have the necessary resources or expertise to safely surf through the massive world of counterfeit drugs.