Bitter Pills:Medicines & The Third World Poor | Page 42

in a recent joint report by the Indian Council of Social Science Research (ICSSR)
and Indian Council of Medical Research (ICMR) which describes the situation
as one where' 'the drugs required by the poor are not produced on the main ground
that there is no profitable market and adequate demand for them, while the country
continues to be flooded by a plethora of costly and wasteful drugs meant for the
minor illnesses of the rich and well-to-do." (43)
The ICSSR and ICMR explain that out of total drug production in India in 1976,
"25 per cent is taken away by vitamins, tonics, health restoratives and enzyme
digestants mostly consumed by the relatively well-fed urban population. Twenty
per cent is covered by antibiotics, only 1.3 per cent by sulphonamides (a very cheap
and useful anti-infective) and 1.4 per cent by antituberculous drugs" ... "Dapsone,
the basic drug for leprosy costing only Rupees 5 [ under 30 pence ] a year's
treatment, is always in short supply." <44) Yet India has a third of the world's
leprosy sufferers (about 4 million people) and an estimated 8 million active TB
cases - the equivalent of the entire population of London. (45)
India has literally thousands of drug manufacturers, ranging from very small local
units to about 100 large-scale manufacturers under varying degrees of Indian and
foreign control. All must share responsibility for producing and creating demand
for non-essential drugs. In terms of the total numbers of these products, many
more are marketed by local than foreign producers. A United Nations Conference
on Trade and Development (UNCTAD) study quotes figures for 1972 showing
that foreign companies accounted for 15% of all the different brands of vitamins
and tonics, 2 1 % of antacids, 14% of digestive enzymes and 13% of cough and
cold preparations. (46) But the UNCTAD study also revealed that up to one-third
of all the drug formulations marketed by foreign- controlled companies in 1972
consisted of vitamins and tonics, cough syrups, tranquilisers, sedatives and
painkillers. (47)
A number of studies have concluded that the way in which local production in
India started up as an 'off-shoot' of the rich world drug industry is to a large extent
responsible for its failure to cater for the needs of the mass of people. (48) For
example, according to the Hathi Committee on the drugs industry which reported
to the Government in 1975, " In India, in spite of efforts to plan socio-economic
growth, the drugs and Pharmaceuticals industry ... operates on the principle of
free market economics. The drugs industry is dominated by the foreign units which
set the pattern in this industry. The drug needs of any country are characteristic
of the climatic conditions, social behaviour and economic conditions in each
society. The foreign units which evolve their policies for the rich countries in
temperate climates, with radically different socio-economic conditions, operating
in free-market systems, promote the same systems in India, which are adversely
detrimental to our national interests." (491
Controls introduced in India to try to limit production of non-essential drugs have
failed to break the mould. Ironically in some instances they have backfired and
actually held back increased production of essential drugs. (50) For example, we
have already singled out the shortages of dapsone - for treating leprosy. The Indian
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