Corruption and the unchecked proliferation of spurious drugs in Pakistan have emerged as one of the gravest public health threats in the country. The recent findings of the Drug Testing Laboratory (DTL) of Sindh, revealing that medicines produced by at least seven pharmaceutical companies were spurious, have once again highlighted the severity of the crisis. These drugs, some containing toxic and psychotropic ingredients in unregulated doses, pose life-threatening risks to unsuspecting patients. The situation reflects a deeply rooted issue of regulatory failure, corruption, and a profit-driven mindset that prioritizes financial gains over human lives.
According to documents signed by DTL Sindh director Syed Adnan Rizvi and reviewed by Dawn, these medicines were found to be fictitious, with fake manufacturing licenses, non-existent registration numbers, and devoid of Active Pharmaceutical Ingredients (API). Among the most alarming discoveries were Eyosef 250mg capsules, manufactured by M/S East Pharmaceuticals, Lahore, used to treat bacterial infections. Similarly, three suspensions used for bacterial infections—Alcoxime suspension (M/S Alpine Laboratories, Karachi), Milixime suspension (M/S Menakline Pharma, Karachi), and Mirzpan suspension (M/S Miraz Pharma, Kasur)—were also declared spurious. Additionally, Mirzolam tablets produced by M/S Miraz Pharma were flagged as adulterated. These findings expose a dangerous loophole in Pakistan’s pharmaceutical regulations, allowing fake medicines to flood the market and jeopardize patient safety.
The pharmaceutical industry in Pakistan is estimated to be worth around USD 3 billion, contributing significantly to the country’s economy. However, experts believe that between 10% and 20% of all drugs available in the market are counterfeit, a staggering figure with potentially deadly implications. The illicit trade of spurious drugs in Pakistan is valued at approximately USD 600 million annually, making it a lucrative business for those involved in the production and distribution of fake medicines. This is further exacerbated by the weak enforcement of pharmaceutical laws, allowing corrupt elements within the industry to operate with impunity.
Noor Mahar, President of the Pakistan Drug Lawyers Forum, has raised concerns about the regulatory failures that have allowed these medicines to be sold in the market despite never being assigned proper license numbers. This points to a fundamental flaw in the oversight mechanism of the Drug Regulatory Authority of Pakistan (DRAP), the body responsible for ensuring compliance with drug safety standards. While DRAP is tasked with monitoring and controlling the pharmaceutical industry, systemic corruption and a lack of resources have rendered it ineffective in combating the counterfeit drug trade.
Provincial Drug Testing Laboratories, such as the DTL Sindh, play a crucial role in drug authentication, but these institutions often suffer from inadequate funding, outdated technology, and limited personnel. Consequently, testing procedures are slow and inefficient, allowing counterfeit drugs to remain in circulation for extended periods. Even when adulterated medicines are identified, delays in punitive action enable manufacturers and distributors of fake drugs to continue their operations unchecked.
The economic ramifications of this unchecked trade are profound. Counterfeit medicines lead to prolonged illnesses, increased hospital admissions, and unnecessary medical expenses. Patients suffering from critical conditions such as cancer, heart disease, and bacterial infections are the most vulnerable, as fake drugs fail to provide the necessary therapeutic effects, resulting in disease progression and, in many cases, death. The burden on the healthcare system increases as hospitals and clinics are forced to allocate additional resources to treat complications arising from the use of substandard medicines.
The consequences for public trust in the healthcare system are equally concerning. When patients lose confidence in the efficacy of prescribed medicines, they may resort to self-medication, alternative treatments, or even avoid necessary medical care altogether. This erosion of trust further compounds health crises, leading to a greater prevalence of untreated or poorly managed diseases. The rise in antibiotic resistance, for instance, is partially linked to the circulation of counterfeit antibiotics that lack the required potency to eradicate infections, allowing bacteria to develop resistance over time.
While Pakistan has legal frameworks in place to combat the counterfeit drug trade, enforcement remains a significant challenge. The Drugs Act of 1976, the Control of Narcotic Substances Act, and the National Drugs Policy outline strict measures for drug manufacturing, licensing, and distribution. However, these laws are often inadequately implemented, with minimal action taken against pharmaceutical companies found guilty of producing and selling spurious drugs. The penalties imposed in past cases have been insufficient to serve as deterrents. Although some manufacturers and distributors have been subjected to fines and short-term suspensions, the lack of severe consequences allows them to re-enter the market with new licenses and continue their illicit trade.
In rare instances where legal action has been pursued, prison sentences have been handed down, but such cases remain anomalies rather than the norm. The pharmaceutical mafia, often with strong political connections, has historically evaded accountability, ensuring that legal proceedings against them are either delayed or dismissed. Corrupt officials within regulatory bodies have further facilitated the survival of counterfeit drug networks, making it nearly impossible for genuine oversight mechanisms to function effectively.
Addressing this crisis requires a multi-faceted approach. Firstly, stringent enforcement of existing laws is imperative. Regulatory agencies must be granted greater autonomy and resources to carry out thorough inspections and testing. Advanced forensic testing equipment should be provided to Provincial Drug Testing Laboratories to ensure timely detection of spurious drugs. The government must also introduce harsher penalties for those involved in the production and distribution of fake medicines, including lengthy prison sentences and heavy financial fines.
Transparency and accountability within DRAP and other regulatory bodies should be enhanced by establishing independent watchdog organizations to monitor their activities. Whistleblower protection programs should be introduced to encourage reporting of corrupt practices within the pharmaceutical industry. Furthermore, digitization of the drug registration process, including blockchain-based tracking systems, can help eliminate fake licenses and prevent unauthorized manufacturers from entering the market.
Public awareness campaigns are crucial in educating consumers about the dangers of counterfeit medicines. Patients must be informed about the risks associated with purchasing drugs from unauthorized vendors and the importance of verifying drug authenticity through official sources. Pharmacies and hospitals should implement stricter procurement policies to ensure that only genuine, government-approved medicines are available to the public.
The unchecked business of spurious drugs in Pakistan is not merely a regulatory failure but a national health emergency. As long as corruption continues to protect those profiting from counterfeit medicines, the lives of millions will remain at risk. The government must take decisive action to dismantle this illicit network, hold culprits accountable, and restore public trust in the healthcare system. Without urgent reforms, the situation will only worsen, leading to more unnecessary deaths and an ever-growing burden on Pakistan’s already fragile healthcare infrastructure.
The views expressed in this article are the author’s own and do not necessarily reflect Coverpage’s editorial stance.
