SUPERBUG CONTROVERSY has been hitting the media headlines for past one month. The debate is going on whether it was a conspiracy against Indian health tourism or excessive use of antibiotics. The report published in latest issue of British medical journal, Lancet Infectious Diseases stated that antibiotics have proved so far ineffective in case of a bacterial gene, named New Delhi Metallo-1 or NDM, which was found in patients travelling to south Asia for medical treatment. It has ignited a controversy in Indian medical circles.
The report has stated that NDM is becoming more common in Bangladesh, India and Pakistan and is also being imported to Britain and other countries in patients returning after treatment from these countries. The issue has caught the attention of ruling as well as Opposition parties, who have joined hands in describing it as a big conspiracy against Indian health tourism which is growing at a fast pace. D Raja of Communist Party of India has described it a conspiracy of developed countries.
Union Health and Family Welfare Minister Gulam Nabi Azad quickly described the report as motivated and conspiracy against Indian health tourism. Its naming after New Delhi has raised suspicion about the motives of the authors of the report. Union Health Minister for state Dinesh Diwedi speaking on the issue has stated that it is a global phenomenon and we are concerned about it adding that it is certainly not area or country specific. The director general of Indian Council of Medical Research, V M Katoch has also clarified that there is no basis to all the rumours spread due to the report.
Undoubtedly Indian health tourism is growing. A large number of foreigners from Britain and other countries are visiting India for availing health facilities which are cheaper. According to confederation of Indian Industries, Indian health tourism was pegged at Rs 1500 crore six years back and it is increasing every year. Foreigners visit India for surgery, heart by pass and bone replacement. The treatment in India is cheaper as compared to Western countries.
But at the same time instead of crying wolf at the warning, we should treat it as a blessing in disguise and take corrective and preventive measures. We are in the habit of underplaying our weaknesses under the cover of patriotism. Recent outbreak of dengue cases in the national capital is the example of this trend as the figures of dengue victims are being underplayed instead of finding out the reasons for its outbreak. The issue of excessive and irrational use of antibiotics should not be downplayed under the cover of describing it as conspiracy against Indian health tourism.
Pharma companies have vested interest in promotion of their products. They approach the doctors with gifts and other, offers who in turn prescribe antibiotics to the patients.
Even the World Health Organisation virtually endorsing the report has advised that countries should be prepared to implement hospital infection control measures to minimise the spread of multi-drug-resistant strains and to reinforce national policy on use of antibiotics.
Karthikeyan Kumarasamy, researcher of University of Madras and co-author of the controversial report while agreeing with the objections raised by the report advising patients not to visit India for treatment has advocated the need of a uniform antibiotic policy.
There should be a registry of hospital-acquired infections and hospitals should be asked to declare the morbidity or mortality due to such infections. Presence of hospital induced infections can’t be denied. Even, V M Katoch has admitted that there is irrational use of antibiotics and no hospital-infection control registry. National antibiotics policy should be formed so that strong antibiotics should be prescribed to the patients having severe infections.
Antibiotics should be sold only on prescription of a qualified doctor. Hospitals should be asked to ensure proper cleanliness and isolation of infectious patients. Dr Anoop Mishra, director and head of department of diabetes of Fortis Hospitals says that physicians should restrict irrational use of drugs. Dr Camilla Rodrigues, consultant microbiologist who has discovered superbug in Mumbai’s Hinduja Hospital also feels that high-end antibiotics should be used with discretion.
Union Health and Family Welfare Minister Gulam Nabi Azad has alleged that Lancet’s report tracing origin of superbug to India was manipulated by foreign pharma firms. Foreign pharma firms are active in taking and destroying Indian generic medicines industry and health tourism. Multinational pharma companies are buying Indian generic medicines and drug manufacturing companies even at exorbitant prices. Not only this they are also trying that patent over several medicines which is going to be expired in next two or three years should be extended for some time.
Although Minister of state, Department of Commerce and Industry, Jyotiraditya Scindia while replying to a question in Lok Sabha denied that no proposal has been received from the European Union Agency for extension of patent protection by another five years.
Basudeb Acharya had asked if there is any such proposal and what is the reaction of the government and the generic medicine manufactures and the corrective steps taken by the government in this regard to thwart such attempts. Minister has stated that since no proposal has been received from the European Union Agency in this regard hence question of corrective measurers does not arise.
They may not have formally put any proposal to the government. But it is being learnt that they are lobbying hard for achieving their purpose. It is interesting to mention here that as many as 61 drugs worth over eighty billion dollars are going off patent between 2011 and 2013. Pharma companies have made representation to the Prime Minister Dr manmohan Singh.
Union Health and Family Welfare Minister Gulam Nabi Azad while confirming this has told that his ministry will no way support the increase in patent period of life saving drugs and medicines for over twenty years. Prime Minister’s Office according to the sources has sought the views of Ministry of Health and Family Welfare and Ministry of Commerce on the issue.
Indian Drug Manufacturers Association, president, N R Munjal had also opposed any such move adding that they will not allow it as it will be tremendously detrimental to the health of our generic drug industry. Standing committee of the Parliament headed by Amar Singh in its report tabled in the house recently has expressed deep concern over the way the multinational pharma companies are acquiring Indian generic drugs and medicines companies and asked the government to take such steps so that these companies remain in Indian hands.
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