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2020

Pricing medicine
THE drug-pricing issue has once again taken centre stage in the debate on affordable healthcare
triggered by the Covid-19 crisis. The government is reported to have approved a proposal to amend the
Drug Pricing Policy 2018 to do away with the existing mechanism that allows pharmaceutical
manufacturers an automatic, inflation-adjusted increase in their prices. The suggested change may
appear innocuous as it doesn’t alter the CPI inflation-based pricing formula. But it isn’t. It stops
pharmaceutical firms from enhancing prices by just informing the health ministry 30 days before
implementing the new rates. In other words, the drug regulator Drap will get back its arbitrary powers
to decide if and when to increase the prices. The present drug-pricing policy was developed on the
orders of the apex court, which was hearing several hundred hardship cases filed by drug manufacturers
seeking an upward revision in their prices. Thus, the amendment is likely to reopen the floodgates of
litigation, besides increasing bureaucratic interventions in purely business decisions, and spawning
corruption. More important, the failure of the regulator to notify the price increase in a timely manner
would make production of certain life-saving medicines and vaccines unviable, resulting in their
disappearance from the market as was the case for several years because of a 13-year freeze on drug
prices.

Drug pricing has always been a political issue in Pakistan. There is no denying the fact that medicines are
a public good. But at the same time drug manufacturing is a ‘for-profit’ business for investors, who
would have to earn enough margins on their products to stay economically viable. No government can
expect medicine producers to bear the burden of healthcare costs for it. While it is important for the
government to control the prices of essential life-saving drugs, as is the case in Bangladesh and India,
the blanket application of such a policy can be detrimental to new investments where capacity
expansion, new technology, quality assurance and exports are concerned. Little wonder that several
foreign companies have already exited Pakistan and the industry lags far behind its regional
counterparts. Unlike Bangladesh, we don’t have a single FDA-approved firm in Pakistan and only one
out of over 600 manufacturers has been able to secure certification to sell its products in Europe and
the UK.

To ensure affordability, the government should improve its oversight of the market to encourage fair
competition, improve Drap’s capacity to make quick decisions on, say, drug approval, and help the
industry reduce its cost of doing business rather than denying manufacturers their legitimate inflation-
based price hike. Further, the authorities also need to create a market for generic drugs, the
formulations sold under their original chemical name at a massive discount compared to branded ones.
The government needs to learn from the regional industry and follow best practices instead of
suffocating manufacturers through price control for short-term political gains.

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An intellectual property

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July 11 Join us on Facebook

2020

Back to school?
AFTER a nearly five-month closure due to Covid-19, schools and universities in Pakistan are scheduled to
reopen on Sept 15. Education Minister Shafqat Mahmood made the announcement at a press
conference, saying that educational institutes will reopen with SOPs in place. Mr Mahmood also said
that authorities are mulling several options: scheduling classes on alternate days, conducting classes
outdoors, training teachers, recalling students to hostels with maximum 30pc occupancy and enforcing
mask wearing and social distancing. All this, however, is contingent upon the lowering of the
coronavirus infection rate. If the crisis is not curbed, Mr Mahmood said, schools and universities will not
open.

There is no doubt that the closure of educational institutions has been a huge setback for students all
over the world. In Pakistan especially, where internet access in many areas is limited, virtual classes
have been tremendously difficult to hold if not impossible. For young children, too, the disruption in
learning has had consequences for their emotional well-being. Therefore, the authorities’ concerns
regarding school closure are legitimate. However, taking any decision before the Eidul Azha holiday,
which is a couple of weeks away, and Muharram, may not be feasible as there is a fear that infection
rates will rise during this time. These fears are evidenced by the government’s repeated statements that
Eid gatherings and flouting of SOPs will undo the lower reported figures. The prime minister has
appealed to the public to mark Eid with simplicity and take precautionary measures. Unfortunately, no
SOPs are being enforced at gatherings in animal markets. As a result, one infectious disease expert has
predicted a frightening scenario of 5,000 new infections per day. If these violations continue and
infections rise, the government should, as it has already indicated, reconsider its decision. Even when
the time comes for schools to open — whenever that may be — the planning needs to be meticulous.
Temperature checks, distancing, mask wearing and rigorous training of teachers on SOPs will be
essential. A safe system will have to be chalked out for those using public transport to get to school.
Children who are immuno-compromised or who live with a vulnerable family member may have to be
offered an alternative to physical attendance. Teaching staff should be given paid sick leave, adequate
PPE and quick testing. This is an uncertain time and uncharted territory for all educational institutions.
However, authorities must support students and faculty by providing and enforcing clear guidelines.

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July 11 Join us on Facebook

2020

Yemen famine
THERE is yet more grim news from Yemen, as the UN says the Arab state is once more on the brink of
famine. According to the World Food Programme, around 10m people face an acute shortage of food
and that the people’s suffering is “unimaginable”. Moreover, the country, battered by over five years of
war, is ill-prepared to face the coronavirus pandemic. While the official tally says there are around 1,300
cases, experts warn the real number may be over a million, as Yemen’s fragile health infrastructure is in
no shape to give accurate data. If hunger and disease were not enough, Yemenis live in the constant
shadow of death either from the skies, in the shape of Saudi-led bombardment of Houthi positions, or
fighting on the ground between multiple factions.

In the immediate future, the international community cannot let Yemen’s vulnerable people starve to
death. While the Covid-19 situation has greatly complicated matters, funds, foodstuff and safe passage
must be guaranteed so that immediate succour can be provided to Yemenis, along with medical aid. But
in the long run, there is only one workable solution to Yemen’s myriad problems: bringing this horrific
war to a swift close. While truces have been called, and broken, it seems the world community has lost
interest in Yemen and its forsaken people. Saudi Arabia, the UK and the US have indeed pledged large
amounts of aid at a recent donors’ event for Yemen. But if they really want to help the country, these
states must declare an indefinite ceasefire, and stop providing the weaponry that is helping prolong the
war. Moreover, the principal Yemeni actors — the government, the Houthis, the southern separatists —
as well as their primary foreign backers including the Saudis, the Iranians and the Emiratis, respectively,
must hammer out an agreement that can help end hostilities forthwith, ensure the integrity and
stability of Yemen, and give Yemenis a chance to rebuild their shattered country.

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