THE ongoing US-Iran war has disrupted the production and supply of life-saving medicines and crucial infant milk formula in Pakistan, highlighting the weaknesses in preparedness, governance and policy planning.

This situation has caused significant distress among the people, as shortages and the country’s inability to produce these products domestically have led to skyrocketing prices and huge inconvenience to a majority of the population.

The government did not have a policy to ensure smooth supplies of essential medicines nor a mechanism to control prices, said Mohammad Atif Hanif Baloch, President of the Wholesale Chemists Council of Pakistan. “If the war in Gulf countries continues, prices of all medicines could rise dramatically, including cancer, diabetes, insulin and heart medications. The war could also cause a severe shortage of baby formula, which is entirely imported, along with a sharp price increase,” he said. “Most of these medicines are used by low-income populations.”

The Drug Regulatory Authority of Pakistan (DRAP) has sounded an alarm over the availability of medicines in the country as the ongoing Gulf crisis affects the supply chain. Notably, Pakistan as failed to produce pharmaceutical ingredients for medicines during the seven decades of its existence. It relies for most of the raw material required to produce basic medicines, while it imports life-saving medicines from different countries. And whatever stocks it has could not last for more than two months. The overall cost of medical treatment in Pakistan is very high and thus unbearable and unaffordable for the majority of the population. Against such a backdrop, the Middle East crisis has made things worse, thanks to the disruption of global supply chain. An official from the Health Ministry accepted that the things could go haywire if the Gulf war continues. “We are also aware that the cost of freight and insurance for shipments coming through Gulf routes has increased due to the sudden spike in fuel prices and the prevailing security situation.”

Dr Akram Sultan, a retired health official from Pakistan, said the inability to produce API could severely affect the availability of medicines, raw material and vaccines in Pakistan. “Pakistan currently has no strategy to produce pharmaceutical raw material domestically. The government could not establish a pharmacopoeia and local pharmaceutical companies do not focus on producing raw materials,” he said.

About 90 percent of the raw materials, also known as Active Pharmaceutical Ingredients (API), are imported to Pakistan through the ports in the Gulf. So, the API supplies now has become scare, uncertain and expensive, said Javed Ghulam Mohammad, the CEO of Martin Dow Group, a Pakistani multinational pharmaceutical company. “Disruption in the Gulf will definitely affect the overall supply of raw material to Pakistan. And it will impact the availability of medicines,” he said. Pakistani importers have switched to air cargo for smooth supplies of life-saving medicines, but it has made the expensive medicines even costlier. However, they said the plan would not be sustainable if the crisis continues for many more days. Industry representatives criticised the government saying that the policy issues such as the delays in price fixation area major roadblock. According to the Pakistan Medical Association, there was a severe shortage of essential paediatric TB medications, which could lead to a “catastrophic surge” in drug-resistant TB in affected children. Pakistan’s reputed newspaper Dawn in its editorial slammed the Islamabad government for its failure and criminal negligence. Karachi-based Dr Hira Ahmed said the price instability and disruptions in the supplies were likely to affect patients undergoing cardiac, cancer, and transplant surgeries.

Interestingly, Pakistan is still dependent on imported vaccines, even for basic diseases like measles, polio, pentavalent, among others. Dr Rafiq Khanani, President of Pakistan Infection Society, expressed concerns over Pakistan’s failure to produce vaccines on its own. If the conflict continues for a long period, the disruption would cause the serious shortage of life-saving medicines, vaccines and even infant formula milk. “Even WHO-qualified vaccines may not reach Pakistan if the conflict continues,” said senior pharmacist Dr Usman Ghani.

— The writer is an educator, based in Sindh.

© Pakistan Observer