I have done an experiment multiple times - each time with essentially the same result. It goes something like this: I go to a pharmacy somewhere near a major public hospital (think PIMS in Islamabad, JPMC in Karachi, etc), and ask them about some drug that is commonly prescribed (could be an antibiotic, or something else for another ailment). The answer is always the same. The pharmacy worker offers a few options, with varying prices. The price range can be substantial, sometimes spanning five to tenfold. I inquire why there is a difference, and the answer is about trust and quality. The pharmacy worker has no qualms about telling me that one (the expensive one) is better than the other. One is reliable, and the other one is not!

My experiment, when I have shared it with colleagues, both those who are in public health and those who are not, is not particularly surprising for them. "Not sure what your point is?" they say. They see this every day in pretty much everything - fans, solar panels, batteries,........

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