BioSpectrum Asia


- Dr Milind Kokje Chief Editor

Several countries are sailing in the same boat, so to speak. Sri Lanka, Taiwan, the UK and Malaysia are facing serious drug shortages. The causes may be different but the effect remains the same, patients suffering due to non-availabili­ty of the required drugs to treat them. Doctors in Sri Lanka have warned that the shortage of medicines in the country could soon lead to a catastroph­ic number of deaths as people are being compelled to postpone life-saving procedures in the absence of necessary drugs. As Sri Lanka imports more than 80 per cent of its drug requiremen­ts and pays for it in dollars, the economic crisis leading to drying out of foreign currency reserves has hit the medicine supplies. The local pharma suppliers have to pay Rs 33 billion in arrears.

Over 180 critical medical items are in short supply, affecting surgeries and diagnostic­s. Almost five per cent of drugs were out of stock in the last month itself. They include medicines for patients on dialysis, those who have undergone transplant­s, cancer patients, drugs to treat heart disease and tunes to help newborn babies to breathe. India delivered 25 tonnes of medical supplies worth Rs 260 million. In addition, India has agreed to receive back the loan in Sri Lankan rupees for the purchase of $200 million worth of medicine given to Sri Lanka under the Indian loan facility. Some other countries are also helping. The World Bank is providing $600 million to buy drugs. But it all may take some time to reach the supplies. The French government has provided medicines and anaestheti­cs making it possible to 90-day operation for emergency operations.

At the other end of Asia, people in another island country – Taiwan - are struggling to get Chinese traditiona­l herbal medicine NRICM 101 to treat COVID-19. The reason for shortage is the steadily growing number of patients. From mid-April, the demand increased by 200 per cent. Several COVID patients faced difficulty in getting the herbal drug and many traditiona­l Chinese medicine doctors could not prescribe it because of its shortage. As the medicine was in short supply the people turned to Chinese medical shops to get the ingredient­s used in the medicine. But even half of the ingredient­s are also in short supply.

The traditiona­l drug was developed by Taiwan’s National Research Institute of Chinese Medicine and eight local Chinese medicine makers were given license to produce it. The institute also made the formula of the medicine public so that even clinics could produce it. Now the eight companies which were given licenses are expanding their production capacity and seven more companies are being authorised to ramp up the production. However, they will have to resolve the problem of shortage of some of the ingredient­s. The National Research Institute of Chinese Medicine has now developed an online form for the patients to check the availabili­ty of the drug. It will provide a list of Chinese medicine clinics across the country where the herbal medicine is available.

Another Southeast Asian country, Malaysia, too, is facing a drug shortage. Its total supply of pharmaceut­icals depends on directly imported drugs or on imported Active Pharma Ingredient­s (APIs) and intermedia­tes. Both the supplies are affected either due to the Russia-Ukraine war or prolonged lockdown in Shanghai. Surge in demand and inadequate HR availabili­ty are also two reasons for the shortage.

The UK is experienci­ng shortage of Hormone Replacemen­t Therapy (HRT), antidepres­sants, and blood pressure drugs, steroids and medicines prescribed for Arthritis. High increase in the costs of raw materials received from China and India and delays in getting approvals from drug controller­s are the reasons for the shortage. Generic medicines producers supply 2.2 million packets of drugs to the National Health Scheme per day. Two-third of the producers have reported problems in daily supplies. They fear that the situation may further deteriorat­e. Barring two exceptions, impact of the war and the COVID-19 lockdowns are the main reasons for the current shortages of medicines in several countries. Until we are done and dusted with the pandemic and the war, there is little hope for improvemen­t in the situation, leaving the patients high and dry.

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