A view to a pill
Katherine Eban’s Bottle of Lies is an extraordinary international corporate crime thriller. Her research is detailed and its findings irrefutably establish widespread criminal malpractices prevalent among multinational generic drug manufacturers.
It is a horror story that features large decades-old award-winning pioneer companies from various countries. Ranbaxy Laboratory Ltd, “a jewel in the crown of Indian pharma”, is Eban’s chosen case study and its reputation has been convincingly torn to shreds. Ranbaxy ceased to exist in 2014. The purpose of Eban’s research, which took a decade, wasn’t to kill one famous company. She discovered how and why the business of making and selling spurious substandard generic drugs worldwide – including to the United States – was hugely lucrative. Indian and Chinese generic drugs manufacturers, in particular, routinely fudged laboratory test records. Falsified analyses were provided that met global world class qualifying standards. Local manufacturing costs in Third World factories were dirt cheap, export prices to first-world buyers were high. The game was as simple as that. Treachery in business runs on trust between diabolical sellers and hoodwinked buyers. Eban drives home the chilling point that making and selling drugs that aren’t what their labels declare involve profoundly organized criminality.
According to the author’s estimates, millions have died in poor African countries in particular. Under the aegis of benign trusted charities, they received cheap adulterated drugs donated by the very companies that make them. In effect, donors donate made-to-design poison pills. None doubted the authenticity of the donated drugs. After all, the same thing was being safely sold in the United States with no harm to anybody. Till Eban challenged the premise, the possibility of labels being printed with lies for one market and truth for another was too evil to investigate.
Eban describes the whistle blowers, informers, fence sitters and obedient employees who kept evil secrets to themselves in a compelling narrative that focuses on bringing out the bizarre truth.
Apart from Ranbaxy,
Eban cites many companies that continue to be active the world over. The author demolishes a belief that has ruled the world of medicine for decades: the invincibility of international drug regulators who hold absolute right to approve or reject applications for introducing drugs within their respective jurisdictions. The hydraheaded regulators’ bureaucratic monstrosities are mind-boggling. India is a tiny player where only two oracles call the shots – the Ministry of Health and Family Welfare and the Central Drugs Standard Control Organization.
The biggest surprise is America. The world knows no drug can be manufactured, bought, sold in or donated to USA without the authoritative approval of its Food and Drug Administration (FDA). Simple? Not if one counts the need to get approvals from its branches and offshoots: Centre for Drug Evaluation and Research, Office of Pharmaceutical Science with its subsidiary Office of Generic Drugs, Office of Global Regulatory Operations and Policy, Office of Consumer Litigation, and Office of Regulatory Affairs, among others.
If you really want to penetrate the morass and emerge alive at the other end please tick each item in Eban’s 37-page Notes (printed in small font size) and 20-page (ditto) Index. You’ll be nobler and wiser if you do.
This book is good for your health. The next pill you pop might not.