Medical experts have told Killid that the bad quality of medicines has meant that patients, who could be cured in two to three days, take months to recover or evendeteriorate. In the worst cases, these medicines have caused the deaths of many patients, they state.
The problem of spurious and expired medicines in the Afghan market is emerging as a major problem for patients seeking medical treatment who often end up sicker than they were. The Ministry of Public Health just denies there is any issue of concern. Killid investigation shows the opposite. We even bought medicines that were proven to be fake.
Medical experts have told Killid that the bad quality of medicines has meant that patients, who could be cured in two to three days, take months to recover or evendeteriorate. In the worst cases, these medicines have caused the deaths of many patients, they state.
Emerging from the Ataturk Hospital in 3rd district of Kabul, Muhammad Tahir told Killid that he spent all he had on medicine and fees, but the patient he was visiting showed no improvement. “They have been writing prescription after prescription. My patient’s condition did not change. Now he is in a critical condition so I’m going to have to take him to Pakistan.”
Jan Agha, a 45-year old man emerges from the same hospital carrying his child. He says it has been seven years since he has been trying to have his child cured, going from hospital to hospital. In his hands is a bag full of the prescriptions he has been given. “People don’t know that so much medicine is out of date. Though the doctors prescribe tons of medicines to their patients, it has no effect.”
Doctors blame medicines
We tried to interview some of the doctors at Ataturk and Ali Abad hospitals, but they refused saying prior permission was required from the Ministry of Public Health. Dr. Muhammad Zahir, an Afghan doctor who now works in an Indian hospital where he treats dozens of patients every week however concurred that medicine quality was bad. He told Killid that the main reason why patients do not get cured in Afghanistan is not the quality of the doctors or medical care, but that of medicines. Medicines available in Afghanistan did not meet prescribed standards. The very small amount of good quality medicine available in Afghanistan was too expensive for most people.
Dr. Zahir says that not only does the low-quality medicine not benefit the patients, but it worsens their condition. “In India even when the patients’ joints are replaced, they get discharged from the hospital on the fifth day – it has nothing to do with the doctors’ expertise, but is attributable to the high-quality medicines. Such operations are not possible in our country due to ineffective medicine and antibiotics which are not able to prevent infections that could take months to cure. This is why I moved to India”.
Dr. Rizwanullah, who is in charge of City Laboratory, complains about the lack of checks on medicines of poor quality. “Neither the government nor any private organization is inspecting the medicine. The people of our country are right – the poor quality of the medicine is proven to us through the substances used in labs. The substances we buy in Kabul are rejected by our machines, but the machines work well with those we buy in Islamabad and Peshawar.” DrRizwanullah accuses the medicine dealers of importing low-quality medicine, which is sold in the markets.
Government denies problem
The head of the Pharmacy Department at the Ministry of Public Health (MoPH), Aysha Noorzai, denies that low-quality medicines are being sold in the market. “No low-quality medicine is imported and we don’t allow it”.
However, the head of the health inspection department of the MoPH, Saed Ibrahim Kamil, says there is low-quality and sub-standard medicine in the market. He says that his department has frequently collected medicine from vendors selling the bad medicine in baskets in front of the Pul-e-Kheshti Mosque.
The association of medicine importers, where 136 importing companies are registered, also verifies that companies import low-quality and substandard medicine. “I can’t close my eyes to the low-quality medicine sold in the market. I have seen people importing fake medicine, but I know of just a few companies importing low-quality medicine”, says the deputy head of the Association, Dr. Ahmad Arsalan Karimi. He does not name any specific company involved in the trade, but says it is the job of the Pharmacy Department to check any medicine for quality and fine the importers of low-quality medicine.
The head of Pharmacy Department, Ms. Noorzai , however says there is no evidence proving that low-quality medicine is sold in the markets of the country and adds that there are no fake medicines in the country at all. “If any fake medicine is imported to the country, we find out about it. We take a sample and check it for quality at the inspection department of the ministry, and after the results are known, we take action”.
Clear evidence of fakes
Although Ms. Noorzai refused to admit that there were low quality medicines being imported, a colleague in the same department confirmed that two sample medicines collected by Killid from the market were fake.
Pharmacist Dr. Muhammad Sharif says that while many companies in Afghanistan import medicine manufactured by reputable companies, there are also some companies importing low-quality and fake medicine from China, Pakistan and Iran in order to make more profit. Giving an example of “Warin” injections, Dr Sharif said the real price of the real injection in the market is 15 Afs (Afghanis) per ampoule. However “the same injections with the same dosage are imported from China that is sold for 1.5 or 3 Afs. Now judge for yourself how effective these Chinese-made injections could be.” Dr. Sharif says that criminal importers of low-quality medicine use the uncontrolled and volatile borders of Afghanistan.
The supervising manager in the pharmacy department of the Ministry of Public Health, Zakaria Fateh Zada has the same opinion and says criminals are exploiting the market for medicines. “There are no border patrol police patrolling all borders, and the mafia is taking advantage of this by smuggling low-quality medicine into the country.”
A staff member of the pharmacy department, Hamidullah also concurs. He told Killid that he believes that his colleagues responsible for taking samples as part of the regular inspections of medicine quality have not sent any samples to the concerned department for the past five years.
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