31.01.2013 Risk to public health
IT is a frightening indictment: a judicial probe into the Punjab Institute of Cardiology deaths that occurred a year ago has revealed that effectively the only protective system against substandard or incorrectly constituted drugs exists at the manufacturing stage. In other words, the state does virtually nothing to ensure that all locally manufactured drugs are safe for consumption, do not contain any surplus ingredient and have been manufactured and tested in compliance with the Current Good Manufacturing Practices; routine compliance audits of pharmaceuticals are not conducted. How serious an issue this is, is evident from the tragedy that led to the probe in the first place: towards the tail-end of 2011, mysterious deaths started being reported from Lahore hospitals, prompting an inquiry by the Punjab government and police. By the time the cause — batch J093 of the medicine Isotab distributed by the PIC through its free pharmacy — had been identified, countered with an antidote and recalled, 213 patients had died and about 1,000 others had suffered adverse symptoms.
The report, finalised by Justice Ijazul Ahsan and handed over to the Punjab home secretary last month, holds most of the parties involved responsible, foremost among them the Karachi-based pharmaceutical that got the constitution of this batch of Isotab wrong. However, it also points out that the distributing company omitted mention of batch J093 in the delivery receipt for the PIC, as a result of which the latter did not include samples from it while having suspect drugs tested. Indeed, it seems to be mere good luck that led to the identification of the cause of the deaths, for according to the judicial probe even the police inquiry and the Punjab administration’s response lacked direction or force. In terms of the PIC, the report points out that the staff of the pharmacy’s storeroom and inventory control that checked and approved the consignment also need to answer the question of why they missed the presence of batch J093.
It is to be hoped that this report will prove to be a wake-up call and that the health authorities will begin to keep a strict eye on the manufacture, distribution and sale of drugs. There was earlier some confusion after the passage of the 18th Amendment as the health sector stood devolved as a provincial subject. But now the Drug Regulatory Authority of Pakistan, signed into law last year, needs to start an immediate overhaul of the drugs sector. It must stringently apply the law where available and propose new legislation where required. Pharmaceutical products that can make people ill constitute a deadly risk.
Tax exemptions
SIX hundred billion rupees borrowed from the IMF between 2008 and December 2012 — and Rs700bn granted as tax exemptions over the same period, the Federal Board of Revenue informed the Senate on Tuesday. Bald figures can often be misleading — not all borrowing is undesirable and some tax concessions may stimulate growth — but they can also be revealing. The juxtaposition with IMF borrowing and tax exemptions falls into the latter category: evocative figures that tell a sordid tale as Pakistan once again slips towards the IMF embrace. With the financial year more than halfway through already and with a general election on the horizon, the possibility of economic reforms at this time is nearly zero. Factor in the utter incompetence and recklessness of the PPP-led federal government and the likelihood of reforms at this moment does become zero.
Yet, if a constituency for reforms is ever to be created, the complex ways in which the state bestows favours on favourites has to be understood. The principal figure in this racket is something known as a Statutory Regulatory Order. While the power to tax ought to be the remit of parliament, the SRO is an often-abused instrument for the executive to override legislative requirements. The PPP did not invent the SRO and is far from the only government to have abused the regime: the Musharraf government before it did and if a non-PPP government follows, it will likely do so too. There is an analogy here: like the suo motu powers of the superior judiciary, the SRO regime is not inherently a bad idea. But when used too often and almost as a default instrument, it undermines the wider system. The SRO regime has been used to grant such wide-ranging tax and duty exemptions that it has effectively dismantled the overall tax system. What is especially harmful about it is that it is used to favour big business and the best-connected special interests. The tax-to-GDP ratio will not be restored to a healthy number merely by ending the abuse of SROs, but clamping down will send a strong signal that the big boys don’t have a free run
A different challenge
IT is not a pleasant situation. The Pakistan women’s cricket team may not be one of the prime contenders for the World Cup tournament that gets under way in India tomorrow, but the circumstances have already made it the grittiest. Before taking on the usual challenge posed by other competitors the Pakistani cricketers must first deal with the very special treatment they have so far received in India. To begin on an inauspicious note, the venue of the Pakistan games had to be shifted from Mumbai to Cuttack following serious threats by hardliners. That was disappointing enough. Now it is learnt that the team has been literally kept in protective custody and is not allowed to leave the premises of the stadium where it is going to play. The adjoining club where the Pakistani cricketers are lodged may be a good enough substitute for a hotel, but it cannot quite reduce the psychological impact the limitations must be having on the players.
The situation does prepare the ground for conjuring up images of a Rocky-style finale — an underdog overcoming the greatest of odds to triumph over the more fancied and more privileged. While there is no bar on dreaming, realities dictate that the game must go on, whatever the constraints. Pakistan’s inability to host international cricket has put it on the back foot and many instances in the recent past show the choice is not Pakistan’s. Only last month, it had to shift its home series to India and play it on India’s terms, for want of an option. The compensation was some good displays by the men led by Misbah-ul-Haq and Mohammad Hafeez. Sana Mir’s team is carrying itself with a lot of grace in trying conditions. This is victory enough.