THE Directorate General of Drug Administration has recently banned the popular acidity drug medicine rantidine because the ingredients used carry carcinogens. The drug was banned a month after the US Federal Drug Administration had raised the flag about the carcinogenic substance in the drug. As pharmaceutical companies do not have laboratories to run metabolite analysis, the government had sent the samples to Singapore before the ban was ordered. In the process, the weakness of drug testing in Bangladesh, with a thriving pharmaceutical industry, has exposed that only 10 per cent of the drugs produced locally each year are tested. The drug administration officials say that 272 manufacturers produce 3,645 generic allopathic drugs under 29,854 brand names, but the National Control Laboratory could test only 2,331 drugs in 2018. Two laboratories usually test drugs but they cannot test the ingredients imported from more than 2,800 sources to manufacture medicines in local companies. The laboratories are also not equipped to test the quality, efficacy, potency and toxicity of drugs available on the market. Homoeopathic, ayurvedic, yunani and other alternative medicines remain outside the purview of testing procedures. This shows that standards of drugs, considered one of the main pillars of an effective public health system, are not properly ensured.
The cost of substandard and adulterated drug has already proved fatal and the problem is not new. In March 2018, 20 people lost sight after surgeries in Impact Masudul Haque Memorial Community Health Centre in Chuadanga as the drugs and surgical instruments, including hand gloves, chemicals and eye-droppers used in the operations, had no license from the Directorate General of Drug Administration. Fourteen patients admitted to Rajshahi Medical College Hospital underwent extreme side effects this May after they had been given antibiotic and antispasmodic medicines supplied by the state-owned Essential Drugs Company Limited. In the verdict of a drug adulteration trial against Adflame Pharmaceuticals, a local court in 2015 observed that many lives could have been saved if the drug administration had acted efficiently in 1991 and identified toxic diethylene glycol in paracetamol syrup for children. Not only are testing facilities in Bangladesh poor in the detection of drug toxicity, the National Pharmacovigilance Centre is not effective. Since its journey in 2013, the system to record adverse reaction received only 2,543 drug reaction reports — 740 in 2017, 665 in 2018 and 340 until June 2019. It is evident from the situation that the government has neglected the drug administration issues as it lacks the capacity to adhere to the globally accepted standards for drugs before they enter the market.
Making safe drugs available for its citizens is a fundamental requirement for any public health system, but successive governments have been negligent to drug market regulation. The ministry of health must immediately allocate necessary funds to modernise drug-testing laboratories and further capacity so that it can ensure that medicines and ingredients used to produce medicines go through a standard testing procedure before medicines are made available on the market.