This story is part of “Pills, Perils, Profits”, a Himal investigative series on Southasian pharmaceutical manufacturing and exports.
Reporting for this story was supported by the Pulitzer Center.
IN MAY 1982, a committee of eight experts submitted a report to Bangladesh’s health ministry proposing an overhaul of the country’s drug regulation regime. At the time, Bangladesh was almost entirely reliant on imports for its pharmaceutical needs, just like many poor countries in Southasia and beyond continue to be today. Most medicines on the market were expensive, and often-unsafe cocktails of antibiotics, cough syrups, digestive enzymes and palliatives were ubiquitous. Some three-quarters of the country’s pharmaceuticals were manufactured by just eight multinational companies, which typically sold their products at exorbitant prices. But medicines were not always easily available even to those willing and able to pay, owing to inadequate and poorly distributed infrastructure.
The expert committee proposed a radical, transformative National Drug Policy (NDP). “Irrational cocktails of digestive and cough syrups and liver tonics were the majority of the drugs in our market,” Abdul Muktadir, the chairperson of Incepta Pharmaceuticals, one of Bangladesh’s largest producers of generic drugs, said. Out of the 56 drug products sold by the British multinational Glaxo in Bangladesh in the early 1980s, 22 were vitamin supplements and tonics – and only three of these were marketed by the company in Britain. “They had little role in the treatment of diseases prevalent in our country,” Muktadir, who is also the president of the Bangladesh Association of Pharmaceutical Industries, added. “If you look at India, to this day, these kinds of cocktails are bestsellers. It doesn’t happen in Bangladesh. The NDP encouraged companies to produce what the country needed, like antibiotics and antiviral medicines. That law was such a big jerk to the whole system. To this day it impacts the psyche of patients and doctors, who don’t put their trust in irrational medicines.”