In my last article I had made the point that we in India are being hit by a double-whammy: too much use of medicines, which are often of poor quality. And the lower socio-economic strata are hit even worse because they are compelled to buy more medicines to counter the adverse effects of the first medicine.
It is true that most of the stuff in the chemists' shops are of reasonable quality. But when you buy a particular strip of any medicine, how do you know whether it belongs to the good quality category or the other half? This is something like a Russian roulette - imagine the same thing happening every time you fall sick!
I am also saying that our medical colleagues prescribe too much, too often. Of this there are numerous examples, and more are coming into the open every day. It is a bit like police brutality - they are supposed to protect you from violence and crime. But when they themselves are too cruel for words, where do you go? Similarly, when the doctors prescribe what is not appropriate, where does the sick person go?
To correct this, there should be prescription audits, as it happens in some countries, and all doctors should have to explain in review meetings, why they have prescribed a certain set of drugs. This may seem idealistic but is surely one road that leads to good medical practice.
Mr. Subrata Mukherjee says in response to my previous article that "May God help the poor!" The answer is: the pharma companies make their money on new drugs, which they induce and entice the doctors to prescribe. Hence, let those drugs be charged at their real price -- let those drugs not be placed under price control. Also they should be protected by patents, so that money spent of research can be recovered.
The ordinary middle class, which includes you and me, can live without those drugs - we can stay perfectly healthy with the help of the 250-odd medicines that figure on the WHO list of essential drugs.
Mr. Mukherjee says the problem is that of availability. I agree. Hence I am saying that one way to curb the demand by placing out of reach of most people. In case there is a genuine need, when a family member is sick, people will try their best to procure a medicine that they might otherwise not be able to afford. But that is only as a last resort; when there is no other way out. And if the family is truly impoverished, financial assistance can be offered through the numerous charitable trusts that exist precisely
for this purpose.
Today medicines are used as a tool of convenience -- as an easy way to solve everyday problems of life. Women use hormonal pills to put off their menstrual periods just before a religious function! At the All India Congress of Obstetricians and Gynecologists, there have been studies that document this.
For routine aches and pains, fevers and nauseas, other solutions will have to be found. In my own house, hot fomentation is used frequently for minor injuries, "local train backache" and other conditions. The only treatment for diarrhea in adults, (in most cases) is plenty of liquids. The remedy for indigestion and acidity is "ajwain" and not antacids. The therapy for light abdominal pain is application of asafetida (heeng) and not Baralgan. This is the crux of my thesis. This is what I advocate. And Mr. Mukherjee, please note, this approach will benefit the poor more than the rich!