Indian Pills

Concern has been expressed about the quality of ethical drugs being marketed in India. A recent private survey showed that about 7% of the pills being sold are tainted in some way, or are sold beyond the expiration. About 2% of the pills had no active ingredient at all. If one were to focus a survey more heavily on rural areas, I surmise these percentages are very low compared to the population mean.

Much the issue is cultural ,unfortunately. Since my uncle started a successful pharmaceutical company in India back in the Sixties, I learned a lot about the business riding shotgun with him on his sales calls to retailers and wholesalers. Pharmaceuticals were considered no different from any other kind of merchandise, like powdered milk, rice or bath salts. Turnover and margin are what the astute shopkeepers care about. So it was very common to find adulterations in all of these products. A big tub of crystalline bath salts, treasured by moms and grandmas, often had fine, white sand integrated into the mixture. There was a big scandal in New Delhi when the biggest purveyor of powdered milk was caught putting non-food extenders into its tins.

Few people complain, and even fewer would go back and demand a refund, and absolutely nobody was silly enough to take a company to court. Pharmaceuticals are just another product, because India doesn't have 24 hour "investigative" media (Dr. Sanjay Gupta, come home!), nor does it have an efficient court system that can prosecute companies for harming the public health.

Now India has companies like Ranbaxy Labs that are recognized leaders in generics and nutritionals. Competing at this scale and in the global pharma regulatory environment brings discipline and efficiency. No such mechanism exists locally in India, especially in the rural markets. Hopefully, this will come with time.