How Nice is Nice

Recently, I was at a pharmacy where a customer requested the pharmacist for a strip of tablets called Nice. The pharmacist promptly handed it to her  India is notorious for patients self prescribing ‘prescription drugs’ and pharmacist think nothing about giving it to them. In fact few pharmacist give you a receipt for the medicines you buy, which in itself is totally illegal and extremely dangerous. For, God forbid should you develop an adverse reaction, you will have little to help you take legal action. Looking at this situation I have often wondered whether the person behind the counter himself is really qualified, as in whether he is a trained pharmacist or has simply ‘learnt’ the trade through an apprenticeship, many of these so called pharmacist look suspicious young, unkempt and I know of some who have even passed comments when requests for certain things are made. Thinking carefully about it, I would not be far from the truth if I said the entire ‘drug’ industry in the country is rather unregulated, thus giving way to huge amounts of fake drugs, quacks who operate as doctors and fraud pharmacists, to mention but a few problems.

So why have I launched out on this tirade?, well Nice is the commonly used name for a drug called Nimesulide, which is not approved for used in the US and about 160 countries of the world including Britain, Australia, Canada etc, and it is no secret from the many forwarded e-mails that I have received and content on the internet, that it has some hazardous side effects and so is not to be consumed. Yet, the Food and Drug Administration in India is yet to verify the claim about adverse effects or ban it, and the drug continues to be sold in the country, freely.

For those who are new to this issue, Nimesulide, according to Wikipedia “is a relatively COX-2 selective, non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties”. The drug is sold under a variety of names and their details can be found on Google.

After the customer had purchased the drug and left, I asked the pharmacist about how it was that he sold this drug, assuming it was banned, to which he asked if I was Indian!, “of course”, I replied, not just a little perturbed as to why my nationality had been brought to bear in the matter. “This drug is banned in the US” he continued, as if reading my mind, “not in India”. As if this information was not bad enough, he went on to add, “our bodies are different; in the US they eat only burgers and coke (and that’s why the adverse reactions!), nothing happens to us here. In fact Nice is as fast moving as Crocine” (another drug commonly self prescribed for cold and fever).

Here the readiness of the reply astonished me, obviously this question had been posed to the pharmacist earlier, this was a studied reply, something that has been fed to him by one of the thousands of neatly attired medical representatives that snake their way to the thousands of hospitals, clinics, doctors and pharmacies each day, or maybe it was some tripe he had prepared on his own, in response to questions from people like me.

Of course it was no point arguing with the pharmacist; for he was just symptomatic of the rot in the system and not the entire system or the rot itself.

It is not untrue

- That we have outdated laws in India that govern the entire ‘health’ system.

- That the bureaucracy is understaffed and largely ineffectual, and besides is largely unmonitored and highly corrupt.

This has left the doors wide open for the World Trade Organization to twist our arms into agreements that allow foreign drug companies to take advantage of our antiquated laws and introduce drugs that have not been adequately tested or approved, thus endangering the lives of thousands of Indians. A case in point is the recent revelation about an anti obesity drug Rinomabant, that was found linked to depression and suicidal tendencies in 20% of the patients consuming it. The drug had not received FDA approval in the US but was freely available here. It was only after the EU banned it that India is considering a ban.

There are numerous health groups working all over the country against unscrupulous drug companies from countries like the US, who have saturated the market there and are now making hay in the largely unmonitored, unregulated market of India.

On the other hand India itself has a twenty thousand crore fake drug market! Some of these drugs are manufactured in slums and in unhygienic conditions, making their consumption extremely dangerous. Recently Malaria drugs bound for Africa were checked in Europe and the entire batch was found to be fake. The Crocine which the pharmacist mentioned could often be simply chalk powder sold as a drug.

The situation is horrifying to say the least, and people are known to have died, because not just minor drugs are faked but the same has been done in the case of life saving medication.

Its time we became aware of this issue of fake drugs, quack doctors and fake pharmacies. I’d suggest the best way to ensure you are safe is

n To buy drugs with a prescription rather than have them self prescribed

n Insist on a bill when you pharmacist gives you a drug.

n Buy your medicines from a proper pharmacy rather than some decrepit hole in the wall.