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Punish The Guilty

Punish The Guilty

The manner and ease with which the drug smuggling cartel, busted in Haryana’s Gurugram this 28 July, had circumvented the supposedly-fool-proof system is appalling. The bunch of crooks, now in police custody, not only hoarded medicines meant for coronavirus (COVID-19) treatment but also planned to smuggle them on a Vande Bharat flight abroad. Worse is that the cartel managed to procure the list of travellers with an intent to send the medicines in small batches through selected travellers apparently to be sold at whopping prices.

Ever since the World Health Organization declared the COVID-19 outbreak a pandemic this March 11, its management and treatment has literally thrown up a plethora of challenges globally and India is no exception. With no preventive medication available at the moment, accelerated efforts by researchers worldwide to develop a vaccine for COVID-19 is commendable.

Considering the emergency and unmet medical need for Covid-19 disease, the Central Drugs Standard Control Organization(CDSCO), India’s drug regulatory authority which monitors the import of drugs and approves new drugs and clinical trials,  approved restricted emergency use of Remdesivir injectable formulations for treatment of patients with severe COVID-19 infection and Favipiravir Tablets for mild to moderate COVID-19 infection subject to various conditions and restrictions, while both the formulations can be sold under the prescription of medical specialists only, Remdesivir would be supplied for use only to the hospital/Institutions only to ensure proper use of the drug as recommended. The Pharma companies need to obtain written informed consent from every patient before initiating the treatment, submit results of additional clinical trials and active surveillance data of all patients treated with the drug and provide a risk management plan besides active post-marketing surveillance and reports of serious adverse events.

The Gurugram incident came to light based on a tip off and police could nab five suspects - four Iraqi nationals and one woman from Uzbekistan who were all said to be employed as interpreters at a local hospital. Did they allegedly have connections with the distributors of the COVID-19 drugs? But this is just the tip of the ice berg and ongoing probe could bring out more information.  Since COVID-19 drugs like Remdesivir is to be only supplied directly by Pharma companies to hospitals, how did the drug surface in the open market? No easy answers.  

According to media reports a local pharmacist had sourced 84 Remdesivir injections without a bill at Rs 15000/- a vial (MRP Rs 5400/-) from another dealer which he sold to the foreigners at Rs 18000/- a vial. Similarly, 55 strips of Fabiflu (MRP Rs 2500 per strip) and 18 packs of Lopikast. (MRP Rs 3990) would easily fetch 4-5 five times its MRP in Iraq, while a vial of Remdesivir would get Rs 1 lakh a vial. The suspects are believed to have told the investigators that they were smuggling medicines to Iraq for the past two years. The foreigners who could not produce any valid visas or passports, confessed they were trying to cash on the drug shortage in Iraq and its high rates in the black market there.

Similarly, recently an eight-member gang led by the Managing Director of Hyderabad-based Pharma company was found diverting anti-viral drugs used for treating COVID-19 through the black market, was nabbed and Rs 35 lakh worth of drugs was seized. The gang used a chain of middlemen to supply drugs to patients after procuring them locally. The one-month old smuggling business, believed to have flourished using WhatsApp, accepted cash as well as digital payments.  Drugs like Remdesivir fetched the gang a profit of nearly Rs 34000/-per vial. Another drug Tocilizumab costing Rs 40,000 per unit, used to treat COVID-19 patients in the ventilator stage was being sold for more than Rs 1 lakh.

In Surat too, according to reports, black-marketing of Tocilizumab at Rs 74000/- a vial was detected when a spurious injection reached a patient and the alert doctor informed the police.

What is disconcerting is that the CDSCO had already flagged the issue after receiving representations of COVID-19 drugs being overpriced and their black marketing by some unscrupulous elements. CDSCO has advised the Drug Controllers of all States and the Union Territories Drug Controllers to initiate measures to prevent black marketing of COVID-19 drugs. Be it Gurugram, or in other places where black marketers seem to thrive is cause for concern as it can fall into a drug cartel which could use them for to fund undesirable activities. So, efforts need to be stepped up to keep vigil, nab the black marketers and swiftly bring them to book to serve as a deterrent.

Last month, the United Nations Office on Drugs and Crime (UNDOC) had expressed worry that the sudden increase in demand for medical products to address the COVID-19 pandemic has led to an expansion in the trafficking of substandard and falsified products.

With health and lives at risk with criminals exploiting the COVID-19 crisis to cash in on public anxiety and increased demand for PPE and medications, UNDOC’s warning that transnational organized crime groups can peddle substandard and falsified medical products ought to serve as a warning for countries including India to put in place effective enforcement measures to keep such undesirable elements at bay.

Someone had said that there is an opportunity in every crisis. But literally the emergence of COVID-19 has unfortunately seen a huge surge in data compromise frauds that includes phishing, email scams etc. As every other day there are reports of cloned websites of apparently legitimate companies trying to cheat vulnerable consumers, there is an imperative need to step up public awareness.

(Published on 03rd August 2020, Volume XXXII, Issue 32)