Health services in India
SRINIVAS JEGANNATHAN
As a clinical research scientist, I know and many of us know that India is fast becoming a hub for clinical research. No doubt, it’s good news to scientists and for the Indian economy. But, what about the plight of thousands of patients, who would be subject to clinical trials?
One of our peers pointed out that clinical trials are already on for years in India, but ‘nothing official about it’. Initially, it was a googly but later on he clarified further: in India thousands of quacks treat lakhs of patients – even in big cities like Mumbai. Aren’t they doing trial and error? What is the regulatory system doing? There are hard core facts, as given below.
Chemists dispense countless drugs over the counter. It must be noted that all the Schedule-H Drugs must be taken strictly under medical supervision, but are sold as OTC drugs without reservation. Who knows the fate of people who buy such drugs over the counter?
Personal experience
Well, there is so much buzz about the hi-tech, global standards and all that. But my personal experience is an eye-opener. I’m writing this sitting in a private hospital in Chennai as our mother, primarily a patient diagnosed with the Parkinson’s disease and dementia, was admitted for critical illness. During the course of investigations she was diagnosed with advanced liver cancer. The oncologist attached to the hospital advised us to give consent for chemotherapy, primarily to reduce her pain and further aggravation, though scope for regression is nil. He did highlight the deleterious side-effects. We took a second opinion from our family physician and a leading cancer specialist. We were advised to consider only palliative care. We conveyed the same to the cancer specialist who wanted to give chemotherapy. You will be shocked at his reply: “Oh God! We have already got all the medicines to the ICU. It’s a waste…!”
Harmful trends
Many pharmaceutical companies are boasting that they are “Disease Management” companies and well on course to creating a ‘holistic approach’ than just selling medicines. If, for example, the “so-called” disease management companies discover a new drug and intend doing clinical trial, where do you think they would prefer to do the trials? What would be the outcome? Does anyone need ‘Einstein’s’ brain to understand this?
It is important to establish good practices in hospitals, among doctors, the pharmaceutical companies, and, more importantly, in the regulatory authority. Otherwise, with the seriously poor levels of public/patient awareness, exploitation is bound to be rampant. The regulatory system must evolve a mechanism to usher in transparency in medical/healthcare practice. If at all India wants to achieve the status as the best destination for medical tourism, clinical trials and drug research, then the Health Ministry MUST act immediately
It is amazing to know the seriousness of the issue. More than 40 people were ready to participate in a ‘signature-campaign’ against exploitation by the medical/healthcare services, and share their woes. The media can organise not only an opinion poll, but also thorough market research to extricate the facts, discern the truths and then establish a proper scientific database. Only then will meaningful solutions evolve.
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