KABUL, Afghanistan – Heavily relying on imported medicine worth millions every year, Afghanistan has suspended licenses of more than 800 medicine importing firms on charges of smuggling and counterfeiting triggering price hikes and uncertainty.
On October 29, Noor Shah Kamawal, director of the National Medicine and Health Product Regulatory Authority, announced that the licenses of some 817 local and 113 foreign medicine import companies have been cancelled on charges of smuggling and counterfeiting.
“These companies were continuously violating the rules and regulations for quite some time now, they have now been given one month time to stop these violations and share their documents with us for evaluation and an ultimate decision,” he said.
The agency did not reveal the identity of the firms blacklisted in the wake of an ongoing campaign.
Obaid Ullah, a local medicine trader in Kabul, told The Globe Post that many genuine importers are now feeling the heat of tightened government control over the sector.
“There wasn’t much control for so many years that led to the mushrooming of all sorts of importers, but now with this sudden tightening some opportunists at the wholesale and retail levels are once again exploiting the vulnerabilities of the people by inflating the prices on one pretext or the other.”
Mr. Kamawal acknowledges that there is a problem with the sale of counterfeit medicine and inflated prices. He told the press in Kabul that in addition to the crackdown on importers, the agency is also looking into the affairs of some 14,500 registered pharmacies across the country.
In a week’s time, Afghan officials seized more than 100 tonnes of expired, counterfeit and substandard medicine from different pharmacies.
While waiting for his turn at a bustling Kabul pharmacy in the Deh Afghanan area, Shad Mohammad, a resident of the southeastern Paktika province, said his wife was diagnosed with some sort of infection, but repeated doses of antibiotic did not help cure her disease. “I was in Dubai for my job and came back urgently to bring her to Kabul for treatment”, he told The Globe Post, adding that the bulk of medicine at pharmacies in Paktika are expired, but no one seems to care.
“People can’t literally read the date, most of them get medicine from the medical stores without a doctor’s prescription, it is horrifying, and here in Kabul prices are much higher.”
Every year, Afghans consumes imported medicine worth around $300 million. According to the Ministry of Public Health, most of the drugs come from Pakistan, Iran, India, Turkey, and Bangladesh. More than 1,100 pharmacy firms registered with the government are involved in drug imports.
According to a study by the international charity Medecins Sans Frontieres (Doctors Without Borders), medicine is a lucrative business for private providers in Afghanistan, and some elements of the private medical sector can be quite unscrupulous.
“While people regularly chose private as the option of quality, many spoke of overprescribing, misdiagnosing and even malpractice from the side of the private practitioners that they visited,” MSF noted in a 2004 report.
The medicine importers’ union in Afghanistan has cautiously welcomed the new regulations. Abdul Khaliq, head of the union told The Globe Post that a “mafia” has dominated government contracts and ministries for many years. “The value of medicine imported illegally is worth $700 million every year,” he said.
Rages of war in the decades since the 1979 invasion of the country by the former Soviet Union have dismantled the public health system in Afghanistan.
The recent relative peace, however, has opened some avenues both in the public and private sector with a number of clinics, pharmacies and dispensaries popping up across the country, particularly in urban areas. But weak or nonexistent regulations have caused serious irregularities in the health sector in rural places as well as a handful of urban centers.
Khan Jan Alakozay, vice president of the Afghanistan Chamber of Commerce and Industries, agrees that the short-term impacts of imposing a ban on so many firms could cause a shortage of medicine, but ultimately the way would be paved for genuine drugs.
“War, lack of investors’ confidence, energy and infrastructure issues are hindering establishment of medicine producing companies in Afghanistan leaving us vulnerable and dependent on others,” he said.