Experts: Most Pakistani imported medicines are low-quality, ineffective

KABUL (Pajhwok): Following the suspension of medicine imports from Pakistan to Afghanistan, a number of health experts say a large portion of these medicines lack are substandard and therapeutically ineffective, while some Kabul residents have lauded the import halt.

The Ministry of Public Health (MoPH) considers the endorsement of the law on preventing the smuggling of food items and medicines a positive step, saying drug smuggling has been significantly prevented and the Islamic Emirate of Afghanistan’s (IEA) efforts in this regard will continue seriously, as the presence of substandard medicines in the market harms Afghanistan’s health system and treatment process.

The ministry also says it is seeking alternative routes to replace medicines previously imported from Pakistan.

About two months ago, Pakistan unilaterally closed transit routes with Afghanistan along the Durand Line. Subsequently, on November 12, IEA suspended all trade with Pakistan.

On November 13, the Ministry of Finance (MoF) announced that medicines imported from Pakistan would no longer be processed through customs after three months, following a directive from the Office of the Deputy Prime Minister for Economic Affairs.

All medicine importers from Pakistan were asked to settle their commercial transactions by that time and seriously shift to alternative routes.

Experts: Most medicines imported from Pakistan are low quality

Dr. Syed Farid Shah Rafiee, an internal medicine specialist at Wazir Mohammad Akbar Khan Hospital in Kabul, told Pajhwok Afghan News it was not possible to make a general judgment about medicine quality based solely on country of origin.

“Medicines imported from different countries vary in quality. Some medicines from certain countries are of good quality, while the majority from others are of lower quality,” he said.

He added the suspension of medicine imports from Pakistan was due to the widespread presence of counterfeit and low-quality drugs.

“We have observed that medicines used within Pakistan are often of good quality, but those sent to Afghanistan are of lower quality. It is possible that companies themselves manufacture lower-quality products for export,” he explained.

He said some medicines were even labelled “for export to Afghanistan only” and were not produced for export to other countries.

Referring to the poor quality of Pakistani medicines, Dr. Rafiee said: “One of the reasons many of our patients sought treatment in Pakistan was the poor quality of medicines. Our doctors are highly competent. I personally witnessed cases where I prescribed the same medicine to patients, but it had no effect. When they travelled to Pakistan and were given the same medicine there, they recovered.”

Meanwhile, cardiologist Dr. Amal Mohad said the highest-quality medicines were imported from India, Iran and Turkey, while Pakistani medicines were generally of poor quality.

“Fortunately, Afghanistan has laboratories to test medicine quality. If a medicine is found to be substandard, it is neither registered nor used and is returned. In the past, many low-quality medicines entered the country, but this has now been prevented,” he said.

He added medicines produced for domestic use in any country were usually of good quality, while exported medicines might lack the same standard and were sometimes smuggled.

Dr. Mohad said the suspension of Pakistani medicine imports was a positive step, adding Afghanistan should prioritise domestic production.

“Medicines produced inside the country are of good quality and deliver good results,” he said.

‘Doctors should prescribe locally produced medicines’

Masjidi Himat, head of wholesale pharmaceutical traders in Kabul, said medicines were imported into Afghanistan from Iran, India, Malaysia, Indonesia, Thailand, Vietnam, Korea, Turkey, China, Germany, Russia, Uzbekistan and several other countries.

He said firms generally import quality medicines, as importing substandard drugs would cause financial losses.

He added all imported medicines were controlled by the Food and Drug Authority of MoPH before being approved for sale.

Commenting on claims about the poor quality of Pakistani medicines, Himat said Afghans were justified in their concerns.

“Through various channels — both legal and illegal — counterfeit, duplicate and copied medicines are smuggled into Afghanistan. There are factories producing such medicines, which end up in our markets,” he said.

He said IEA had decided to block smuggling and ensure medicines enter the country only through legal routes.

He urged doctors to prescribe locally produced medicines instead of Pakistani ones to familiarise the public with domestic pharmaceutical products.

Citizens complain about counterfeit, low-quality medicines

A number of Kabul residents have also welcomed the suspension of Pakistani medicine imports.

Syed Farid Hashimi, a resident of Kabul, said: “I am extremely happy because Pakistani medicines were medicines in name only. When compared with medicines we used to have before, they were completely ineffective. We want domestic production in our own country.”

He called on MoPH to monitor importing companies and test medicines in laboratories so people could access quality drugs.

Ali, a resident of Chahar Qala-i-Wazir Abad in Kabul, said: “We are very happy that Pakistani medicine imports have been stopped. They are low quality and do more harm than good. Instead of curing one illness, they cause ten more.”

He also urged the IEA to support domestic pharmaceutical production.

MoPH efforts to ensure standard, quality medicines

Dr. Sharafat Zaman, spokesman for MoPH, said access to standard medicines was essential for treatment.

“Unfortunately, before the re-establishment of the IEA, drug smuggling was widespread, which allowed substandard medicines to enter Afghanistan. Since then, smuggling has been largely prevented and illicit medicines have almost been eliminated,” he said.

He added another positive step was the endorsement of the law preventing the smuggling of food and medicines, under which a ministerial board was formed to block the entry of substandard and smuggled drugs.

He said laboratories have been established in different zones to prevent smuggling, with more than 300 million afghanis spent on equipment and facilities.

“The presence of substandard medicines damages Afghanistan’s health system and leads people to believe Afghan healthcare workers lack competence, whereas we have many qualified professionals. Poor-quality medicines prevented patient recovery,” he said.

He added low-quality medicines caused diseases to progress to advanced stages, even when early treatment was possible.

Another issue, he said, was poverty. “When medicines are ineffective, people waste money and are forced to repeatedly visit health centres.”

Dr. Zaman said laboratory standards have improved and corruption reduced. Previously, test results were unreliable, but now medicines must meet set standards, be registered, licensed and approved before entering the country.

He said MoPH teams continuously monitor pharmacies and hold conferences to raise public awareness.

“IEA is committed to providing standard and quality healthcare,” he said.

MoPH has recently signed an implementation plan with Iran and held discussions with India’s health minister to secure alternative medicine supplies to replace those previously imported from Pakistan, he concluded.

kk/sa