By Kamran Khan.

When Makhdoom Shahabuddin suddenly replaced Ejaz Hussain Jhakrani as the federal health minister last month and terminated the services of Dr Suresh Kumar, the drugs controller, Ministry of Health, on the very first day in office, no official explanation was provided for this tumult in the ministry whose actions affect the life of every Pakistani.

An investigation by this correspondent has revealed that a decision to quickly dispatch Jhakrani from an all-important Health Ministry to the least important Sports Ministry and simultaneous sacking of the drugs controller was ordered when Prime Minister Yousuf Raza Gilani was flooded with information on record-breaking corruption in the Ministry of Health.

The prime minister was told that thousands of new drugs were being registered at a supersonic speed at the expense of the local pharmaceutical industry, select few companies were getting the much-needed price revision for their products, and procurements for various programmes of national health funded with billions of rupees of taxpayers’ money were being made on the basis other than transparency, fair play and best value for money.

Specific examples are available to prove that the companies, who had established relationship at the top level of the Ministry of Health, got their new products registered, in some cases within a few weeks, while many others following the prescribed route were made to wait for months and in few cases, over a year.

“On the face of it, the drugs registration process officially travels from bottom to top, but in actual, it was the other way round. There was a price even to get your case included in the agenda of the registration board,” said an executive with a well-known pharmaceutical company, who made secret recordings of his negotiations with important Health Ministry officials for the registration of some new products. The recordings showed that a sum of Rs 0.5 million changed hands at various levels for each of the four products registered by the same company last year.

The scale of money involved in the process can be gauged from the fact, officially confirmed by the Ministry of Health, that some 4,000 new products were registered in the past 18 months. A massive depreciation of rupee against the US dollar last year forced a scramble by hundreds of local and multinational pharmaceutical companies, wholly dependent on import of raw material and finished products, to seek a price revision for their products from the Ministry of Health. A list of pharmaceutical companies, lucky enough to get the prices of their products revised, some substantially than others, by pressing the right buttons at the ministry showed that a flimsy formula was twisted to adjust the chosen few. Specific cases of price revision showed that imported vaccines and medicines of same formulae received different treatment.

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The situation, due to an appreciation of the US dollar against the Pak rupee, forced even some of the multinational companies to play to the tunes of masters at the Health Ministry. “Even a passing examination of each of the product that got registered and those received price increase in the year 2008 and last year and informal questioning of relevant staff in the ministry will unfold the whole scam,” claimed a senior Health Ministry insider.

The same source and other informed industry sources relate corruption in the registration and related matters at the Health Ministry to Minister Jhakrani’s decision, soon after taking over as Minister for Health, to induct Dr Suresh Kumar into the Health Ministry as the drugs controller. Kumar was earlier serving at a laboratory, run by the Sindh Health Ministry.

But rampant corruption in the Ministry of Health was not restricted to the issues of registration and pricing of pharmaceutical products, the prime minister had been informed of massive corruption in tens of billions of rupees worth national health programmes such as the Expanded Programme on Immunisation (EPI); National Maternal, Neonatal and Child Health (MNCH); Malaria Control Programme and Hepatitis Control Programme.

In most cases, unqualified, least experienced but politically-connected people were handpicked in the later half of 2008 to run the above-mentioned about Rs 30 billion health programmes of national importance. These programme managers were also being hurriedly changed by the new health minister, though without ordering a formal probe into the misdeeds that impacted almost every Pakistani’s life in the past two years.

The most controversial, however, remained the EPI, the national health programme aimed at protecting children by immunising them against childhood tuberculosis, poliomyelitis, diphtheria, pertussis, measles, and tetanus.

The children have not been getting the best value for the tax payers’ money for the last two years when the Ministry of Health abandoned a cheaper and much better procurement of vaccines through Unicef in favour of local suppliers of vaccines, including a supplier, who monopolises the supply of critically important measles vaccines.

The procurement of vaccines and other products for the Rs 12 billion EPI programme from the world recognised and cheaper supply chain of Unicef was abandoned by the Ministry of Health ostensibly under an uncontested submission by senior health officials before the Lahore High Court, Rawalpindi bench, pledging to discontinue the purchase from Unicef and initiate local purchase, without informing the court that this would cost more to the children of Pakistan in terms of quality, quantity and above all, the price.

Documents revealing how rules and regulations were tempered with from the most important procurement of vaccines to the printing of material for the EPI programme illustrate how local as well as multinational pharmaceutical companies influenced decision-making from the programme manager to all the upper bureaucratic levels at the Ministry of Health. Jhakrani has been relocated to the Sports Ministry and former drugs controller Suresh Kumar has been sacked, but like all other cases of alleged mega corruption, the perpetrators continue to enjoy immunity against any action.

The News
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