A deadly mix of medical negligence and pursuit of the profit motive has spelt countrywide disaster and shows no signs of abating as yet. There is a spine-chilling story about the raging swine flu that has caused more than 10,000 deaths in the country over the past six years.
While the failure to detect the flu in its incipient, early stages is the primary reason for the deaths â still more scandalous is the manner in which the medical establishment has gone in for importing highly exorbitant ABIÂ kits for detection of the disease, which makes those at the receiving end shell out Rs 5,000 for testing positive and twice that amount for testing negative.
In contrast, the indigenous detection kits could have been put to use for just Rs 700 per sample test. According to available figures, 47,000 ABIÂ kits were imported in 2009 alone, the year that saw the pandemic break out in allÂ its fury.
Even as the Delhi High Court directed the Centre and the Delhi government to provide affordable kits forÂ testing swine flu, the racket in providing for affordable treatment continues. Meanwhile, it is authoritatively learnt that certain government-recognised Âinstitutions such as the Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGI), Lucknow, and the National Institute of Mental Health and Neuro Sciences Â(NIMHANS), Bengaluru, have averred that the indigenous kits are either as effective or more effective than the imported ones, and accomplish the job at a fraction of the cost Âincurred in using imported kits.
It may be noted that ABIÂ (Applied Biosystems Incorporated) merged with Invitrogen in 2008, forming Life Technologies, which was taken over by ThermoFischer Scientific, a US-based firm, in 2014.
It is intriguing that two separate wings of the Union health ministry were busy passing the buck and virtually presided over a racket of astronomical proportions.
The sordid tale is told in medical circles about how an indigenous firm was thwarted in its attempt to procure a manufacturing licence when it approached the concerned government body. It was directed to get in touch with the Indian Council of MedicalÂ Research (ICMR). When Tehelka asked the ICMR why the necessary No Objection Certificate (NOC) was not provided to the indigenous firm, it was asserted that only the Drug Controller General of India (DCGI) had the necessary authority to issue such a clearance.
On his part, Dr Vishwa Mohan Katoch, who was the director-general of the ICMR in 2009, told Tehelka that there had been a huge error and the officials concerned would be duly punished. Katoch expressed disgust at the apathy shown by his staff, but then such an attitude is prevalent at all levels of officialdom. Katoch admitted that the American firm, which supplied the testing kits, had made a neat killing and also that the swine flu tests were too exorbitant for anybodyâs good and helped the firm rake in millions. That apart, the US firm also received unintended free publicity, he added. TS Jawahar, senior deputy director-general (administration) at ICMR and also the chief vigilance officer, admitted there was âutter lack of coordinationâ within the ICMR under the former UPA regime.
Consider this. Each of the 47,000 imported kits can be used to test at least 100 samples. The government has to pay Rs 10,000 to ABIÂ for each test. In other words, the government incurred an expenditure of Rs 4,700 crore. Moreover, a senior official at the National Centre for Disease Control (NCDC) told Tehelka, âSome kits can be used for 100 tests and the rest for 1,000 tests.â If we take the higher limit intoÂ account, the expenditure incurred runs into Rs 47,000 crore.
On the other hand, one test by the indigenous kit costs only Rs 700. This means the government would have spent only Rs 329 crore for the same number of tests. So, if the indigenous kits had been used instead of the imported ones, it would have saved the exchequer a whopping Rs 4,371 crore (or even Rs 46,671 crore).
In marked contrast to the ICMRâs claim of providing medicare to a maximum number of poor people at the optimum level, this is a glaring example where unwittingly hundreds of patients have died even as the US firm makes super-profits. Jawahar concurredÂ with the view, saying: âYes, in this case the profit motive overrode other considerations.â
There were contradictory responses from the ICMR to an RTI application filed by the Indian firm that had applied for a manufacturing licence. The ICMR in its response said that it had no information in this matter. This clearly shows that one or the other government department was trying to evade responsibility.
When queried, the two ICMR officials, Dr Katoch and Jawahar, admitted to the blunder. Utter apathy and disregard has become so patent that Dr Arvind Rai, joint director of the division of biochemistry and biotechnology at the NCDC and member-secretary of the centreâs bio-safety committee, not only admitted that he was among those who favoured imported kits, but was also simply oblivious to the gaping cost differential between the imported and the indigenous kits. He also said, âIf someone said that the cost of positive and negative results ought to be same, there was no logic in that.â
The flip side of the multi-million loot became manifest as investigations carried out by Tehelka revealed that several hundred lives could have been saved had the health department acted swiftly on the claim of the Indian firm Genome Diagnostics Pvt Ltd. The firm had come up with a kit, which they said was useful in detecting the swine flu virus at a Âpreliminary stage. The firm contacted the health ministry to get the necessary approval and authentication, but to no avail.
After swine flu was declared a pandemic in May 2009, several research projects were carried out across the globe on various aspects of the disease,Â including its detection, prevention and treatment. It was during this period that the ICMR announced that India was importing detection kits from a US-
Soon after, when Genome contacted the DCGI, it was asked to first get its product validated from the ICMR. The ICMR had earlier asked the firm to get the necessary validation from three centres. That same month, the firm wrote a letter to Dr Surinder Singh of the DCGI and the health ministry. Even former prime minister Manmohan Singhâs intervention was sought, but to no avail.
AT A GLANCE
â˘ Approximately 10,000 persons died in the last six years following late detection of the swine flu virus
â˘ Expensive kits were imported from a US-based company, while the indigenous kits were available at a much cheaper rate and also had better capability
â˘ While positive and negative tests done by ABIÂ kit costed Rs 5,000 and Rs 10,000 respectively, the indigenous kit was available at Rs 700 per test
â˘ In 2009 alone, 47,000 kits were imported; the exchequer could have saved Rs 4,371 crore by using the indigenous kits
â˘ SGPGI, Lucknow, stated the indigenous kit was better than the imported one, while NIMHANS, Bengaluru, stated that it was just as good
â˘ When the indigenous firm approached the DCGI for a NOC, DCGI asked it to go to ICMR, while ICMR told Tehelka that only DCGI was authorised to giveÂ NOC
â˘ ICMR DG said, âIt made me very sad. It is a big blunder due to which ABIÂ made a lot of money. The guilty will be punishedâ
â˘ ICMR replied to an RTI application from Genome that they donât have information about the firm having approached it for a licence