The Punjab Institute of Cardiology, where 140 people have died from tainted drugs. (Photo: The Nation Pakistan)
Due to its tumultuous political history and frequent changes of government, Pakistan’s people have never fully enjoyed the benefits of democracy at the local level, as frequently-changing governments traditionally kept power highly centralized. However, in April 2010, after intense debate, Pakistan’s current democratically-elected government passed a sweeping amendment to the 1973 constitution devolving many government powers to the provinces. Thanks to the 18th Amendment, provincial governments can now make significant decisions at the local level without federal interference.
This change brought significant improvements in the decision making process, but it has also created unprecedented challenges for provinces when it comes to taking over tasks that were once the responsibility of the federal government. Seemingly technical debates over resource allocation and regulatory affairs hit home this month when more than 140 people died from adverse reactions to a lifesaving medication given to patients at the Punjab Institute of Cardiology. The death toll continues to increase – according to one estimate, about 25,000 patients were given this medicine.
The Chief Minister of Punjab has stated categorically that the registration of drugs and their pricing and licensing mechanisms were being controlled by the federal drug regulatory agency, even after the enactment of the 18th Amendment. The federal government, in turn, is blaming the Punjab government for irresponsible behavior in handling patients at cardiology institute.
Historically, an agency within the federal Ministry of Health was responsible for regulating the pharmaceutical sector in the country. However, after devolution, this responsibility was shifted to respective provinces. Although provinces had their own health ministries, their previous scope of work did not include regulation of the pharmaceutical sector. As a result, many lacked the resources or expertise to carry out their new role effectively – which in Punjab has now resulted in hundreds of deaths.
There is no doubt that democracy is in infancy in Pakistan, and this deadly failure is a particularly stark example of a well-intentioned reform which had unintended consequences. Blaming individuals will not solve this problem: the lesson here is that the government did the right thing by devolving, but did not provide a mechanism for enabling the governing ministry to properly regulate the pharmaceutical sector.
Due to its tumultuous political history and frequent changes of government, Pakistan’s people have never fully enjoyed the benefits of democracy at the local level, as frequently-changing governments traditionally kept power highly centralized. However, in April 2010, after intense debate, Pakistan’s current democratically-elected government passed a sweeping amendment to the 1973 constitution devolving many government powers to the provinces. Thanks to the 18th Amendment, provincial governments could make significant decisions at the local level without federal interference.
This change brought significant improvements in the decision making process, but it has also created unprecedented challenges for provinces when it comes to taking over tasks that were once the responsibility of the federal government. Seemingly technical debates over resource allocation and regulatory affairs hit home this month when more than 140 people died from adverse reactions to a lifesaving medication given to patients at the Punjab Institute of Cardiology. The death toll continues to increase – according to one estimate, about 25,000 patients were given this medicine.
The Chief Minister of Punjab has stated categorically that the registration of drugs and their pricing and licensing mechanisms were being controlled by the federal drug regulatory agency, even after the enactment of the 18th Amendment. The federal government, in turn, is blaming the Punjab government for irresponsible behavior in handling patients at cardiology institute.
Historically, an agency within the federal Ministry of Health was responsible for regulating the pharmaceutical sector in the country. However, after devolution, this responsibility was shifted to respective provinces. Although provinces had their own health ministries, their previous scope of work did not include regulation of the pharmaceutical sector. As a result, many lacked the resources or expertise to carry out their new role effectively – which in Punjab has now resulted in hundreds of deaths.
There is no doubt that democracy is in infancy in Pakistan, and this deadly failure is a particularly stark example of a well-intentioned reform which had unintended consequences. Blaming individuals will not solve this problem: the lesson here is that the government did the right thing by devolving, but did not provide a mechanism for enabling the governing ministry to properly regulate the pharmaceutical sector. Devolution cannot work if the newly-empowered authorities do not have the tools to carry out their mission.
Steps have already been taken to avoid a repeat of this particular tragedy. The pharmaceutical company that manufactured the killer drug has been closed, and the Supreme Court has ordered the creation of a Drug Regulatory Authority at the federal level. But it is essential for parliament to build the capacity of devolved ministries, and make clear their responsibilities, so that another disaster of this magnitude can be averted.
Steps have already been taken to avoid a repeat of this particular tragedy. The pharmaceutical company that manufactured the killer drug has been closed, and the Supreme Court has ordered the creation of a Drug Regulatory Authority at the federal level. But it is essential for parliament to build the capacity of devolved ministries, and make clear their responsibilities, so that another disaster of this magnitude can be averted.
