Probing pharmacies without digitising antibiotic-sales will only lead to an inspector raj
The government’s thrust on checking antibiotic resistance—against the backdrop of an American national dying of complications related to the NDM-1 superbug—is admirable. But the way it seems to be going about this seems quite ham-fisted. While the government mandated a ‘red line’ on the tablet-strip to indicate that a particular antibiotic wasn’t to be consumed or sold without a prescription, the problem is that even the so-called “weaker” antibiotics have the potential to drive up resistance. At the same time, lacking awareness, patients often consume antibiotics without adhering to dosage and duration of drug administration specified. A 2011 WHO study showed that 53% of Indians were taking antibiotics without a prescription. The sale of carbapenems in the country had increased to 3.8 standard units per 1,000 population by 2010, from 0.15 standard units in 2005—which shows how fast resistance is spreading.
The government’s newest directive to state authorities, to crack down on pharmacies selling antibiotics without prescription may be well-intended, but it is likely to spawn an inspector raj than do any real damage control. To control reckless selling and consumption of antibiotics, there has to be some kind of digitisation of the record of antibiotic-sales. This would make tracking far easier and make it less prone to regulatory excesses. Similarly, while there have been calls for auditing to check if doctors are making out unwarranted prescriptions of antibiotics, this will need a digital repository of prescription details. The government has to also focus on better tracking of consumption of antibiotics through its public health programmes, especially for disease like TB that have a high susceptibility.