This week I’ve spent time shadowing the doctors at Shivaji Nagar. The place is packed in the mornings. Patients in line hover over the patients who are currently sitting with the doctor. The doctor sees each patient in less than five minutes, asking them about their symptoms and then writing a prescription.
At the geriatric clinic, the one that treats many of the diabetes patients, the doctors often talk to their patients about the pills they are taking using physical descriptions such as “big pill” or “pink pill.” They ask if the patient is taking the big pill or the small pill in the morning and how many times the patient takes the pill. I have not heard them refer to a pill by its name or what it does. One of the patients even asked at the end of the appointment, “So, which one is for diabetes?”
It makes sense that the doctors do not talk about pill names and what they do with a relatively uneducated population, many of whom cannot read the name of the drug written on the package. But in general, even in more educated populations in India, there is a problem of lack of consumer awareness about the drugs. As a result, the pharmaceutical industry profiting from that ignorance.
I’ve noticed this with my own treatment. In Jaipur, I had some serious stomach issues twice. When I went to the doctor, he quickly wrote down medicines and then the pharmacist handed me the the number of pills I needed. Unlike the orange bottles we receive in the U.S., there were no warnings on the pills, lists of ingredients or the literature that my science nerd self often likes to peruse about the drug and what it does.
I once googled the name of one of the drugs I was taking here only to find that absolutely no information was available. The only thing I found was the drug name on a pharmaceutical company’s stock list. Another time I googled a drug I was taking and found that the wikipedia article for the drug had one sentence about how the drug was for chickens.
Given the prevalence of counterfeit medications and harmful chemicals in drugs in India, I get very nervous about taking drugs here. India and China are the world leaders in producing counterfeit drugs. The World Health Organization estimates that 20% of drugs sold in India are fake. In milder cases, the drugs are substandard and have lowered quantities of active ingredient in and in serious cases, they contain toxic ingredients that cause death or serious injury.
Counterfeit drugs are mostly produced by some of the many small pharmaceutical firms in India. The drugs are often in fake packaging that perfectly imitates the packaging of drugs produced by major multi-national brands. It is important to note that not all small Indian pharmaceutical firms produce fake drugs. Many adhere to strict quality standards. These companies also often produce social good by greatly reducing the cost of drugs, making them affordable to the average Indian consumer. This pharmaceutical industry is hugely profitable in India, and while some efforts have been made to regulate the industry, they have not been able to tackle the extent of the problem.
Let me be clear, Shivaji Nagar’s health center is likely not distributing counterfeit medications: because they are a government hospital, they are subject to more regulation and scrutiny than private health centers. However, the majority of India’s poor do not exclusively go to public clinics, most go to private clinics with doctors who often do not have medical training. It is from these clinics that counterfeit medications are most prevalent.
This is why the medical culture, where patients are kept ignorant about drugs and what they do is toxic. While regulation is important, consumer awareness is also crucial. People need better education so they can understand how to identify potentially fake drugs and awareness to pay attention to whether they feel drugs are working. Currently, patients are expected to listen to the doctor’s advice and accept drugs from the pharmacist with minimal questioning.
Thankfully, there are initiatives to help reduce counterfeiting. Many medications contain a barcode and a number to which an SMS can be sent to confirm that the medications are properly manufactured by the company listed on the package. What is needed now, is consumer awareness to make sure they verify the legitimacy of the drugs they take.
Read more about counterfeit drugs in India:
Svaast Ke Liye 
A nice insight Kavya..Though there may be some amount of counterfeit drugs but India has a lot of other systems of medicine.We are in allopathy..but there is Homeopathy,Ayurveda and others also.Happy exploring!! Looking forward to further posts .Regards, Khyati