THE 12-page document submitted to the health minister claiming corruption in the supply of drugs to the government (FMT, June 13, 2018) may be shocking to the public, but not for those in the industry. If one cares to do a quick Google search, there are already similar and more serious examples of corruption involving the pharmaceutical industry. After all, with global medicine expenditure expected to grow to US$1.3 trillion (RM5.1 trillion) this year, enthusiastic pursuits in political lobbying by the pharmaceutical industry can be expected. 

In 2016, Transparency International published a damning report, titled Corruption in the Pharmaceutical Sector, accusing governments and pharmaceutical corporations of turning a blind eye to bribery and corruption that allowed mega profits in the hands of a few while damaging the health of many. The report said that “pharmaceuticals stands out as a sub-sector that is particularly prone to corruption. There are abundant examples globally that display how corruption in the pharmaceutical sector endangers positive health outcomes. Whether it is a pharmaceutical company bribing a doctor for prescribing medicines irrespective of a health need or a government employee facilitating the infiltration of substandard medicines into the distribution system, public resources can be wasted and patient put at risk”.

Among other corrupt practices highlighted were using doctors to participate in surveys of medicines they have never even prescribed; ghostwriting articles and clinical trials before attribution to certain doctors and then passing them off as research and academic work; drug manufacturing companies going around manufacturing regulations and standards; and, falsifying clinical trial data to suggest positive results.  

The lure of mega profits for the pharmaceutical industry is so superfluous that even severe multimillion-dollar fines imposed on companies that contravene regulations do not deter them. Large advertising funds and the huge spending power of the industry has found easy prey among government officials. Lack of will and commitment to act against corruption have led government leaders to implement reforms only after a crisis has happened. All these compound corruption problems in the healthcare industry.

Eleven years ago in 2005, a British House of Commons’ Health Committee report, titled The Influence of the Pharmaceutical Industry, reported even more incriminating details regarding the healthcare industry, in Britain in particular, and the world in general. The 126-page report examined the influence that the pharmaceutical industry has upon the healthcare industry. Besides contributing to phenomenal economic success for Britain and described as a “jewel in the crown of the UK economy”, there were several failings with the industry. Two very unpleasant consequences of the failings were the unsafe use of drugs and medicalisation of society – “a pill for every ill”. 
The modus operandi of the pharmaceutical industry was to secretly promote the use of drugs and cast the net as wide as possible to a worldwide populace. Along with this goal, the medicalisation of society, there was intention to create a pill for every ill. 

Other failings described in the House of Commons’ reports were failure of the government to ensure a patient-centred healthcare system; the overall influence of the pharmaceutical industry being “pervasive and persistent”, with some covert campaigns deemed “particularly worrying”; safety issues concerning drugs; drug-induced illness; poorly designed clinical trials to show favourable results for the drugs; ghostwriting practices; illegal marketing practices; and, drug companies’ sponsorship of organisations to promote awareness of a disease. 

Even though the 2005 report did not touch on corruption, it provided great insight into the shortcomings of the healthcare system, as there was plenty of room for corruption in subtle ways. The 2005 report questioned the pharmaceutical industry’s ability to put patients’ health needs and interests first. With profit for its shareholders as its main motive, the industry’s intent to medicalise society sounded alarm bells, both in terms of its implications on long-term health effects and corruption. 

The revelation of the discrepancies and corruptible acts regarding the supply of drugs through the procurement system is only the tip of the iceberg. After a purge to cleanse the system of corruption in drug and equipment procurement, our Health Ministry ought to explore other equally important aspects of our healthcare system, such as the economic burden of chronic diseases, including drug-induced illness. Currently, there is no data on this important aspect. There is a serious need to explore novel treatment approaches to curtail the unending drainage of wealth to treat chronic and seemingly incurable diseases. This aspect is the sunken part of the iceberg, and there are answers. – June 14, 2018.

* Capt Wong Ang Peng reads The Malaysian Insight. 

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.