Decline of Pakistan's bioethics.

The whistle has blown towards a new health crisis. Drug regulators and local administrators are once again going to have a long night. This time because of an injection named Avastin.

We are well versed and sadly immune to medical negligence, malpractice and lack of medical ethics in Pakistan. Only when there is a loss of life or limb do we start raising questions about the very fabric of our healthcare system and existence altogether.

Let me take you back to 2019, where we lost a nine month old baby named Nishwa to medical negligence when she was allegedly administered an injection wrongly. In 2017, the scam of low-quality and expired cardiac stents shamed us. Not long ago, in 2022, a pregnant woman lost her life allegedly because she was given an expired dose of anaesthesia medicine during delivery. This time people have lost their eyesight because of an injection which was manufactured locally in a faulty and illegal manner.

Avastin is a drug used to slow down the growth of cancer cells by blocking certain enzymes in the body that are involved in the growth and spread of cancer cells. It is an FDA-approved drug primarily indicated in cancers of the brain, lungs, breast and colon. Avastin also finds its role in diabetic eye disease where it blocks the growth of abnormal blood vessels along with blocking leakage of fluid from faulty blood vessels. This fluid leakage can affect vision. In eye disease Avastin is considered an 'off-label' drug which means that the FDA has allowed its use if doctors are well informed about the product and studies prove the drug as helpful.

Investigation, so far, has revealed the market price of Avastin injection to be 28 to 40 thousand rupees. Local manufacturers were extracting almost 80 doses from one injection, each of which was being sold for approximately 1500 to 2000 rupees. This low price injection was sold to low-income individuals, generating a profit of about 1.5 lakh from each injection. These substandard and non-sterile...