Indians are not pill poppers. Or so I thought until a report in the Lancet Infectious Disease Journal linked an antibiotic-resistant "superbug" to India. In a somewhat dubious compliment the new "genetic mechanism" is even named after us: New Delhi metallo-beta-lactamase 1 or NDM1. The report, published in August, caused uproar in the Indian and international medical community. The Indian health ministry has appointed a committee that will frame and monitor policy on antibiotic use.
Hard as it is to believe, India really doesn't have a comprehensive framework on how to prescribe, control and monitor the use of pharmaceutical drugs, including antibiotics. As a result, Indians self-medicate; in large numbers it seems, according to the Lancet. This is contrary to my own experience. Everyone I know of my parents' generation hates popping pills. My father complains bitterly about problems he has sleeping but refuses to be persuaded to take a sleeping pill. My mother has a veritable array of lotions, unguents and Ayurvedic oils by her bedside. But no pills.
She prefers Amrutanjan for headaches, Vicks VapoRub for colds and Tiger Balm for aches and pains. No wonder Indian pharmaceutical companies had to look abroad for their generics businesses, I thought. The Indian pharmaceutical industry is in robust stock-market health, having outperformed the broad market index substantially over the past two years. But it is also in the throes of intense self-reflection on how to prevent chronic degeneration, and in the coming months will attempt to reinvent itself to remain relevant in these changing times.
A couple of weeks ago, the health minister Ghulam Nabi Azad convened what was dubbed a "high-level" meeting with the captains of the pharmaceutical industry. The springboard for the meeting was the so-called "sell-outs" among Indian drug companies to foreign multinationals. Piramal, for instance, recently sold its domestic formulations division to the US-based Abbott for an up front payment of US$2.2 billion (Dh8.08bn) and additional cash influx of $400 million a year for the next four years starting next year.
Shantha Biotech and Dabur Pharma, too, have sold controlling stakes to the France-based Sanofi-aventis and the German company Fresenius Kabi, respectively.Some Indian firms, such as Lupin Pharmaceuticals, have followed a different route to the same result by acquiring foreign-branded pharmaceutical businesses. Recently, Sun Pharma bought a controlling stake in the Israeli company Taro Pharma, after a bitter three-year battle.
Taro, which makes topical dermatological products, was seen as the perfect niche branded business that Sun needed to complement its existing stable of products. So far, the pharmaceutical industry has been pretty much going it alone. The Indian government left them to fend for themselves. Mr Azad wants to change all this. He assured the industry chief executives the Indian government would help them address urgent and long-term issues regarding what the industry called "eking out profits in an increasingly competitive world".
In turn, Mr Azad wanted the companies to supply low-cost drugs to the poorest of poor Indians. The reason for all this angst, both in government and industry circles, is the fact that the industry needs to change course. In the next three years, several products are coming off-patent in the West, thus ending the ride that Indian drugs companies have enjoyed on the coattails of generics. Now that sales of generic drugs are expected to peak worldwide, the industry is being forced to look at new revenue streams.
At the pharmaceuticals industry get-together held in Hyderabad last month, the buzz was all about CRAMS (contract research and manufacturing services) and branding Indian drugs. According to several analysts, drugs industry growth is largely being driven by branded generics, which are expected to generate almost $8bn in sales this year and double that by 2015. Concomitantly, the global market for CRAMS is expected to increase from a value of $26.2bn to $43.9bn, according to the numbers bandied about at the conference.
The other driver is something I see everyday: more and more Indians are falling prey to chronic illnesses and lifestyle diseases such as diabetes and hypertension. They need branded drugs they can trust and use long-term. Until now, affluent Indians used to buy medicines abroad and bring them home. Nowadays, as Indian brands gain credibility, many of them buy their drugs at their local pharmacy. I used to bring all my children's medication from the UK or the US, either when I travelled abroad or when relatives and friends travelled they would buy them and bring them back for me.
Now that I have tried branded Indian remedies for my children and found them to be effective, I don't mind paying first-world prices for these medicines. The point is that there is a segment of Indians who are willing to pay for branded drugs and this segment is growing. Indian pharmaceutical companies have realised their domestic businesses will grow just when their foreign businesses are showing signs of strain.
If only one of these pharma hotshots can figure out a way to prevent Indians from self-medicating, particularly with antibiotics. We do so many things wrong on that front: stopping halfway through the course, choosing our own antibiotic based on past experience rather than go to the doctor. I am ashamed to say that since moving back to India, I've done all this, too. The health ministry's committee that will frame policies on antibiotic and other drugs has its work cut out.
Shoba Narayan is a journalist based in Bangalore and the author of Monsoon Diary
Abu Dhabi World Pro 2019 remaining schedule:
Wednesday April 24: Abu Dhabi World Professional Jiu-Jitsu Championship, 11am-6pm
Thursday April 25: Abu Dhabi World Professional Jiu-Jitsu Championship, 11am-5pm
Friday April 26: Finals, 3-6pm
Saturday April 27: Awards ceremony, 4pm and 8pm
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%3Cp%3E%3Cstrong%3ECreator%3A%3C%2Fstrong%3E%20Ramez%20Galal%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStarring%3A%3C%2Fstrong%3E%20Ramez%20Galal%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3EStreaming%20on%3A%20%3C%2Fstrong%3EMBC%20Shahid%3C%2Fp%3E%0A%3Cp%3E%3Cstrong%3ERating%3A%20%3C%2Fstrong%3E2.5%2F5%3C%2Fp%3E%0A
Killing of Qassem Suleimani
Porsche Macan T: The Specs
Engine: 2.0-litre 4-cyl turbo
Power: 265hp from 5,000-6,500rpm
Torque: 400Nm from 1,800-4,500rpm
Transmission: 7-speed dual-clutch auto
Speed: 0-100kph in 6.2sec
Top speed: 232kph
Fuel consumption: 10.7L/100km
On sale: May or June
Price: From Dh259,900
KILLING OF QASSEM SULEIMANI
UK-EU trade at a glance
EU fishing vessels guaranteed access to UK waters for 12 years
Co-operation on security initiatives and procurement of defence products
Youth experience scheme to work, study or volunteer in UK and EU countries
Smoother border management with use of e-gates
Cutting red tape on import and export of food
UAE currency: the story behind the money in your pockets
UAE v Gibraltar
What: International friendly
When: 7pm kick off
Where: Rugby Park, Dubai Sports City
Admission: Free
Online: The match will be broadcast live on Dubai Exiles’ Facebook page
UAE squad: Lucas Waddington (Dubai Exiles), Gio Fourie (Exiles), Craig Nutt (Abu Dhabi Harlequins), Phil Brady (Harlequins), Daniel Perry (Dubai Hurricanes), Esekaia Dranibota (Harlequins), Matt Mills (Exiles), Jaen Botes (Exiles), Kristian Stinson (Exiles), Murray Reason (Abu Dhabi Saracens), Dave Knight (Hurricanes), Ross Samson (Jebel Ali Dragons), DuRandt Gerber (Exiles), Saki Naisau (Dragons), Andrew Powell (Hurricanes), Emosi Vacanau (Harlequins), Niko Volavola (Dragons), Matt Richards (Dragons), Luke Stevenson (Harlequins), Josh Ives (Dubai Sports City Eagles), Sean Stevens (Saracens), Thinus Steyn (Exiles)
Sole survivors
- Cecelia Crocker was on board Northwest Airlines Flight 255 in 1987 when it crashed in Detroit, killing 154 people, including her parents and brother. The plane had hit a light pole on take off
- George Lamson Jr, from Minnesota, was on a Galaxy Airlines flight that crashed in Reno in 1985, killing 68 people. His entire seat was launched out of the plane
- Bahia Bakari, then 12, survived when a Yemenia Airways flight crashed near the Comoros in 2009, killing 152. She was found clinging to wreckage after floating in the ocean for 13 hours.
- Jim Polehinke was the co-pilot and sole survivor of a 2006 Comair flight that crashed in Lexington, Kentucky, killing 49.
BIGGEST CYBER SECURITY INCIDENTS IN RECENT TIMES
SolarWinds supply chain attack: Came to light in December 2020 but had taken root for several months, compromising major tech companies, governments and its entities
Microsoft Exchange server exploitation: March 2021; attackers used a vulnerability to steal emails
Kaseya attack: July 2021; ransomware hit perpetrated REvil, resulting in severe downtime for more than 1,000 companies
Log4j breach: December 2021; attackers exploited the Java-written code to inflitrate businesses and governments
A MINECRAFT MOVIE
Director: Jared Hess
Starring: Jack Black, Jennifer Coolidge, Jason Momoa
Rating: 3/5
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Tax authority targets shisha levy evasion
The Federal Tax Authority will track shisha imports with electronic markers to protect customers and ensure levies have been paid.
Khalid Ali Al Bustani, director of the tax authority, on Sunday said the move is to "prevent tax evasion and support the authority’s tax collection efforts".
The scheme’s first phase, which came into effect on 1st January, 2019, covers all types of imported and domestically produced and distributed cigarettes. As of May 1, importing any type of cigarettes without the digital marks will be prohibited.
He said the latest phase will see imported and locally produced shisha tobacco tracked by the final quarter of this year.
"The FTA also maintains ongoing communication with concerned companies, to help them adapt their systems to meet our requirements and coordinate between all parties involved," he said.
As with cigarettes, shisha was hit with a 100 per cent tax in October 2017, though manufacturers and cafes absorbed some of the costs to prevent prices doubling.
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UPI facts
More than 2.2 million Indian tourists arrived in UAE in 2023
More than 3.5 million Indians reside in UAE
Indian tourists can make purchases in UAE using rupee accounts in India through QR-code-based UPI real-time payment systems
Indian residents in UAE can use their non-resident NRO and NRE accounts held in Indian banks linked to a UAE mobile number for UPI transactions
if you go
Defence review at a glance
• Increase defence spending to 2.5% of GDP by 2027 but given “turbulent times it may be necessary to go faster”
• Prioritise a shift towards working with AI and autonomous systems
• Invest in the resilience of military space systems.
• Number of active reserves should be increased by 20%
• More F-35 fighter jets required in the next decade
• New “hybrid Navy” with AUKUS submarines and autonomous vessels
Labour dispute
The insured employee may still file an ILOE claim even if a labour dispute is ongoing post termination, but the insurer may suspend or reject payment, until the courts resolve the dispute, especially if the reason for termination is contested. The outcome of the labour court proceedings can directly affect eligibility.
- Abdullah Ishnaneh, Partner, BSA Law
Results
2pm: Al Sahel Contracting Company – Maiden (PA) Dh50,000 (Dirt) 1,200m; Winner: AF Mutakafel, Tadhg O’Shea (jockey), Ernst Oertel (trainer)
2.30pm: Dubai Real Estate Centre – Maiden (TB) Dh60,000 (D) 1,200m; Winner: El Baareq, Antonio Fresu, Rashed Bouresly
3pm: Shadwell – Rated Conditions (TB) Dh100,000 (D) 1,950m; Winner: Lost Eden, Andrea Atzeni, Doug Watson
3.30pm: Keeneland – Handicap (TB) Dh84,000 (D) 1,000m; Winner: Alkaraama, Dane O’Neill, Musabah Al Muhairi
4pm: Keeneland – Handicap (TB) Dh76,000 (D) 1,800m; Winner: Lady Snazz, Saif Al Balushi, Bhupat Seemar
4.30pm: Hive – Conditions (TB) Dh100,000 (D) 1,600m; Winner: Down On Da Bayou, Royston Ffrench, Salem bin Ghadayer
5pm: Dubai Real Estate Centre – (TB) Handicap Dh64,000 (D) 1,600m; Winner: Lahmoom, Royston Ffrench, Salem bin Ghadayer
UAE currency: the story behind the money in your pockets
Scorebox
Dubai Hurricanes 31 Dubai Sports City Eagles 22
Hurricanes
Tries: Finck, Powell, Jordan, Roderick, Heathcote
Cons: Tredray 2, Powell
Eagles
Tries: O’Driscoll 2, Ives
Cons: Carey 2
Pens: Carey
The biog
Favourite book: Homegoing by Yaa Gyasi
Favourite holiday destination: Spain
Favourite film: Bohemian Rhapsody
Favourite place to visit in the UAE: The beach or Satwa
Children: Stepdaughter Tyler 27, daughter Quito 22 and son Dali 19
1971: The Year The Music Changed Everything
Director: Asif Kapadia
4/5
The specs
Engine: 3.9-litre twin-turbo V8
Power: 620hp from 5,750-7,500rpm
Torque: 760Nm from 3,000-5,750rpm
Transmission: Eight-speed dual-clutch auto
On sale: Now
Price: From Dh1.05 million ($286,000)
Zayed Sustainability Prize
More on animal trafficking