The tragedy related to the death of children in Uzbekistan due to taking the Doc-1 Max drug clearly showed the problems in the healthcare and pharmaceutical sector of Uzbekistan. The “Yuksalish” nationwide movement stated that such situations can be prevented in the future only by combining the efforts of all parties and made several proposals in this regard.
First, we believe that the practice of unsupervised use of drugs needs to be completely revised. Because we often consult pharmacists, not doctors, about which medicine to take. Many medicines can be easily bought from a pharmacy without a doctor’s prescription, and this creates the risk of misuse of medicines.
Studies conducted in different countries show that an average of 10-20% of hospitalized patients experience adverse drug reactions, and interestingly, this rate is twice as high in developing countries.
In 2008-2018, 2,300 cases of health deterioration as a result of self-medication with drugs were registered in Uzbekistan.
Therefore, we believe that, first of all, it is necessary to introduce restrictions on the direct advertising of drugs in the mass media. In particular, advertising of medicinal products should be carried out only with the permission of the Committee for Developing Competition and Protection of Consumer Rights. In the future, it is necessary to consider the possibility of banning direct advertising of drugs in the mass media. For this purpose, it is necessary to study the experience of countries such as Turkey, Switzerland, and Canada.
According to the WHO, the increase in uncontrolled use of drugs and self-medication is due to advertising. Deaths from such treatment rank 5th after injuries, circulatory diseases, oncological and pulmonological diseases. Of course, consumers cannot assess the risk of side effects caused by the use of drugs, their compatibility and the individual reaction of the body.
In fact, we treat medicines as ordinary consumer goods, and this makes the situation even worse. Therefore, this issue is relevant for Uzbekistan, where on average there are 25-27 pharmacies per 100,000 inhabitants.
Secondly, we propose to strengthen the liability for violations of the legislation on advertising of medicinal products. Last year, the Law “On Advertising” was adopted. Although it sets clear rules for drug advertising, every day we see violations of the law on television, radio and other types of advertising. We see that pharmaceutical companies approach the requirements of the law recklessly.
According to the Administrative Responsibility Code, an administrative fine of up to 15 BCAs is provided for violation of the advertising legislation. However, there is no liability for violating the rules and regulations related to the advertising of medicinal products. For this reason, we believe that it is necessary to impose separate administrative responsibility for violations of the procedure and legislation related to the advertising of medicinal products, and criminal liability should be imposed if such cases lead to serious consequences. We can see that Italy, Switzerland, Canada, Japan, Finland, Germany, Hungary, Great Britain and other countries have increased the liability of violating the law precisely to solve the problems of self-medication.
Third, it is extremely important to strengthen the responsibility of drug manufacturers, importers and certification organizations. As it was reported, Doc-1 Max and Ambronol drugs were not subjected to laboratory tests in accordance with the procedure established by the “Scientific Center for Standardization of Medicines”. As a result, low-quality drugs were allowed to be put on sale. For this purpose, it is proposed to include among the subjects of Article 186-3 of the Criminal Code persons who allow the distribution of low-quality, counterfeit and non-safety-compliant drugs.
Fourthly, it is necessary to accelerate the transition to a medical insurance system based on uniform standards of treatment for citizens to use modern diagnostic capabilities. People often try to self-medicate, without knowing the exact diagnosis, believe in advertising and take various drugs. Such errors also occur in the process of prescribing drugs by doctors. Unfortunately, some of them are seeking financial benefit from promoting certain drugs. That is why we need to move to health insurance system as soon as possible.
Fifth, it is necessary to ensure openness and transparency in the field of pharmaceuticals. The population has the right to know which drugs are being imported, who are the manufacturers, their reputation abroad, and how the certification process is conducted. We also believe that it is necessary to create an open database providing information on the pharmaceutical industry, which is of interest to the general public. It is important to speed up the process of mandatory digital marking of all types of drugs for sale. The buyer can check the authenticity of the drug by marking.
The “Yuksalish” nationwide movement called on the parliament, responsible ministries and agencies to take immediate measures, medical institutions and institutes of the pharmaceutical sector to give priority to social interests rather than commercial ones.
