Bengt Mattson

I gave my reflections earlier today here on the blog to the last few days of reports on Swedish Radio, mainly in "the Echo" (i.e. "Ekot" in Swedish), regarding releases of active pharmaceutical ingredients from manufacturing in India. After that, additional reports have been aired:

"Ekot 7": “Where drugs are produced is a secret”

The consumer who wants to buy an environmentally friendly medicine will get problems. The Echo has just reported on how the environment is destroyed in the Indian Hyderabad because of medical manufacturing. But neither the MPA or trade associations for pharmaceutical companies think the time is here to tell where each individual drug is manufactured. Meanwhile, many customers want to have a choice. 

- Absolutely. In the case of pharmaceuticals, I think we know too little, and it is so difficult to find out, while we know so much about light bulbs and everything else in our everyday environment, "says Helen Rehn.

- It would be great if you could get information about it, kind of like when you buy a plane ticket, where you can always see the environmental impact. Then, you could make a conscious choice, "says Sara Åsberg.

Would you care if such information existed?

- Absolutely!

Those who today want to know whether a drug is manufactured in an environmentally sound manner has no way find out. Information on how and where drugs are produced are kept secret, both by companies and by the MPA. Despite the reports of environmental damage related to the manufacture of medicines. In Hyderabad, the Indian medicine factories caused an environmental disaster. In surrounding lakes, there is as much antibiotic as humans have in their blood during an ongoing treatment. But that is no reason to tell where a drug comes from, thinks Kenneth Nyblom of Generic Association, which is the trade association for the companies that produce cheap generic copies.

- The question is whether it is the right way to go and if it really helps the environment. I think we should be working on a general rise in standards. That would most benefit the environment.

Instead of that companies themselves will tell you where drugs are produced, the Generics Association wants stricter rules on an international level. Something that MPA estimates can take ten years to complete. Also the MPA has information on which factories producing medicines. But this information cannot be disclosed, was the news when the echo requested the documents.

- We have information on where companies produce their drugs, but that information is in the current situation classified as secret, "says Charlotte Unger, who is environmental manager at the MPA.
There was also a live debate in "Studio 1" (aired roughly at 17.30) presented as follows:

"Listen to a debate in Studio One between Cecilia Marlow, president of the pharmacy Kronans Droghandel and Anders Blanck, vice president of the Pharmaceutical Association, LIF. Also hear Mona Hambraeus from “the Echo” about the damage that Swedish pharmaceutical manufacturing contribute to in India."

Both Cecilia and Anders said they were positive to try to make changes in order to enable consumers to make "green choices". Anders however also described some obstacles that need to be managed in order for such choices to be possible. This is well inline with LIF's ideas I have described earlier about making changes not only within international regulations such as GMP, but actually work within the Swedish "pricing and reimbursement systems". If people want to make "green choices" they should be able to do so. But where are the "green incentives" in the systems enabling this?

I hope the discussions from this week will help drive the debate on "green criteria" and "green incentives", in addition to the work that Swedish MPA has been commissioned already to further investigate changes in the GMP-regulation.

If you would like additional reading on this matter I also recommend you to read Agneta Borgström's article in the paper "Vi" (Number 2, 2011, pages 30 - 37). It is always valuable I think to get as many different views and perspectives on issues as possible when you should develop your own opinion on an issue. The article in "Vi" is pretty much the same material that has been aired by "the Echo" over the last few days.

Bengt Mattson