A prescription for disaster

There is around one physician for every one thousand people in Pakistan. The resulting vacuum has seemingly been filled by an assortment of quacks and lay people playing the role of medical professionals. It also does not help that of the doctors that are present, many have been found to be highly unprofessional over the years. One of the side effects of this gross inadequacy in health services has been the unchecked rise of self-medication and diagnosis and health experts have now revealed that an alarming 70 per cent of antibiotics are being used unnecessarily in Pakistan. The indiscriminate use of antibiotic medication can lead to the rise of deadly drug-resistant bacteria and antimicrobial resistance (AMR). Of the five million people around the world who lose their lives to complications arising from AMR an estimated 14 per cent are from Pakistan, with AMR leading to around 700,000 deaths annually in the country as infections caused by bacteria that are not responding to third- and fourth-generation antibiotics according to health experts. This makes AMR the third leading cause of death in Pakistan after cardiovascular diseases and maternal and neonatal disorders. Meanwhile drug-resistance bacteria cause around 300,000 deaths per year. Therefore, indiscriminate use of antibiotics could be causing up to a million deaths per year in Pakistan.

It is hard to blame ordinary people for resorting to self-medication given the lack of access to even the most basic health services in Pakistan. Aside from an acute shortage of physicians, the costs of healthcare in the country are spiralling out of control. The cost of providing healthcare services reportedly tripled between 2021 and 2023 due to rising consultation fees, at least a 30 per cent hike in medicine prices and the cost of diagnostic tests doubling. The latter is especially pertinent to the misuse or overuse of antibiotic drugs, especially in a country where an estimated 80 per cent of the population is earning Rs32000 per month or less. It is simply unaffordable for most to get a diagnosis, let alone a consultation, if they get sick which would likely lead people turning to unprofessional medical advice from friends or relatives and unlicensed quacks. Rare is the medical store that will stop someone from buying antibiotics even if they lack a prescription. This likely explains why Pakistan is the world’s third largest consumer of antibiotics after India and China, with antibiotic medicines worth Rs126 billion consumed in the country last year alone.

That being said, experts claim that even trained physicians are not always averse to giving unjustified prescriptions for antibiotics. Aside from stricter supervision of doctors and those pretending to be doctors, there also needs to be an expansion of healthcare services in the country to cope with this issue. People need to be able to get a diagnosis and consultation at affordable prices in order to ensure that they are prescribed the right medication and not given antibiotics unnecessarily. Moreover, the unbridled access to medication as long as one has the cash has to end. This means cracking down on pharmacies issuing antibiotics and other drugs without a prescription and those selling medication without a licence.