Some Pharmacies in rural areas have still not adhered to the government directive to remove cough syrup brands containing dextromethorphan.
Reports say that there is no mechanism to monitor the removal of cough syrup brands as the Drug Regulatory Authority regulations lack teeth to ensure their adherence. Therefore, the removal of cough syrups containing dextromethorphan is taking place, technically, at the sole discretion of pharmacy owners!
This further clarifies the non-existence of a robust drug policy which will help to manage the distribution as well as proper usage of drugs. It also means that the Health Ministry cannot assure a safe environment for the sick in this country. One reason why the Health Ministry is not able to monitor this and create a safe environment for consumers is the existence of a large number of unqualified pharmacists employed by unlicensed pharmacies who would not adhere to any set code of conduct. One clearly cannot expect ethics, integrity and professionalism from such entities.
The cough syrup ban was imposed in Sri Lanka following a notice issued by the World Health Organization which said that nearly 60 people in Pakistan had died after consuming cough syrups containing dextromethorphan.
Nisar Ahmad Cheema, Director General of Health of the Punjab province in Pakistan, confirmed to the media that dextromethorphan - an active ingredient imported from India - was found to be responsible for these cough syrup-related deaths in Lahore and Gujranwala districts.
“Samples taken from victims in Lahore show a very high concentration - 4.1 mg/ml to 7.8 mg/ml - of dextromethorphan,” he told Pakistani reporters.
Dextromethorphan is a cough suppressant drug used as an active ingredient in many over-the-counter cold and cough medicines manufactured in India and Pakistan. In the preliminary inquiries, the World Health Organization found out that the raw material used in cough syrups,Tyno and Dextromethorphan, included 22 percent and 11 percent respectively of the “lethal” levomethorphan drug which is harmful.
Following the WHO notice, Sri Lanka’s Health Ministry imposed an immediately effective ban on cough syrups containing dextromethorphan, until such time Pakistani authorities conclude investigations into the matter.
As a result of the ban, more than 90 percent of dry cough syrup brands are expected to have been removed from pharmacies in Sri Lanka (a vast majority of dry cough syrups contain dextromethorphan).Following the ban, most pharmacies in Colombo and other urban areas now sell only phlegm cough syrups which do not contain the banned component.
Since the consumption of a seemingly harmless cough mixture has now become life threatening, there is a question whether the Health Ministry should hand over this matter to the police who could conduct surprise raids on errant pharmacies.