The country cannot continue to pay a heavy price for incompetence and costly blunders at the expense of public funds
By Mrinal Roy
An umpteenth scandal is rocking the country. The procurement of vital medical supplies and medicine by government to fight coronavirus, treat and cure Covid-19 infected persons and save lives is once again at the centre of controversy and serious allegations of wrongdoings. Will government never learn from the plethora of costly blunders of the past?
The disturbing information provided and allegations made by the Leader of the opposition in Parliament last week regarding the emergency procurement of 1 million generic Molnupiravir tablets from a new local company holding stocks of this tablet at a price of Rs 79.90 per tablet i.e., Rs 70 more per tablet than the 800,000 Molnupiravir tablets bought at Rs 9.30 per unit on the eve by government raises a host of germane questions.
Why was the new supplier holding such important stocks at a cost? This has prompted allegations of insider trading. What was the urgency of sourcing Molnupiravir at a substantial price premium paid from public funds when government had on the eve bought Molnupiravir tablets at Rs 70 less per tablet?
Such abject profiteering on drugs meant to fight the Covid-19 pandemic and save lives, under the nose of the authorities in a context of rising Covid-19 related death toll have raised a furore in the country.
Legitimate questions have also been raised as to whether the authorities have carefully assessed the scientific evidence on the efficacy of Molnupiravir before hastily buying the tablets at a significant price premium under the cover of emergency procurement procedures.
Molnupiravir was initially heralded by public-health officials as a game-changer for Covid-19. The reality is that a small-scale global trial covering 775 infected persons who experienced mild to moderate Covid-19 symptoms was used to test the efficacy of the drug. This trial led by the US pharmaceutical company Merck Sharp and Dohme (MSD) and Ridgeback Therapeutics which developed the experimental antiviral pill Molnupiravir found that the drug reduces the risk of hospital admission or death from Covid-19 by approximately 50%.
However, full clinical-trial data showed lower-than-expected efficacy. The FDA advisory committee that reviewed Molnupiravir found that the oral antiviral drug decreased the risk of hospitalization from Covid-19 by 30% instead of 50% observed in the initial small-scale trial. The FDA advisory committee’s narrow vote to recommend at its meeting on 30 November the emergency use of Molnupiravir by 13-10 is therefore a far cry from the overwhelming approval expected after Merck announced its preliminary trial results.
The agency’s lengthy deliberations could signal uncertainties about the antiviral’s efficacy and safety as full trial data submitted to the FDA suggest that Molnupiravir is less effective than originally thought, dampening scientists’ hopes that the relatively cheap and easy-to-administer treatment might change the course of the pandemic.
It must be flagged that Merck has an agreement with the United Nations-backed Medicines Patent Pool to provide such licences to manufacture and sell low-cost versions of Molnupiravir.
Last year, the country and mainstream citizens questioned and condemned the process of emergency government procurement tenders to source medicines, protective equipment, medical supplies and equipment and laboratory supplies in 2020 to fight the Covid-19 pandemic at a cost of more than Rs 1 billion to the public Exchequer from a nondescript array of suppliers. As a consequence, 50 ventilators purchased since 31 July 2020 at a cost of Rs 80 million lie distressed and uncommissioned by the suppliers. There was a public outcry at the questionable manner government emergency procurement tenders were organized and the purported links with the suspect deaths of a political activist and persons involved in the tender process. More than a year later, the various investigations to get to the bottom of these allegations remain stalled.
Since the beginning of the pandemic last year, the government has repeatedly touted the decisive role of the Covid-19 High powered Committee chaired by the Prime Minister which takes all decisions regarding the management of pandemic in the country. People were therefore obviously taken aback by the Prime Minister’s admission this week that he was not aware of the information relating to the purchase of Molnupiravir revealed in Parliament and that after examining the procurement file with the Minister of Health, they had decided to refer the whole case to ICAC for investigation. The government has therefore decided to keep the payment of the controversial purchase made, in abeyance.
Is there no pilot in the cockpit?
This flabbergasting situation obviously raises questions about the decision making process of the High powered Committee. Is the Committee not the final arbiter of all the key decisions relating to the management of the pandemic in the country? In the space of some 17 months, the process of emergency procurement of medical supplies, equipment and medicine has once again been plagued by allegations of wrongdoing. Is there no transparency and accountability and commercial oversight of the emergency procurement decisions taken? Is there not an informed appraisal of the scientific findings on the evolution of the Covid-19 pandemic, variants, efficacy of new drugs and the state of infection in the countries which are our main sources of tourists before decisions are taken?
It is patently evident that a system of governance based on nepotism and the appointment of the coterie or the party faithful to head key institutions of the country or to cushy government posts is the root cause of the systemic failings of the government decision making process and the ineptitude which undermines the management of the affairs of the state. The country cannot continue to pay a heavy price for incompetence and costly blunders at the expense of public funds. Such a decried system of governance is untenable.
It is also evident that the lack of strict transparency and accountability rules in the government decision making process as well as robust checks and balances to stem malpractices offer a field day for unbridled greed and profiteering. It is above all particularly galling that investigations to nab and bring culprits to justice are inordinately protracted. This cannot go on.
As a nation, we cannot accept the hollow rhetoric about eliminating corruption, graft and ensuring absolute transparency and accountability of the government decision making process and public expenditure when the country continues to be plagued by an endless array of costly scandals.
In a context where more than 60% of income earners obtaining up to Rs 20,000 per month are eking out a living in a context of unchecked and continuously escalating prices of essential existential needs, people are obviously up in arms at such decried scandals and greedy profiteering on drugs meant to fight the pandemic and save lives There is a rising feeling of revolt in the country as this umpteenth scandal is the last straw.
* Published in print edition on 17 December 2021
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