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| LETTER TO THE EDITOR |
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| Year : 2013 | Volume
: 45
| Issue : 1 | Page : 106 |
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Taxing essential medicines is inhuman
Vijay Thawani
Pharmacology Department, VCSGGMSRI, Srinagar, Pauri-Garhwal, Uttarakhand - 246 174, India
| Date of Web Publication | 24-Jan-2013 |
Correspondence Address:
Vijay Thawani
Pharmacology Department, VCSGGMSRI, Srinagar, Pauri-Garhwal, Uttarakhand - 246 174
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0253-7613.106453
How to cite this article:
Thawani V. Taxing essential medicines is inhuman. Indian J Pharmacol 2013;45:106 |
Sir
Medicines are important for sustenance and maintenance of human health. Access to essential medicines (EM) is fundamental to human rights. [1] The medicine availability in health facilities and public access to them contributes to maintaining the population's confidence and trust in the health care delivery system. However people continue to die although effective medicines exist. [2] In the low income countries, spending on medicines largely comes from household resources and has to be paid from out of the pocket at the time the person is ill. [3] Lack of access to EM is particularly prevalent in Africa and India. [4]
Since its first publication in 1977, the concept of EM of WHO is globally known. The EM are those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost effectiveness. EM are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality and adequate information, and at a price the individual and the community can afford. [5] The EM save lives, reduce suffering and improve health, but only if they are of good quality and safe, available, affordable and properly used. However in many countries today not all these conditions are being met. [6] Economically developing countries whose financial resources are scarce, can not afford to spend on non EM. [7] In a country like India the market is flooded with thousands of medicines, most of which are non EM. To meet the definition of EM we must concentrate only on EM and weed out the non EM.
The EM concept allowed national governments to have their own need based EM lists, with the focal point to make all needed medicines available to the populations at all times. But this concept even though adopted in letter, has been diluted in spirit. The governments of the developing nations, to bring in the revenue, continue to tax all medicines, irrespective of their EM status. Taxes on EM are widely applied but rarely discussed. These have been criticised as "sick taxes that hinder access to treatment". [8] Some governments have abolished the taxes on EM but others continue to earn through taxes on EM.
| » Taxes on EM Exploit the Sick | |  |
In the countries where health is guaranteed constitutionally as a fundamental right, all EM should be made available to the citizenry free, as right of its population. However the marginalised economies have limitations to give the EM medicines free. But these countries can surely do away with taxation on EM, to make them more affordable for their populations. Exempting the EM from all taxes may have some marginal negative impact on the country's treasury but will surely improve the affordability of EM. Taxes on EM target the sick that are least able to pay. Such taxation is nothing short of exploiting the sick. Taxation on EM is detrimental to the health of its population and does not serve the aims of a "Welfare State", more so for countries like India which boast of a developing economy. For a country, health of the population must be above earning through taxes from EM. May this common sense prevail upon the political economists.
Recently the Supreme Court of India issued directive to the Govt of India to regulate the prices of EM. It is expected that under this pressure the Govt may finally be getting its act together, bringing 348 essential medicines under price control. [9] At present the Govt regulates prices of 74 medicines under the Drug Price Control Order, 1995. [10] This move, when implemented, will succeed in checking the industry initiated spiralling prices of EM but yet will not result in removing the taxes on EM. No wonder that World Medical Situation published by WHO in 2004, in chapter 7, Access to EM states that "lack of access is particularly concentrated in Africa and India". [11] It is a matter of shame when such fame comes to our country's name.
The public interest seems to be vanishing from public health system. Denial of health rights is omnipresent, omniprevalent and all pervasive but is swept under the carpet and is being ignored. Public consciousness is needed to stand up and raise the voice. No wonder that the goal of "Health for all" has not worked in 25 years.
| » References | | |
| 1. | The selection of essential medicines. WHO policy perspectives on medicines. Geneva: WHO; 2002. p. 5. 
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| 2. | Afro Essential Medicines: Price indicator. WHO Regional Office for Africa; 2003. p. 6.
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| 3. | In: The world medicines situation. WHO; 2004. p. 2.
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| 4. | Access to essential medicines. In: The world medicines situation. WHO: Geneva; 2004. p. 61.
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| 5. | The selection of essential medicines. WHO policy perspectives on medicines. Geneva: WHO; 2002. p. 1.
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| 6. | WHO medicines strategy - Countries at the core 2004-2007. Geneva: WHO; p. 2.
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| 7. | Concept of essential drugs. In: Beyond rational drug therapy: A "show how" manual for educators on prudent use of medicines and medicare. Educators of Quality Update of Indian Physicians (EQUIP), Pondicherry, India; 1995. p. 8.
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| 8. | Taxing essential medicines - a sick tax that hinders access to treatment. Medicine Pricing Matters. Health Action International and WHO; 2009. p. 1.
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| 9. | Available from: http://mohfw.nic.in/showfile.php?lid=785. [Last accessed on 2012 Sep 23].
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| 10. | Mukherjee R. After apex court stick, GoM to finalize prices of 348 drugs. The Times of India, New Delhi; 2012. p. 10, Col. 1-7.
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| 11. | Available from: http://apps.who.int/medicinedocs/en/d/Js6160e/9.html. [Last accessed on 2012 Sep 23].
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