Last week, the Centre extended Drug Controller General of India Eswara Reddy’s term by another three months.

The DCGI’s appointment has been an interim posting, extended every three months since Reddy was appointed this February.

This arbitrary trend in key regulatory postings involving healthcare has people involved with the segment rather unhappy. It reflects the lack of importance given to healthcare in the larger scheme of things and the reluctance to attract scientific talent in a transparent manner from outside the ministry, say people familiar with the developments.

Take the appointment of National Pharmaceutical Pricing Authority (NPPA) chief RK Vats. It was an additional charge for him. The Medical Council of India has been disbanded and recast. Though this was on the cards, its composition is being questioned, given the lack of doctor representatives from other parts of the country and the absence of women.

The situation becomes still more fluid when it comes to medical devices, as it gets tossed between being viewed as a drug or device.

All this happens at a time when health-related controversies come tumbling out one after another. There’s the issue involving Johnson & Johnson’s faulty hip implants that have been recalled in 2010. But patients are still trying to get redress for their medical problems linked to surgery and compensation for the trauma caused. And more recently comes another outrageous situation involving contaminated polio vaccines given to some children in Uttar Pradesh and possibly supplied to other States as well. A shocker since India had, in 2014, been declared polio-free, a label it wore with much pride.

Alongside these come the ongoing regulatory issues involving the abuse of oxytocin (used to stop excessive bleeding during child birth) and the rampant use of combination drugs — both situations that needed court intervention.

‘Revolving doors’

This being the landscape, say observers, the “revolving doors” at the different regulatory offices overseeing healthcare becomes even more disconcerting.

Without making it personality-driven and yet taking the case of the DCGI appointment, a regulatory policy expert points out that the present person at the helm has been in the drug regulatory system for 20 years. So, if the government finds him technically fit to give three-month extensions, why not a fixed term so the office can run without interruption for say three or five years? Besides, the end of the previous appointee’s term was known, so the process of mentoring or planning should have started two years ago, he points out.

Commenting on the “additional charge” appointment at the helm of the NPPA, a former bureaucrat says it should not be an additional responsibility as it needs complete attention, given that it controls the prices of medicines and devices that directly affects consumers and patients.

Under its previous chief Bhupendra Singh, the NPPA cracked down on trade margins that had priced cardiac stents beyond the grasp of patients. His term was cut short, after a little over two years. His predecessor’s term was less than a year.

Conflict of roles

In fact, adds the expert, the NPPA needs to be under the Health Ministry as its role as a regulator is in conflict with the outlook of the Department of Pharmaceuticals, which is to promote the industry. So there comes a conflict between the “ease of doing business” outlook and initiatives taken in patient interest.

Several representatives who have been with the Health Ministry share similar observations. Arbitrary regulatory appointments have been a staple in healthcare for the last 25 years, one of them says, adding that the government needs to show greater political will and give health its rightful importance.

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