Serious thinking needed in approach to drugs

PUBLISHED : Friday, 08 January, 2010, 12:00am
UPDATED : Friday, 08 January, 2010, 12:00am

Amid the ebb and flow of human diseases - from old killers such as tuberculosis to the latest strains of influenza - an abiding worry for health authorities is resistance to treatment with antibiotics and other pharmaceutical drugs as a result of abuse. That is particularly so in Hong Kong. As long ago as 2001, a Hospital Authority study showed that misuse of antibiotics here had made them less effective against bacteria than in the US and Britain. A recent World Health Organisation poll of public health experts paired illnesses due to antibacterial resistance with a flu pandemic at the top of the 10 most important diseases of the next decade.

The government's move this week to plug serious loopholes in our pharmaceutical drugs regime is therefore welcome, if overdue. Controlled drugs including antibiotics can be bought at some pharmacies and drug stores without a prescription. Reforms include a bid to stamp out over-the-counter sales by making written orders mandatory. This would enable the authorities to trace them, both for law enforcement and safety recalls. Sadly, some doctors have been involved in illegal distribution by selling on supplies obtained cheaply or free from drug firms in return for orders.

Improper use of legally supplied antibiotics is not uncommon. Examples are prescriptions for viral conditions that do not respond to them and failure to complete courses of treatment. Illegal sales and self-medication are an even more serious problem.

Pharmacists complain that the reforms do not go far enough. They want the law amended to require that all new pharmacies be majority-owned by pharmacists, giving them control over the sale of drugs instead of just being employees of pharmacy owners. Permanent Secretary for Food and Health Sandra Lee Suk-yee says this would spell the end of small, independent pharmacies. But the government should seriously consider whether the robust entrepreneurial spirit for which Hong Kong is known - rather than professional qualifications and ethics - is appropriate to the supply and proper use of controlled drugs.