The Department of Drug Administration has directed drug manufacturers and importers to furnish details of the production and imports of drugs they supplied in the past three fiscal years.

The move of the national drug regulator aims to assess the share of essential drugs produced by domestic companies and foreign firms.

“The government aims to be self-sufficient in the production of free essential drugs. We need details to ascertain the actual market coverage of domestic producers,” said Narayan Dhakal, director general of the department. “Once we figure out production and import status of free essential drugs, we can take measures to promote production within the country.”

State-run health facilities across the country provide up to 98 types of medicines free of cost to ailing patients seeking cure. Free essential drugs include medicines for communicable and non-communicable diseases. Earlier, the health ministry provided more than 70 types of medicines for communicable and non-communicable diseases from all district hospitals with at least 25 beds.

Patients used to get more than 60 types of essential medicines at primary healthcare centres and 35 types of drugs at health posts.

However, after the country embraced federalism in 2015, the number of medicines on the free list was increased to 98. The health ministry used to purchase medicines and supply them to the districts. The ministry later started allocating budgets for the purpose to the provinces and local governments. What concerns experts is that no agency guarantees the quality of drugs in the country.

“We also plan to carry out a post-marketing survey of medicines to monitor their quality,” said Pramod KC, the department's information officer. We plan to start from Bagmati Province and expand to other provinces next year.

According to KC, the department's drug inspector will collect samples of free essential drugs being distributed from state-run health facilities, which will be tested at the DDA’s laboratory.

Public health experts urged the agencies concerned to ensure the quality of medicines being provided free of cost to the patients and give more attention to non-communicable diseases, which have long been responsible for over two-thirds of the country’s total deaths.

Along with that, they asked the authorities concerned to ensure the availability of free drugs in health facilities.

A 2019 study on the prevalence of noncommunicable diseases by the Nepal Health Research Council found that noncommunicable diseases accounted for 71 percent of the deaths in the country. Reports show heart disease, chronic obstructive pulmonary disease, lower respiratory infection, and stroke are the leading killers.

A report of the STEP survey of non-communicable disease risk factors—jointly carried out by the World Health Organization, the health ministry, and the Nepal Health Research Council—revealed alarming signs on several issues: alcohol consumption, tobacco use, salt and junk food intake, vegetable and fruit intake, and the risk of cardiovascular diseases.

Changing lifestyles—increasing sedentary behaviour, tobacco and alcohol use, and unhealthy diets—are the main factors of deaths and disabilities, according to multiple reports.

Experts say a lot of people suffering from high blood pressure, diabetes, respiratory diseases, and heart ailments, among others, could not afford to purchase medicines, which is among the reasons for premature deaths. Out-of-pocket payments are the reasons in many cases for discontinuity of the medications, doctors say. Patients suffering from most non-communicable diseases can’t discontinue their medication without consulting their doctors.

According to doctors, medication for most non-communicable diseases—high blood pressure, diabetes, respiratory diseases, and heart diseases—works only when taken regularly. They advise that those suffering from these ailments should not discontinue their medicines, even when their health returns to normal.