The Parliamentary Standing Committee on Health and Family Welfare tabled a Report in Parliament on May 8, 2012, on the functioning of the Central Drugs Standard Control Organization (CDSCO).  CDSCO is the agency mandated with the regulation of drugs and cosmetics in India.  The Report covers various aspects of drug regulation including organizational structure and strength of CDSCO, approval of new drugs, and banning of drugs, among others. Following the Report, the Minister of Health and Family Welfare has constituted a Committee to look into the procedure for drug regulation.  The Committee is expected to make its submissions within a period of two months. This post focuses on irregularities in the approval of new drugs by CDSCO.  It discusses the regulations relating to drug approval and the Standing Committee's observations on the working of CDSCO. Approval of new drugs Drugs are regulated by the Drugs and Cosmetics Act, 1940 and Drugs and Cosmetic Rules, 1945 [Rules].  The CDSCO, under the Ministry of Health and Family Welfare, is the authority that approves new drugs for manufacture and import.  State Drug Authorities are the licensing authorities for marketing drugs. New Drugs are defined as:

  • drugs that have not been used in the country before,
  • drugs that have been approved by a Licensing Authority but are now being marketed for different purposes, and
  • fixed dose combinations of two or more drugs that have been individually approved before but are proposed to be combined in a fixed ratio that has not been approved.

The Rules require an applicant for a new drug to conduct clinical trials in India to determine the drug’s safety and efficacy.  These trials are necessary for both domestically manufactured and imported drugs.  However, the authority can exempt a drug from the requirement of local and clinical trials in the public interest based on data available in other countries. Observations and recommendations of the Committee The Committee found that a total of 31 new drugs were approved between January 2008 and October 2010 without conducting clinical trials on Indian patients.  The Report mentioned that drug manufacturers, CDSCO officials and medical experts colluded to approve drugs in violation of laws.  Following are some of the Report’s findings:

  • Under the Rules, the Drugs Controller General (India) (DCGI), the head of CDSCO, can clear sites of clinical trials after ensuring that major ethnic groups are enrolled in these trials to have a truly representative sample.  This rule was violated by the DCGI when sites for clinical trials were approved without ensuring diversity.  The Committee recommended that the DCGI approve sites for trials only if they cover patients from major ethnic backgrounds.
  •  The Report found that certain actions by experts were in violation of the Code of Ethics of the Medical Council of India.  A review of expert opinions revealed that several medical expert recommendations had been given as personal opinions rather than on the basis of scientific data.  Additionally, many expert opinions were written by what the Report calls ‘the invisible hands’ of drug manufacturers.  The Committee recommended that CDSCO formulate a clear set of written guidelines on the selection process of experts with emphasis on expertise in the area of drugs.
  •  The Rules ban the import and marketing of any drug whose use is prohibited in the country of origin.  CDSCO violated this rule by approving certain Fixed Dose Combination drugs for clinical trials without considering the drugs’ regulatory status in their respective country of origin.  Drugs such as Deanxit and Buclizine, which have been prohibited for sale and use in their countries of origin, Denmark and Belgium, respectively, were approved for clinical trials.  The Committee recommended an inquiry into the unlawful approval of these drugs.
  • The Rules require animal studies to be conducted for approval of a drug for use by women of reproductive age.  CDSCO violated this rule in approving Letrozole for treating female infertility.  Globally the drug has only been used as an anti-cancer drug for use among post-menopausal women.  The drug has not been permitted for use among women of reproductive age because of side effects.  The Committee recommended that responsibility be fixed for unlawfully approving Letrozole.
  •  Rules require Post-marketing Safety Update Reports (PSURs) on drugs to be submitted to CDSCO.  PSURs are used to collect information on adverse effects of drugs on Indian patients as a result of ethnic differences.  When asked by the Committee to furnish PSURs on 42 randomly selected new drugs, the Ministry was able to submit PSURs for only 8 drugs.  The Report contended that this action reflected a poor follow-up of side effects on Indian patients.  The Committee recommended that manufacturers of new drugs be warned about suspension of marketing approval unless they comply with mandatory rules on PSURs.

According to news reports (see here and here), the Cabinet approved four Bills for discussion in Parliament.  The Bills cleared for consideration and passing are: the Copyright (Amendment) Bill, 2010; the National Accreditation Regulatory Authority for Higher Educational Institutions Bill, 2010 and the Protection of Women against Sexual Harassment at Work Place Bill, 2010.  It cleared the Universities for Research and Innovation Bill, 2012 for introduction in Parliament. In this post, we discuss the key provisions of the Bills and the recommendations made by the Standing Committee on Human Resource Development (HRD). The Copyright (Amendment) Bill, 2010 The Bill was introduced on April 19, 2010 in the Rajya Sabha and referred to the Standing Committee on HRD, which tabled its report on November 23, 2010.  The government had attempted to pass it in the Winter session twice.  However, the Opposition raised the issue of conflict of interest.  The Rules of the Ethics Committee state that a MP has to declare his personal or pecuniary interest in a matter, which is under discussion in the Rajya Sabha.  The MPs contended that the HRD Minister, Kapil Sibal, could not pilot the Bill without declaring his interest.  They argued that his son was the lawyer for a music company which is party to a legal dispute with TV broadcasters to which the amendment would apply (see here for debate on the issue in Parliament). The Copyright Act, 1957 defines the rights of authors of creative works such as books, plays, music, and films.  Two key amendments proposed in the Bill are: -          Copyright in a film currently rests with the producer for 60 years.  The Bill vests copyright in a director as well. -          The Bill makes special provisions for those whose work is used in films or sound recordings (e.g. lyricists or composers).  Rights to royalties from such works, when used in media other than films or sound recordings, shall rest with the creator of the work. (See here for PRS analysis of the Bill) Key recommendations of the Standing Committee: (a) Drop the provision that makes the principal director the author of a film along with the producer; and (b) Keep the provisions for compulsory licensing in line with the terms of international agreements. (See here for PRS Standing Committee Report summary) The National Accreditation Regulatory Authority for Higher Educational Institutions Bill, 2010 The Bill was introduced on May 3, 2010 in the Lok Sabha and referred to the Standing Committee on HRD, which tabled its report on August 12, 2011.  This Bill is part of the government’s attempt to reform the higher education sector.   The key objective is to provide an effective means of quality assurance in higher education. Presently, accreditation is voluntary.  Higher educational institutions are accredited by two autonomous bodies set up by the University Grants Commission and the All India Council of Technical Education.  The Bill makes it mandatory for each institution and every programme to get accredited by an accreditation agency.  The agencies have to be registered with the National Accreditation Regulatory Authority.  Only non-profit, government controlled bodies are eligible to register as accreditation agencies. (See here for PRS analysis of the Bill) The Standing Committee made some recommendations: (a) assessment for accreditation should start after two batches of students have passed out of the institution; (b) there should be specific provisions for medical education; and (c) registration to accreditation agencies should initially be granted for five years (could be extended to 10 years).   (See here for PRS Standing Committee Report summary) The Protection of Women against Sexual Harassment at Work Place Bill, 2010 The Bill was introduced on December 7, 2010 in the Lok Sabha and referred to the Standing Committee on HRD, which tabled

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its report on December 8, 2011. The Indian Penal Code covers criminal acts that outrage or insult the 'modesty' of women.  It does not cover situations which could create a hostile or difficult environment for women at the work place.  The Supreme Court in 1997 (Vishaka judgment) laid down guidelines to protect women from sexual harassment.  This Bill defines sexual harassment and provides a mechanism for redressing complaints.  The protection against sexual harassment is applicable to all women at the workplace.  However, the Bill does not cover domestic workers working at home. (See here for PRS analysis of the Bill) The Standing Committee recommendations addressed issues of gender neutrality, inclusion of domestic workers and the modified definition of sexual harassment. (See here for PRS Standing Committee Report summary) The Universities for Research and Innovation Bill, 2012 The Bill was cleared by the Cabinet and is likely to be introduced in Parliament this session.  It seeks to provide for the establishment and incorporation of Universities for Research and Innovation.  These universities shall be hubs of education, research and innovation. Although an official copy of the Bill is not yet available, newspaper reports suggest that this is an omnibus law under which innovation universities (focused on specific research areas such as environment, astrophysics and urban planning) shall be established.  In India, a university can only be set up through an Act of Parliament or state legislature.  The Planning Commission’s Working Group on Higher Education report stated that these universities could be funded by the private sector as well.  The government aims to create 14 innovation universities, which would be world class.