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.

On October 16, the Group of Experts on Privacy, Chaired by Mr. A. P. Shah, submitted its Report to the Planning Commission.  The Expert Group was appointed to set out the principles that Indian privacy law should abide by.   Even though privacy has been held to be a fundamental right as long back as in 1962, India does not have a law that specifies safeguards to privacy.  Moreover, recent government initiatives, such as the UID, involve collection of personal information and storage in electronic form.  The absence of a law on privacy increases the risk to infringement of the fundamental right. In this blog we list the recommendations made by the expert group, discuss the status of the right to privacy in India, and why there is a need for an enactment. Recommendations of the Expert Group on Privacy

  • The Expert Group recommended that the new legislation on privacy should ensure that safeguards are technology neutral.  This means that the enactment should provide protections that are applicable to information, regardless of the manner in which it is stored: digital or physical form.
  • The new legislation should protect all types of privacy, such as bodily privacy (DNA and physical privacy); privacy against surveillance (unauthorised interception, audio and video surveillance); and data protection.
  • The safeguards under the Bill should apply to both government and private sector entities.
  • There should be an office of a ‘Privacy Commissioner’ at both the central and regional level.
  • There should be Self-Regulating Organisations set up by the industry.  These organisations would develop a baseline legal framework that protects and enforces an individual’s right to privacy.  The standards developed by the organisations would have to be approved by the Commissioner.
  • The legislation should ensure that entities that collect and process data would be accountable for these processes and the use to which the data is put.  This, according to the Group, would ensure that the privacy of the data subject is guaranteed.

Present status of the Right to Privacy While the Supreme Court has held privacy to be a fundamental right, it is restricted to certain aspects of a person’s life.  These aspects include the privacy of one’s home, family, marriage, motherhood, procreation and child-rearing.  Therefore, to claim privacy in any other aspect, individuals have to substantiate these are ‘private’ and should not be subjected to state or private interference.  For instance, in 1996 petitioners had to argue before the Court that the right to speak privately over the telephone was a fundamental right. Risks to privacy Government departments collect data under various legislations.  For instance, under the Passport Act, 1967 and the Motor Vehicles Act, 1988 persons have to give details of their address, date of birth etc.  These enactments do not provide safeguards against access and use of the information by third parties.  Similarly, information regarding ownership of property and taxes paid are publicly available on the MCD website. Furthermore, recent government initiatives may increase the risk to infringement of privacy as personal information, previously only available in physical form, will now be available electronically.  Initiatives such as the National e-Governance Plan, introduced in 2006 and Aadhaar would require maintenance of information in electronic form.  The Aadhaar initiative aims at setting up a system for identifying beneficiaries of government sponsored schemes.  Under the initiative, biometric details of the beneficiaries, such as retina scan and fingerprints, are collected and stored by the government.  The government has also introduced a Bill in Parliament creating a right to electronic service delivery.  As per news reports, a draft DNA Profiling Bill is also in the pipeline.