A few medicines prescribed under the Indian System of Medicine (ISM) have been found contaminated with life-threatening heavy metals and other contaminants in J&K.
Last month, eight samples of ISM drugs tested sub-standard at the Indian Institute of Integrated Medicine (IIIM), Jammu. Four of these samples had been lifted from market and four from the drug warehouse J&K Medical Supplies Corporation Limited (JKMSCL), which handles drug procurement for quality.
As per the reports from the drug testing laboratory, the impurities included “heavy metals above permissible limits”, “aflatoxins above permissible limits” and “yeast and mould above permissible limits”.
A doctor said aflatoxins are dangerous chemicals produced by certain organisms in foods and are carcinogenic in nature.
“These may result in serious illnesses as they are known to be teratogenic, mutagenic, carcinogenic, immunotoxic or hepatotoxic,” he said.
The failed samples were of “commonly consumed” drugs such as Hubbe Shifa, Hubbe Surfa, Sharbati Sandal and Qurs Sozak.
Last year, 37 out of the 156 samples tested were found to be substandard by the IIIM.
The heavy metal contaminations, as per the reports in possession of Greater Kashmir, included mercury “57 times than the permissible limit”, arsenic “thrice the upper limit” and “lead twice the upper limit”.
Heavy metal poisoning can take place due to prolonged exposure to metals like mercury, lead, arsenic and cadmium.
“It can lead to organ damage, behavioural changes, and other health complications,” said the doctor.
Another doctor working with ISM department expressed shock over the test reports. He said that most people, who opted for ISM or alternate medicine drugs, believed these to be “entirely safe from side effects”.
“Now, it is not the side effects we should be worried about but the dangerous direct effects,” he said.
However, an official in the department said, the figures of substandard drugs, were not representative as only a small sample was tested because of the shortage of manpower in ISM.
He said there were only two drug inspectors for the ISM in the entire state, one each for Jammu and Kashmir.
“Given the vast geographical area these two drug inspectors are expected to cover we can gauge the intensity, robustness and representativeness of the samples,” he said.
He said the “overworked” drug inspectors were required to lift samples, send these for testing and follow up with documentation and reporting from the government as well as the private sector.
The official said that compared to the quantum of drugs procured for the department, the manpower was a “cruel joke”.
During 2018-19, the ISM procured drugs worth Rs 5 crore. Of this, drugs worth Rs 2.5 crore were funded by the National Ayush Mission.
In 2016, the state government handed over the procurement process of ISM and AYUSH drugs to the JKMSCL after reports of contaminated drugs surfaced in the media.
The corporation was expected to ensure quality and safety of these drugs with the mechanisms instituted for the purpose, such as “triple sampling”.
A corporation official said two quality checks are already accomplished when the medicines are out for distributing and consumption.
“First, the supplier provides us batch-wise quality certificate from an accredited laboratory,” he said, adding that the corporation then quarantines the stock, sends another sample from the batch for testing and then release the batch only if the certificate has been approved.
However, doctors working in the field questioned how a drug, which has already been given a green signal twice by two different laboratories, could be contaminated with heavy metals.
“Testing is a science, not probability,” a senior ISM doctor said. “If one laboratory is able to detect an impurity in a sample, why does the other one fail to do so?” he asked.
Director ISM J&K Dr Phuntsog Angchuk said the “dilapidated condition” of ISM dispensaries was “contributing to contamination of the drugs”.
“Most of our dispensaries operate from rented buildings, which have very conducive atmosphere for growth of moulds and other organisms,” he said.
He added that metal impurities were due to “plant based nature” of the medicines. “Soil sometimes has high metal impurities,” he said.
Asked about the disparity between JKMSCL testing reports and those done by the department, he said “I have no idea but the lab we get our tests done from is a very reputed one.”
The IIIM is the quality control division of the department functioning under Council of Scientific and Industrial Research. The laboratory is accredited by National Accreditation Board for Laboratories (NABL).
Dr Angchuk acknowledged the dearth of drug inspectors in the department. “We have already written to the government to provide us at least 12 drug inspectors for the state,” he said.