Facing challenges and converting threats into opportunities

In the last more than 20 months, the world has experienced unprecedented health calamities caused by a virus leading to human suffering, death and disaster. Human endeavour, intellectual efforts and mind fought relentlessly to act against the challenges. The war is still not over – the death virus still exists, affecting people in different parts of the world. Understanding its venom and power in the future is more challenging – especially on medical infrastructure, drug industries and on people awareness.

As far as Indian pharmaceutical industry is concerned, which is ranked third worldwide on production and 14^th on value, it recorded around $42 billion in 2021, annual growth of seven per cent against projected 12 per cent.

Some of the major challenges and threats to the industry, especially post-pandemic, are as follows:

• Reduced demand for prescription medicine
• Reduced purchasing power
• Reduced consumer confidence
• Increased prevalence of chronic diseases
• Predominance of critical care areas
• Expected change in the overall marketing concept, approach and dynamics of pharmaceutical products
• Practical changes in the in-clinic atmosphere and the doctors’ overall approach and need

The industry must assess the collaborative needs of the patients, the expected pattern of the past pandemic complications and that of the continued effect of the mutated virus.

Expected scenarios of complications and Indian pharmaceutical industries

• Mental health and psychological disturbance will be a major area for the industry to ponder upon and evaluate newer and safer molecules for long-time use.
• Chronic metabolic disease like diabetes, hypertension, arthritis and neuro-muscular complications are already on rise, adding newer patients from the post-COVID complication in time. This is further to rise severely and needs medical assistance.
• There are possibilities of organ disorders, especially that of lungs and heart, and COPD will be a major threat area.
• Indian pharma industry worked quite innovatively to formulate and produce indigenous vaccines, a great breakthrough to save millions of lives, not only of our own, but of people in several other countries, too. We have learnt what is must to be aatmanirbhar and still improvisation is on. Better percentage efficiency, longer duration action and safety should be the key areas for vaccines. Recently, Lancet mentioned Bharat Biotech’s Covaxin efficiency as around 76 per cent of their phase-III trial, which is indeed a great achievement. Vaccine through nasal route of BB is almost in the last phase of trial. This is going to be the revolution in the concept of COVID vaccine expected to be highly effective as it will directly cover the respiratory system.

Those under the age of 18 comprise 41 per cent of the Indian population, amounting to around 570 millions. Understanding infectivity rates from previous wave around 10 per cent, the number comes around 57 million pediatric cases. God forbid, we should not experience such days, but extensive preparation to face such situation, including proper drugs and therapeutic portfolio is the need of the hour.

Immediate challenge of vaccination of children aged between two and 12 years stands as the most emergent area. Considering our child population and expected vulnerability, dosage, safety and effective time duration of the vaccine shall be the prerogative. Newer oral antiviral from Merck’s molnupiravir has been launched in 105 countries. Recently, Pfizer launched Paxlovid, which is supposed to be an effective oral antiviral, convenient dosage schedule to fight against COVID. Report says, it’s very effective at the initial stage of infection and can drastically reduce the severity and hospital need. The generic form of the product will be available in India, as presently five-to-six pharma companies are working on it. This is a great opportunity.

The uncertainties of COVID virus, its unpredictable mutation is the major concern of the scientists. As of now, after steep downfall of the cases in over 26 European countries and after good percentage of vaccination, fresh attack in 10 countries have again become a major threat. In Russia, the recent affected number went up to 25,000/day, similarly, in Germany. Though few countries are going for booster doses, but it is still not advocated by the World Health Organization (WHO). However, one area which has come up quite conclusively is the role of “immunity” as a factor to combat the infection. “Herd immunity,” so far, is an inconclusive area, so is the post-infected immunity. Building body’s own defence system in specific terms can be the area of studies and research.

Though specificity of ‘body immunity’ to counteract infection in process and value is a matter of extensive research, but worth studying. It is the time to face challenges and convert threats into opportunities.