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[e-drug] Netherlands TV documentary: the real price of cheap medicine

E-DRUG: Netherlands TV documentary: the real price of cheap medicine
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[The Dutch investigative journalists Jos van Dongen and Annette Schaetzle have 
made 2 documentaries that expose some serious side-effects of generic 
production in India. Although we are all happy about affordable prices, and 
most generic products arriving in Europe are good quality, we should not ignore 
the sustainability issues of reasonable wages and protection of the 
environment. E-drug welcomes discussion on these programmes, which have been 
translated into English. WB]

'Manufacturer of Dutch medicines exploit workers and pollute the environment'

The pharmaceutical company Aurobindo Pharma takes a reckless attitude towards 
both people and the environment in India, according to experts interviewed in 
this edition of ZEMBLA. Aurobindo, one of the biggest manufacturers of generic 
drugs for the Dutch market, doesn't pay its employees enough and contravenes 
health and safety regulations in its factories. ZEMBLA also shot footage at 
multiple locations in India where Aurobindo and other pharmaceutical companies 
have illegally discharged chemical effluent. As a result, the nearby residents 
are exposed to health risks and the environment has been contaminated. 
According to environmental and employment experts, companies like Aurobindo 
ignore legislation in order to save money. 'They want to cut manufacturing 
costs.' Aurobindo stated that they comply with local and international 
legislation.

Many of our medicines are made in India, which provides development 
opportunities for the country. However, according to Prof. Prasad, a 
sociologist at Hyderabad University, the local population and the employees are 
paying a high price for our cheap medicines. 'People in developing countries 
are being exploited.' Every day, over 60,000 boxes of Aurobindo medicines are 
dispensed by Dutch pharmacies.

Poor working conditions

Research by ZEMBLA shows that trained Aurobindo employees earn less than the 
minimum wage (between E150-E250 per month), with the technical staff claiming 
to earn a monthly salary of around E110. 'It's only just enough to buy food,' 
they explain. With a permanent contract, they would earn almost twice as much, 
but Aurobindo employees are not given permanent contracts, even if they've been 
working there for six years, or even ten years. 'If we complain, we lose our 
job.' 

The employees also report that Aurobindo is less than stringent when it comes 
to employee safety. 'There is no safety equipment such as protective glasses, 
gloves, masks, and safety shoes.' The Indian media report that in the last ten 
years, many accidents have occurred in Aurobindo factories, resulting in at 
least eight deaths and many more injuries. The firm told ZEMBLA that its 
employees' wages are in compliance with all legal provisions. 'All employees 
receive the same level of health and safety facilities,' according to Aurobindo.

No jobs

Near the Indian village of Polepally is an Aurobindo factory that manufactures 
drugs for the Dutch and other markets. Residents of the poverty-stricken 
farming community were forced by the Indian government to move away in order to 
make space for the pharmaceutical industry. The farmers were promised jobs with 
Aurobindo, but they say Aurobindo will not employ them. 'The jobs are given to 
migrant workers, as they are cheaper.' Aurobindo doesn't respond to questions 
about the villagers' situation. 

Antibiotic resistance 

Aurobindo also violates environmental law. Documents obtained by ZEMBLA show 
that in 2017, Aurobindo and other pharmaceutical companies were fined for 
illegal disposal of chemical effluent. The pollution resulted in the death of 
230,000 fish in the lakes near the factories. Local fishermen told ZEMBLA that 
so far, they haven't received a penny in compensation. This isn't the first 
time that pharmaceutical companies have released chemical waste into the 
environment in order to cut costs. 

Studies conducted by a variety of institutions - including the British 
organization Changing Markets - show that Aurobindo was also illegally 
releasing industrial effluent in 2016. In a water sample taken at an Aurobindo 
factory, Changing Markets discovered a bacterium that is resistant to six 
different antibiotics. Residents living near the Aurobindo factory in question 
told ZEMBLA that dumping of these pollutants only stopped in December 2017. 
Furthermore, teachers and pupils at a primary school next to an Aurobindo 
production unit are suffering health problems due to air pollution from the 
factory. The teacher at the school takes a very dim view of the situation. 'The 
result of the pharmaceutical industry in India is that businesses make even 
bigger profits while the people here get sick.'

CZ 

Aurobindo is a major supplier of preferred medicines. Marie-Jose van Gardingen, 
spokeswoman for the health insurer CZ, stated that the decision to purchase 
Aurobindo medications was based only on price and not whether the drugs are 
sustainably produced. 'This footage makes me feel sick. We must take it 
seriously, it simply cannot be ignored.' CZ is considering possible measures 
against Aurobindo. 'We have to look for alternatives, and I'm sure we'll find 
one.' 

CZ has announced that by 2019, it will require suppliers like Aurobindo to 
provide a sustainability declaration. 'We want everyone we do business with to 
sign a declaration stating that they fulfil their responsibilities with regard 
to people, nature and the environment.' The health insurers VGZ, Zilveren 
Kruis, and Menzis also purchase medicines from Aurobindo, but declined to 
respond to our findings on camera. They stated that the situation must be 
brought to the attention of Aurobindo and the government. 

2nd Documentary "the bitter pill" on the quality of medicines

ZEMBLA broadcasted on 18 April another documentary on the quality of medicines 
being used in Europe.

This Zembla documentary was partly shot in Germany and the last 20 minutes 
focus on the generic medicines coming from India into Europe.
What is the quality of these pills coming from India? 
Our conclusion is that we do not know because these medicines are not 
structurally investigated by our European inspection services.

Links to English language documentaries:

The real price of cheap medicine:
https://www.youtube.com/watch?v=190by1BjAT8

The Bitter Pill:
https://www.youtube.com/watch?v=5EKQ7DmlkEI

If you know Dutch, try these:

De prijs van het goedkope medicijn:
https://zembla.bnnvara.nl/nieuws/de-prijs-van-het-goedkope-medicijn
De bittere pil:
https://zembla.bnnvara.nl/nieuws/de-bittere-pil

regards

Jos van Dongen
Journalist | ZEMBLA
BNNVARA
Jos.van.Dongen@bnnvara.nl
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