An appreciation

I have been carefully reading your various articles published in Pulse International for the last many years. This is indeed a monumental effort of a true and dedicated Pakistani which reflects great concern on all medical and health issues.

The clarity and precision with which you have addressed all issues is your singularly rare distinction. The crusade must go on till the battle is won. This is no mean task to try to change attitudes of the vested interests but your commitment and dedication and steadfastness is so solid that soon some tangible and palpable results must surface. Kindly accept my most sincere felicitations. May Allah Almighty grant you courage and fortitude to continue this noble task till its logical end. Ameen.

Dr. Khalid Saifullah Khan,MBBS,DPH
114-P, Model Town Extension Scheme

 UHS First convocation

I am indebted to you to have come all the way from Karachi to witness the First Convocation of UHS, Lahore on 18th December, 2015. This shows your passion for Education, Educational Institutionsand love for UHS and your care for me, in particular. I salute you and your professionalism.

May Allah always bless you and your family (Aameen).

Maj. Gen. [Retd]
Professor Muhammad Aslam
Vice-Chancellor, University of Health Sciences
Khayaban-e-Jamia Punjab
Lahore – Pakistan

 PharmEvo Thematic
Calendar 2016

Dear Shaukat Sb., 

Thanks for your kind words. We are obliged to your presence in our allsessions. I am touched with your gesture as you took out almost a week fromyour extremely busy schedule and accompanied us around Pakistan. 

We are also extremely thankful for your support in disseminating thismessage to larger audience by having extra 800 copies of this issue. I am astrong believer of combining the energies of good people in our society tocreate more good which is badly needed in our beloved country, Pakistan.Alhamdolillah, our multiple collaborations spanning over a decade arewitnessing this synergistic combination and its multiplying effects onPharma industry. 

Once again I am indebted with your kind gesture. 

Jamshed Ahmed
Chief Operating Officer
PharmEvo (Pvt) Ltd.
Karachi. Pakistan.

“Plight of a Medical Editor”
- an autobiography

Dear Shaukat,

Over our Christmas vacation I had time to read your biography. I am very impressed with what you have done with your life. Truly you are a success story.

As an American, it’s easy to forget that the things I take for granted——peace, prosperity, access to education, for or example——are not available for much of the world. I have an intellectual understanding of it, of course, but reading about your early life and the violence, economic hardships, and challenges you had to overcome brings it much closer to home. Look what you did with taking the classes in shorthand and typing. Such a small start but it set a direction. Asking the President for money to attend college was an amazing thing to do, especially because it worked!

I was also saddened to hear of the death of your youngest child. I can’t imagine the grief. I was struck, too, at your comment about the death of your mother and wishing she could have died at home instead of in a hospital. I have attached what has become a famous essay, How Doctors Die which was written by a good friend. I think he captured your sentiments very, very well.

I noticed you visited the Cleveland Clinic in 1987. I started working there in 1990. You also visited Dhaka a few years before I began teaching there, too. (My host has been Mujibur Rahman, who in 2012 was Secretary General of the Association of Physicians of Bangladesh and works at  Shaheed Surawardy Medical College Hospital.

It was also fascinating to read about how medicine developed in Pakistan and that you documented it so well for so long. The amount of detail in the book is amazing.

Another theme that struck me was how important family and connections were and are to you in your life. They are important in the US, too, but we have replaced many interpersonal relationships with procedures rather than with reciprocity. Thought-provoking, to be sure.

Anyway, I just wanted to tell you how much I appreciated your gift of the book and how much I enjoyed reading it. I hope our paths will cross again soon.

Happy New Year!

Tom Lang
Tom Lang Communications and Training International
10003 NE 115th Lane • Kirkland,
WA 98033 • 425-636-8500 
This email address is being protected from spambots. You need JavaScript enabled to view it.

 Contributions of Prof. A. J. Khan,
Former DG Health

I have read with great interest the achievements of Professor A.J Khan in “Plight of a Medical Editor” – an autobiography  and the subsequent write up published in Pulse International of  November 1 – 15th 2015 Issue.I had long associations with Professor A.J Khan during my 30 years career dealing with drug regulatory affairs and quality control in various capacities in the Ministry of Health. I had the privilege to work with him as Drug Controller when he was the D.G Health in late 1980’s.No doubt he made some bold attempts to bring about much needed reforms as mentioned in the article but the record needs to be straightened.

1) As regards the Scientific System of Prices of Drugs stated to be devised by him, the fact is that this system was devised in early 1980’s and was being followed in 1985 when I was the Drug Controller. The formula being followed for over a decade was -  Prime Cost ( i.e. cost of raw material + cost of packaging material + Direct Labour) + 75% Mark up for all dosage forms except injectables in which case markup was 115% to cover all extra costs of Manufacturing of Dosage Forms.

2) His statement about Reduction of Drug Prices is not evidence based. Drug Prices are fixed by the Government under Section 12 of the Drugs Act 1976 by an expert committee and notified in the official Gazette which is not on record.Drug Prices showed downward trend only when the “The Drugs (Generic Names) Act 1972 and Rules” was enforced under which nobody was allowed to manufacture, sell, stock, and prescribe drugs, except under generic (scientific names). It is common knowledge that items with generic name are always cheaper than the branded items.

3)The incidence he has mentioned about a Pharmaceutical Company demanding increase in prices (referred by the Prime Minister) of certain drugs (raw materials) probably pertains to M/s Ciba Giegy of Switzerland who wanted price increase on imported raw materials of certain antibiotics which were already high on the plea of their “Superior Quality” than the other Firms. If I remember I being the senior most in the drug section, I confronted the Chief Executive and his associate asking him to prove that the quality of their raw material was superior when technically and legally there are no two standards in drugs. The drug (raw material) is either of Standard quality if it confirms to all quality specifications given in International Pharmacopoeias i.e. British, United States, WHO, European or Sub- standard when it does not. The Chief Executive was so confused and nervous that he failed to provide any answer. Perhaps Professor A.J Khan might be talking of some other incidence of which we have no knowledge.

In those days the Multinationals (including Ciba-Giegy) were involved in “Over Pricing” of imported Raw Materials, the Technical Term used was “Transfer Pricing” which means that the Raw Materials for making drugs were imported at exorbitant prices as compared to international market. A study carried out by the undersigned in early 1984 about Transfer Pricing in respect of seven lifesaving drugs revealed that Foreign Exchange savings could have been to the tune of $6.5 million (Rs. 100 million) per Annum if these were imported from competitive sources as provided in Import Policy of Ministry of Commerce which was never implemented.1

4)Professor A.J Khan has stated that he has been the founder of the Pakistan Drug Information which gave information about the Drugs Registration, good or bad affect and side effects, toxicity of certain drugs and the cost and prices of Drugs. Such a book is not available in any library or book store. However a similar book of 570 pages titled Pakistan Drug Information Sheets is freely available everywhere.2 This book was published by the Ministry of Health in 1996 under the Patronage of the then D.G Health, Professor N.M Sheikh, in consultation with the Representatives of specialist organizations, Provincial Governments, and Armed Forces Services, and contained information on clinical and pharmaceutical aspects of drugs included in the National Essential Drugs list 1994. From Armed Forces medical side, Lt. General Professor Emeritus Mahmud Ahmad Akhtar, played a key role in the preparation of NEDL 1994 and Registration of drugs as a member of the Drug Registration Board.This book does not give toxicity and the cost and prices of Drugs. In fact this book is a copy of Pharma Guide and Drugs Index, two commercial publications of chemist, Druggist and Manufacturers Association giving all the information about the Registered Drugs notified by the Ministry of Health/Drug Registration Board.

5) Cancellation of 2000 Drugs out of 10,000 drugs as claimed by Professor A.J Khan is again not evidence based. The mechanism of Registration and Cancellation is given under section 7 subsection (11) of the Drugs Act 1976. Under this Act, Registration Board consisting of over a dozen experts under the chairmanship of D.G Health has only the authority to de-register any Drug on the basis of information and inquiry by giving a chance of hearing to the party. The only legal evidence of de-registered Drugs is available in Notification No. SRO 1069 (1) 85, Dated 24th October 1985 by which 78 Drugs were de-registered by the Board. 3

These were some of the inaccuracies which have been pointed out but it does not in any way diminish the contributions made by Prof. A. J. Khan in the field of medicine and pharmaceuticals. I sincerely hope that these remarks may not be taken negatively or criticism in view of his great contributions.


  1. Proceedings of International Seminar on Policies, Management and Quality Assurance of Pharmaceuticals. International Seminars. Karachi 85.
  2. Pakistan Drug Information Sheets. Ministry of Health, Government of Pakistan, Islamabad.
  3. Manual of Drug Laws 1992 by S. A. Khan advocate Lahore High Court ( List of de-registered drugs)

Dr. Inam-ul-Haq,
Retired Drugs controller/chairman
Quality Control Authority,
Ministry of Health,
Government of Pakistan, Islamabad.

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