Md. Shawkat Alam Faisal

Recent reports show a substantial shift in Bangladesh's pharmaceutical business, with anti-ulcer drugs dominating sales. Notably, five of the top 10 best-selling medications are intended to address stomach disorders. Leading this category is 'Sergel,' a Healthcare Pharmaceuticals Limited product that has earned impressive sales figures. According to a recent report by the Daily Star, Sergel's sales in the first nine months of this year alone totaled Tk 918 crore, representing for 2.67% of Bangladesh's overall pharmaceutical market.

Sergel contains esomeprazole, a proton pump inhibitor (PPI) that reduces stomach acid output by blocking the H+/K+-ATPase enzyme system in the gastric parietal cells. This technique significantly lowers stomach acidity, offering relief from illnesses like gastroesophageal reflux disease (GERD) and erosive esophagitis. Several reasons in Bangladesh contribute to the increase in sales of gastric drugs such as Sergel. Unhealthy eating practices, such as the intake of spicy and greasy meals, as well as widespread food adulteration, have all contributed to an increase in gastrointestinal troubles in the population. This has resulted in increased demand for over-the-counter and prescription drugs to treat similar diseases.

Bangladesh's pharmaceutical industry has seen constant rise in anti-ulcerant medicine sales. Since 2015, this segment has grown at a pace of more than 12% per year, showing the increasing frequency of stomach disorders in the general population. The market dominance of stomach drugs highlights the competitiveness of Bangladesh's pharmaceutical sector. With over 265 allopathic medication manufacturing businesses active in the country, the top ten corporations control around 68% of the market. This concentration reflects a highly competitive environment in which prominent companies attempt to grab large market share through excellent product development and marketing methods.

The dominance of gastric pharmaceuticals in Bangladesh's pharmaceutical business is further demonstrated by the combined annual sales of just three top stomach medicines—Sergel, Maxpro, and Pantonix—which total almost 2000 crore taka. This figure does not take into consideration the different brands of gastrointestinal medications produced by various pharmaceutical companies, or the widespread production and use of antacids. With every major pharmaceutical business offering its own versions of gastric tablets, capsules, and antacids, the total yearly sales of these medications in the country may be estimated to be between ten and twenty thousand crore taka. This startling statistic demonstrates the high demand for gastrointestinal therapies, showing not only the widespread prevalence of gastric illnesses but also the profitability and strategic relevance of this sector in the Bangladeshi pharmaceutical industry.

The gastric medicine market is only one aspect of Bangladesh's greater health crisis caused by food poisoning and bad lifestyle choices. Cancer and kidney disease are intimately related to the same variables that cause stomach issues. Prolonged exposure to pesticides, heavy metals, and toxic chemicals in food not only irritates the digestive system, but can also cause cancer and chronic renal disease. Heavy metal bioaccumulation in the body, which is frequently caused by contaminated food, has been linked to kidney damage and several types of cancer, according to studies. Similarly, abuse of medications such as proton pump inhibitors without sufficient medical supervision can worsen kidney problems in the long run. This connection implies that the health and pharmaceutical businesses confront a multifaceted issue, as demand for therapies for various ailments is anticipated to mirror the increasing gastric medication market. Addressing these concerns holistically necessitates a coordinated strategy to food safety, healthcare access, and public health awareness.

The high demand for gastric drugs raises serious concerns regarding the underlying reasons of such prevalent gastrointestinal problems. In Bangladesh, the daily intake of staple foods such as rice, potatoes, vegetables, fish, poultry, and eggs frequently exposes people to dangerous pesticides, heavy metals, and other toxic compounds. Trans fats included in cooking oils and fried foods exacerbate health problems.

This worrisome truth raises the unsettling possibility that food intoxication and contamination are not accidental, but rather the product of institutional carelessness or, worse, deliberate acts motivated by profit. There is speculation that such broad health crises could have an indirect benefit for the pharmaceutical sector. The industry stands to benefit handsomely from the population's reliance on gastric drugs to alleviate these side effects. This presents a bleak image of a loop in which public health suffers while the pharmaceutical sector profits from the aftermath. While these accusations require further study, they underscore the crucial need for stricter food safety rules, as well as a probe into the potential links between food contamination and Bangladesh's thriving pharmaceutical industry.

Bangladesh's legal system protects the right to safe and healthy food, demonstrating the state's commitment to its residents' well-being. Article 15 of Bangladesh's Constitution expresses the state's responsibility to ensure the fundamental essentials of life, particularly food, for its citizens. Furthermore, Article 18 states that one of the state's key obligations is to improve nutrition and public health. To carry out these constitutional responsibilities, the Food Safety Act of 2013 was passed, establishing the Bangladesh Food Safety Authority (BFSA).

This authority is responsible for regulating and coordinating operations linked to food production, import, processing, storage, supply, marketing, and sales in order to ensure safe food access through proper scientific measures. The Bangladesh Standards and Testing Institution (BSTI) is the national regulatory organization in charge of monitoring and implementing quality control procedures in food items to prevent pesticide, heavy metal, and other harmful substance contamination. However, complaints of poor testing, monitoring, and standard enforcement have resulted in a flood of defective and potentially unsafe food products on the market.

Despite these strong legal safeguards, the practical implementation of the right to safe food remains a major concern. The frequency of food adulteration, pesticide and heavy metal contamination, and the widespread use of toxic additives all point to a disconnect between law aim and actual enforcement. This disparity highlights the need for more enforcement of current regulations, increased public awareness, and increased regulatory monitoring to transform the constitutional right to safe food from a theoretical entitlement to a realistic reality for all citizens.

Finally, the high sales figures for gastric drugs, particularly Sergel, show a growing health concern in Bangladesh regarding eating habits and lifestyle choices. The pharmaceutical industry's response to this demand illustrates the problems and opportunities that exist in meeting the population's healthcare demands. As the market evolves, healthcare professionals and governments will need to focus on preventive measures and public awareness to address the root causes of such health disorders.

The writer is a, LLM Student at the University of Rajshahi & an Apprentice Lawyer at the Bangladesh Bar Council.