Moshiur Rahman Selim, Comilla South 

Hundreds of thousands of people in the southern region of Cumilla, particularly across the greater Laksam upazila, are facing severe health risks due to a rampant trade in adulterated, expired, and smuggled medicines, coupled with untrained pharmacy staff illegally practicing as physicians.

Local sources revealed that while almost all economic sectors in the region suffered over the past three years due to various crises, the pharmaceutical sector witnessed an unprecedented boom, with medicine companies and local pharmacies raking in excessive profits under different pretexts. Rural hats and bazaars across four upazilas in southern Comilla are currently flooded with unauthorized private clinics and medicine shops popping up like mushrooms. Alarmingly, nearly 90 percent of these pharmacies do not possess any valid registration or legal documentation from the drug administration.

Taking advantage of inadequate monitoring, a section of unscrupulous wholesalers is pushing counterfeit, substandard, and banned Indian drugs smuggled through border routes into rural pharmacies and quack doctors. Prices of life-saving drugs are being hiked arbitrarily, leaving consumers trapped between soaring costs and artificial supply shortages. Locals alleged that the situation has deteriorated to a point where pharmacy owners and counter salesmen have assumed the roles of specialized doctors, diagnosing illnesses and prescribing high-strength medicines without any regulations.

Due to the acute shortage of authentic medicines, lack of modern technical diagnostic tools, and a rise in risky illegal medical procedures like unauthorized MR and DNC by quacks, rural patients are increasingly being forced to move to major cities for reliable healthcare.

Although various regulatory and professional bodies—such as the Druggists and Chemists Association, the Village Doctors Association, and the Pharmacy Owners Association—exist on paper, they function merely as signboard-only organizations. Barring a handful of registered pharmacists and diploma-holding physicians, the vast majority of these medicine shops operate completely outside the purview of the law, sustaining a chaotic, commission-based market.

It is learned that out of around 23,000 registered medicines in the country, the government directly regulates the quality, testing, and pricing of only 117 items. Drug manufacturing companies completely control the pricing of the remaining vast majority of medicines, leading to sudden and erratic price hikes in the retail market. Furthermore, a move is currently underway to increase the prices of another 52 medicines. The market is also heavily saturated with controversial foreign medicines and imported products labeled as "food supplements," whose quality remains highly questionable.

Sources from local private hospital medical boards revealed that laboratory tests funded by the World Bank on various locally manufactured energy and cold drinks have previously exposed alarming results, showing excessive and hazardous levels of sodium benzoate.

Public grievances are mounting over a toxic "give-and-take" commission culture where pharmaceutical representatives offer hefty financial incentives to quack doctors, clinic owners, and pharmacy operators to push these substandard and adulterated products to unsuspecting patients.

While the local administration occasionally conducts sporadic market monitoring and mobile court drives, the Directorate General of Drug Administration (DGDA) and the Health Department have reportedly turned a blind eye to the deep-rooted anarchy, failing to initiate any permanent systemic reforms or disciplinary actions against the syndicates.