Indians are not pill poppers. Or so I thought until a report in the Lancet Infectious Disease Journal linked an antibiotic-resistant "superbug" to India. In a somewhat dubious compliment the new "genetic mechanism" is even named after us: New Delhi metallo-beta-lactamase 1 or NDM1. The report, published in August, caused uproar in the Indian and international medical community. The Indian health ministry has appointed a committee that will frame and monitor policy on antibiotic use.
Hard as it is to believe, India really doesn't have a comprehensive framework on how to prescribe, control and monitor the use of pharmaceutical drugs, including antibiotics. As a result, Indians self-medicate; in large numbers it seems, according to the Lancet. This is contrary to my own experience. Everyone I know of my parents' generation hates popping pills. My father complains bitterly about problems he has sleeping but refuses to be persuaded to take a sleeping pill. My mother has a veritable array of lotions, unguents and Ayurvedic oils by her bedside. But no pills.
She prefers Amrutanjan for headaches, Vicks VapoRub for colds and Tiger Balm for aches and pains. No wonder Indian pharmaceutical companies had to look abroad for their generics businesses, I thought. The Indian pharmaceutical industry is in robust stock-market health, having outperformed the broad market index substantially over the past two years. But it is also in the throes of intense self-reflection on how to prevent chronic degeneration, and in the coming months will attempt to reinvent itself to remain relevant in these changing times.
A couple of weeks ago, the health minister Ghulam Nabi Azad convened what was dubbed a "high-level" meeting with the captains of the pharmaceutical industry. The springboard for the meeting was the so-called "sell-outs" among Indian drug companies to foreign multinationals. Piramal, for instance, recently sold its domestic formulations division to the US-based Abbott for an up front payment of US$2.2 billion (Dh8.08bn) and additional cash influx of $400 million a year for the next four years starting next year.
Shantha Biotech and Dabur Pharma, too, have sold controlling stakes to the France-based Sanofi-aventis and the German company Fresenius Kabi, respectively.Some Indian firms, such as Lupin Pharmaceuticals, have followed a different route to the same result by acquiring foreign-branded pharmaceutical businesses. Recently, Sun Pharma bought a controlling stake in the Israeli company Taro Pharma, after a bitter three-year battle.
Taro, which makes topical dermatological products, was seen as the perfect niche branded business that Sun needed to complement its existing stable of products. So far, the pharmaceutical industry has been pretty much going it alone. The Indian government left them to fend for themselves. Mr Azad wants to change all this. He assured the industry chief executives the Indian government would help them address urgent and long-term issues regarding what the industry called "eking out profits in an increasingly competitive world".
In turn, Mr Azad wanted the companies to supply low-cost drugs to the poorest of poor Indians. The reason for all this angst, both in government and industry circles, is the fact that the industry needs to change course. In the next three years, several products are coming off-patent in the West, thus ending the ride that Indian drugs companies have enjoyed on the coattails of generics. Now that sales of generic drugs are expected to peak worldwide, the industry is being forced to look at new revenue streams.
At the pharmaceuticals industry get-together held in Hyderabad last month, the buzz was all about CRAMS (contract research and manufacturing services) and branding Indian drugs. According to several analysts, drugs industry growth is largely being driven by branded generics, which are expected to generate almost $8bn in sales this year and double that by 2015. Concomitantly, the global market for CRAMS is expected to increase from a value of $26.2bn to $43.9bn, according to the numbers bandied about at the conference.
The other driver is something I see everyday: more and more Indians are falling prey to chronic illnesses and lifestyle diseases such as diabetes and hypertension. They need branded drugs they can trust and use long-term. Until now, affluent Indians used to buy medicines abroad and bring them home. Nowadays, as Indian brands gain credibility, many of them buy their drugs at their local pharmacy. I used to bring all my children's medication from the UK or the US, either when I travelled abroad or when relatives and friends travelled they would buy them and bring them back for me.
Now that I have tried branded Indian remedies for my children and found them to be effective, I don't mind paying first-world prices for these medicines. The point is that there is a segment of Indians who are willing to pay for branded drugs and this segment is growing. Indian pharmaceutical companies have realised their domestic businesses will grow just when their foreign businesses are showing signs of strain.
If only one of these pharma hotshots can figure out a way to prevent Indians from self-medicating, particularly with antibiotics. We do so many things wrong on that front: stopping halfway through the course, choosing our own antibiotic based on past experience rather than go to the doctor. I am ashamed to say that since moving back to India, I've done all this, too. The health ministry's committee that will frame policies on antibiotic and other drugs has its work cut out.
Shoba Narayan is a journalist based in Bangalore and the author of Monsoon Diary
Gulf Under 19s final
Dubai College A 50-12 Dubai College B
The biog
Name: Fareed Lafta
Age: 40
From: Baghdad, Iraq
Mission: Promote world peace
Favourite poet: Al Mutanabbi
Role models: His parents
How to donate
Send “thenational” to the following numbers or call the hotline on: 0502955999
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
Founders: Ines Mena, Claudia Ribas, Simona Agolini, Nourhan Hassan and Therese Hundt
Date started: January 2017, app launched November 2017
Based: Dubai, UAE
Sector: Private/Retail/Leisure
Number of Employees: 18 employees, including full-time and flexible workers
Funding stage and size: Seed round completed Q4 2019 - $1m raised
Funders: Oman Technology Fund, 500 Startups, Vision Ventures, Seedstars, Mindshift Capital, Delta Partners Ventures, with support from the OQAL Angel Investor Network and UAE Business Angels
Women’s World T20, Asia Qualifier, in Bangkok
UAE fixtures Mon Nov 20, v China; Tue Nov 21, v Thailand; Thu Nov 23, v Nepal; Fri Nov 24, v Hong Kong; Sun Nov 26, v Malaysia; Mon Nov 27, Final
(The winners will progress to the Global Qualifier)
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
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- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
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- Disruption Lab and Research Centre for developing entrepreneurial skills
THE SPECS
Engine: 6.75-litre twin-turbocharged V12 petrol engine
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Director: Clint Eastwood
Stars: Clint Eastwood, Dwight Yoakam
Rating:**
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Takreem Awards winners 2021
Corporate Leadership: Carl Bistany (Lebanon)
Cultural Excellence: Hoor Al Qasimi (UAE)
Environmental Development and Sustainability: Bkerzay (Lebanon)
Environmental Development and Sustainability: Raya Ani (Iraq)
Humanitarian and Civic Services: Women’s Programs Association (Lebanon)
Humanitarian and Civic Services: Osamah Al Thini (Libya)
Excellence in Education: World Innovation Summit for Education (WISE) (Qatar)
Outstanding Arab Woman: Balghis Badri (Sudan)
Scientific and Technological Achievement: Mohamed Slim Alouini (KSA)
Young Entrepreneur: Omar Itani (Lebanon)
Lifetime Achievement: Suad Al Amiry (Palestine)
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The smuggler
Eldarir had arrived at JFK in January 2020 with three suitcases, containing goods he valued at $300, when he was directed to a search area.
Officers found 41 gold artefacts among the bags, including amulets from a funerary set which prepared the deceased for the afterlife.
Also found was a cartouche of a Ptolemaic king on a relief that was originally part of a royal building or temple.
The largest single group of items found in Eldarir’s cases were 400 shabtis, or figurines.
Khouli conviction
Khouli smuggled items into the US by making false declarations to customs about the country of origin and value of the items.
According to Immigration and Customs Enforcement, he provided “false provenances which stated that [two] Egyptian antiquities were part of a collection assembled by Khouli's father in Israel in the 1960s” when in fact “Khouli acquired the Egyptian antiquities from other dealers”.
He was sentenced to one year of probation, six months of home confinement and 200 hours of community service in 2012 after admitting buying and smuggling Egyptian antiquities, including coffins, funerary boats and limestone figures.
For sale
A number of other items said to come from the collection of Ezeldeen Taha Eldarir are currently or recently for sale.
Their provenance is described in near identical terms as the British Museum shabti: bought from Salahaddin Sirmali, "authenticated and appraised" by Hossen Rashed, then imported to the US in 1948.
- An Egyptian Mummy mask dating from 700BC-30BC, is on offer for £11,807 ($15,275) online by a seller in Mexico
- A coffin lid dating back to 664BC-332BC was offered for sale by a Colorado-based art dealer, with a starting price of $65,000
- A shabti that was on sale through a Chicago-based coin dealer, dating from 1567BC-1085BC, is up for $1,950
NO OTHER LAND
Director: Basel Adra, Yuval Abraham, Rachel Szor, Hamdan Ballal
Stars: Basel Adra, Yuval Abraham
Rating: 3.5/5
MATCH INFO
Who: UAE v USA
What: first T20 international
When: Friday, 2pm
Where: ICC Academy in Dubai
Our legal consultant
Name: Dr Hassan Mohsen Elhais
Position: legal consultant with Al Rowaad Advocates and Legal Consultants.
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%3Cp%3EAverage%20amount%20of%20biofuel%20produced%20at%20DIC%20factory%20every%20month%3A%20%3Cstrong%3EApproximately%20106%2C000%20litres%3C%2Fstrong%3E%3C%2Fp%3E%0A%3Cp%3EAmount%20of%20biofuel%20produced%20from%201%20litre%20of%20used%20cooking%20oil%3A%20%3Cstrong%3E920ml%20(92%25)%3C%2Fstrong%3E%3C%2Fp%3E%0A%3Cp%3ETime%20required%20for%20one%20full%20cycle%20of%20production%20from%20used%20cooking%20oil%20to%20biofuel%3A%20%3Cstrong%3EOne%20day%3C%2Fstrong%3E%3C%2Fp%3E%0A%3Cp%3EEnergy%20requirements%20for%20one%20cycle%20of%20production%20from%201%2C000%20litres%20of%20used%20cooking%20oil%3A%3Cbr%3E%3Cstrong%3E%E2%96%AA%20Electricity%20-%201.1904%20units%3Cbr%3E%E2%96%AA%20Water-%2031%20litres%3Cbr%3E%E2%96%AA%20Diesel%20%E2%80%93%2026.275%20litres%3C%2Fstrong%3E%3C%2Fp%3E%0A
How to protect yourself when air quality drops
Install an air filter in your home.
Close your windows and turn on the AC.
Shower or bath after being outside.
Wear a face mask.
Stay indoors when conditions are particularly poor.
If driving, turn your engine off when stationary.
A MINECRAFT MOVIE
Director: Jared Hess
Starring: Jack Black, Jennifer Coolidge, Jason Momoa
Rating: 3/5
More on Quran memorisation:
Seven tips from Emirates NBD
1. Never respond to e-mails, calls or messages asking for account, card or internet banking details
2. Never store a card PIN (personal identification number) in your mobile or in your wallet
3. Ensure online shopping websites are secure and verified before providing card details
4. Change passwords periodically as a precautionary measure
5. Never share authentication data such as passwords, card PINs and OTPs (one-time passwords) with third parties
6. Track bank notifications regarding transaction discrepancies
7. Report lost or stolen debit and credit cards immediately
2025 Fifa Club World Cup groups
Group A: Palmeiras, Porto, Al Ahly, Inter Miami.
Group B: Paris Saint-Germain, Atletico Madrid, Botafogo, Seattle.
Group C: Bayern Munich, Auckland City, Boca Juniors, Benfica.
Group D: Flamengo, ES Tunis, Chelsea, Leon.
Group E: River Plate, Urawa, Monterrey, Inter Milan.
Group F: Fluminense, Borussia Dortmund, Ulsan, Mamelodi Sundowns.
Group G: Manchester City, Wydad, Al Ain, Juventus.
Group H: Real Madrid, Al Hilal, Pachuca, Salzburg.