Page 31 - CMA Journal (Jan-Feb 2026)

Blockchain Against
Focus Section

Fake Medicines:

A Lifeline for Pakistan

Overview Counterfeit
Medicine Crisis in
Poor quality and fake drugs still present severe health
and governance issues in low and middle-income Pakistan
nations, and the World Health Organization estimates Poor-quality and coun-
that close to one in ten health and medical products in terfeit medical
developing economies is either substandard or falsified products represent a
(Organization, 2017). Over time, weak supply chain grave threat to world-
transparency and product integrity have been revealed wide health, especially
through regulatory recalls and quality checks in Pakistan in developing econo-
(Zaheer et al., 2019), and counterfeit penetration of the mies (middle and low
income) with weak
market has distorted the competitive environment, regulatory controls
reduced the credibility of regulators, and added to the and supply chains.
overall healthcare costs. According to the World Abdul Qayyum, FCMA
As a reaction, blockchain technology, with its Health Organization, it Group Finance Manager,
decentralized and irreversible ledger structure, has been is estimated that Lootah Group, UAE
almost ten percent of
suggested as a tool to improve traceability and medical products in
strengthen audit procedures in pharmaceutical developing countries are of poor quality or falsified, thus
distribution systems (Casino et al., 2019). This paper is an compromising the safety of patients and their treatment
in-depth critique of the question of whether blockchain outcomes (Organization, 2017). In Pakistan, regulatory
can strategically enhance the governance and inspections and laboratory monitoring have recurrently
transparency of the pharmaceutical industry in Pakistan found issues with medicine quality, including the absence
or whether institutional and infrastructural constraints of post-marketing oversight and limited provincial capaci-
might limit its potential effect. ty to enforce regulations (Rasheed et al., 2019).
Table 1: Prevalence Estimates of Substandard and Falsified
Medical Products in Low- and Middle-Income Countries

Regulatory/Policy Notable enforccement/ survveillance Governaance
t
u
c
Period
Milestone (Pakistan) evidencce & examplees implication
t
e
s
e
2010–2012 Post-PIC crisis reforms; impetus for a Large public crisis at Punjab Institute of RReactive reform: ccrisis-driven
d
stronger federal regulator Cardiology (2012) proompted nationall-level ccentralization of rregulatory
g
r
t
culminating in the DRAP Act (DRAP reform and forensic investigations. (DDRAP Act aauthority; focus oon closing
2
Act passed 2012). origin; PIC crisis repoorting). (Drug Reggulatory immmediate safetyy gaps.
h
Authority of Pakistann)
d
O
a
2013–2015 DRAP operationalization and initial WHO launched/expaanded GSMS repoorting CCentral oversight
a
a armonize capacity; WHO notedd growing reportting strengthened on paper, but
provincial/federal roles under the participation by Memmber States (GSMMS baseline ppost-marketing surveillance &
i
e
e
p
v
DRAP Act (implementation phase). activity). (World Health Organization)) innter-provincial cooordination
m
reemained unevenn.
g
2016–2020 Expansion of post-marketing Peer-reviewed situatiional analyses doocumented TTransition from reeactive to
-
o
i
surveillance and laboratory testing persistent gaps in rouutine surveillance and mmore structured ssurveillance
t
e
capacity; regulatory guidance enforcement capacityy in Pakistan (Rassheed et al., ee mentation
c
g
updates. 2019). WHO continueed GSMS monitoring hheterogeneity across
9
showing global signaals. (PMC) pprovinces.
w
c
O
t
2021–2025 Growing focus on digitalization, WHO GSMS activity rreport (Aug 20177–Dec 2021) MMovement towarrd system-
r
a
u
track-and-trace discussions and documents hundredss of incidents; reccent leevel visibility andd digital
a
increased rapid alerts (DRAP public DRAP/WHO alerts (e.gg., 2024 contamiinated solutions, but perrsistent
P
alerts); international alerts (WHO) propylene glycol / ethylene glycol seiizures) ooperational, infrastructure
r
W
p
on contaminated ingredients demonstrate continuued enforcementt activity. aand data-quality barriers
n
t
highlight ongoing vulnerabilities. (World Health Organiization) reemain.
i
r
n
ICMA’s Chartered Management Accountant, Jan-Feb 2026 29