India's mortality rate has seen a notable increase, reaching 7.473% in 2024, up from 7.416% in the previous year. This rise of 0.770% is significant, especially when compared to historical trends. The highest previous increase was only 0.500% from 2018 to 2019. Such a sharp rise prompts an investigation into the underlying causes, particularly the role of diclofenac, a common painkiller, and the domino effect triggered by its patent expiry.
Diclofenac, a widely used pain relief medication, has been on the market since the 1970s. However, its patent expired in 1993, allowing numerous smaller pharmaceutical companies to produce cheaper, generic versions. This led to a flood of low-quality diclofenac products entering the market, dropping prices by nearly 90%. While this made the drug more accessible, it also raised concerns about its safety and efficacy, especially in veterinary use.
As diclofenac became a popular choice for treating livestock ailments, particularly joint pain, its consequences soon became evident. Farmers began using the drug extensively on their animals, unaware of the devastating impact it would have on the ecosystem. The drug's presence in livestock carcasses became a significant threat to vultures, which are scavengers and play a crucial role in maintaining the health of the environment.
Reports from 2006 linked the alarming decline of vulture populations in South Asia to diclofenac use in livestock. A study published by the National Library of Medicine confirmed that vultures exposed to diclofenac-contaminated carcasses suffer kidney failure within days. The vulture population, which was around 40 million in the 1980s, plummeted to between 5,000 and 15,000 by 2017. This drastic decline in vulture numbers is alarming and has profound implications for public health.
Vultures serve an essential function in the ecosystem by disposing of dead animals, thereby preventing the spread of diseases. With their population in sharp decline, carcasses began to accumulate, creating a breeding ground for pathogens and viruses. The absence of vultures to clean up these carcasses has led to a rise in disease transmission, which may have contributed to the increase in India's mortality rate.
The situation raises critical questions about public health and sanitation in India. While the link between vulture deaths and rising mortality rates is complex, it highlights a broader issue of inadequate waste management and sanitation practices. Despite recognizing the problem nearly two decades ago, effective measures to address the disposal of carcasses and the protection of vultures remain largely unimplemented.
The expired patent of diclofenac serves as a cautionary tale about the unintended consequences of pharmaceutical practices. The rapid production of generic versions, while beneficial in terms of accessibility, has led to a public health crisis that could have been mitigated with better regulation. As India grapples with its rising mortality rate, the lessons learned from the diclofenac saga may prove invaluable in shaping future policies on drug regulation and environmental conservation.