It is a constant struggle. Opium is grown in India and morphine should be available at low cost for those in pain. But that of course would not suit the Industry.
Fortunate indeed that in the 1990s, Ms Gilly Burn, the British nurse got Dr Yusuf Hamied of Cipla Pharmaceuticals interested in the matter, and we started getting inexpensive morphine.
Unfortunately, in recent years, Cipla stopped producing morphine. Competitors who sell it at five times the cost have taken over. In Kerala, so far we have been OK because, thanks to the initiative of the then drugs controller Mr Venkatakrishnan in the 1990s, Lisie Hospital Pharmaceuticals started giving (and still gives) us inexpensive immediate release morphine. But this fragile arrangement is under constant threat. Often technicalities are brought in so as to stop their production somehow.
Obviously indigenous low-cost morphine production is something we must nurture. Please read about the Rwandan experience that is built on Dr Anne Merriman’s experiment in Uganda which spread over Sub-Saharan Africa. Rwanda avoids US-style opioids crisis by making own morphine
We should all be asking the question that kept Dr. Christian Ntizimira sleepless. “I went home and questioned myself: ‘Why study so many years if I can’t help someone in pain?’”