The Merriam-Webster dictionary describes the domino effect as “a cumulative effect that arises when one event initiates a sequence of similar events”. While fluctuations in mortality rates are not really worrisome, a sharp, unusual increase that is different from the previous year’s record demands a deeper investigation into what could be the reason behind it. The domino effect’s own insidious manifestation following the expiry of a painkiller’s patent – potentially leading to a surge in deaths in India, makes an interesting case study.
Where does India’s mortality rate stand?
According to the Macrotrends report, this year India’s mortality rate or death rate has seen a rise of 0.770 percent from 2023. The exact numbers are 7.473 percent and 7.416 percent, respectively. This is a matter of concern because the mortality growth rate has seen a significant increase from the trends of previous years, with its highest growth rate recorded at 0.500 percent between 2018 and 2019. Then, what prompted this sudden jump?
Diclofenac’s growing legacy
The answer to the question asked above is very simple – diclofenac. To put it simply, diclofenac is a painkiller. It is also used as an ingredient in painkillers like sprays and gels. Diclofenac in its authentic form enjoyed a status as a trusted painkiller in the first 2 decades of its use. However, the biggest thing in this case was that its patent expired in 1993. Until then, its production and distribution were effectively controlled by the pharma company Novartis.
The expiry of the patent was seen as a golden opportunity for many small pharma houses, leading to a surge in the production of substandard generic diclofenac. In fact, the rate at which diclofenac flooded the markets led to a substantial drop in its market price, by about 90 percent to be precise. These figures do not really need to be highlighted when it comes to the quality of production.
Facility Accidents
Before the dominoes turned around to take their toll on the country’s mortality rate, the fall in the production price of diclofenac left a bloody mark on livestock as well. As mentioned earlier, diclofenac is a painkiller. After the drug hit the market, it did not take long for it to emerge as the most preferred choice for treating livestock ailments, especially joint pain. This cost-effective and timely remedy appeared to be working well until the bigger picture came into view.
The scavenger celestial squad sensed the danger
In 2006, several reports unanimously linked catastrophic mortality of vultures in South Asia to the large-scale use of diclofenac for livestock. For example, a multi-authored report from the US National Library of Medicine confirmed, “Three endemic vulture species Gyps bengalensis, Gyps indicus, and Gyps tenuirostris are critically endangered after dramatic declines in South Asia due to exposure to diclofenac, a veterinary drug present in the carcasses of livestock that they consume”. It also reported, “Vultures die of kidney failure within days of exposure to diclofenac-contaminated tissues”.
To understand the dire consequences of Diclofenac 2.0 ruling the market, it is pertinent to mention that the vulture population in South Asia was estimated at 40 million around the 1980s – thus, before Diclofenac 2.0 – with numbers recorded as low as 19,000 in 2017. Recent data suggest that these numbers have fallen to between 5,000 and 15,000, depending on the locality.
Connecting the dots
The situation so far is something like this – the patent for diclofenac has expired; a mass-produced variant has flooded the markets and spread to livestock; vultures are dying in the millions. So, how is all this connected?
Speaking of the cleaning crew, vultures are predators by heritage, but are a natural, yet indelible part of the mortality and sanitation cycle. For a long time, they served as the primary agents ensuring the effective ‘disposal’ of rotting carcasses. More than a system, it was an effective specimen of Mother Nature’s well-oiled machinery. Feasting on carcasses laden with diclofenac residues wreaked havoc on the vulture population, which perished in millions in a very short time.
Very soon, the impact was felt on the human population on the ground as well. How? By removing the rotting carcasses quickly, the vultures were essentially preventing the spread of pathogens, viruses and diseases. With the vulture population declining significantly, the rotting carcasses lay for much longer. The measures taken to deal with this situation include temporary landfills at some distance from human inhabited areas or worse, water bodies. This makes the spread of pathogens, viruses and diseases very easy, which, though very small, ultimately affects the mortality rate of the population.
Is there any solution to this?
The answer is both yes and no. The deterioration in the quality of diclofenac can be directly blamed for the slaughter of the vulture population in India, but the domino effect that is at work points to the apparent lack of sanitation drives. The news of the threat to vultures is not new and dates back almost 2 decades. Then, why has no effective solution been found to ensure the problem of manual disposal of carcasses?
Mortality had a negative growth rate in the first decade of this century, which has gradually increased to almost a full percentage point. Vulture deaths and lack of sanitation systems may not be the only reasons for this, but there is no doubt that this is much more than a few bloody drops in the ocean.
Do you think India has any chance of stabilising its mortality rate?
