Photo-imaging by Ashish Bagchi
pharmaceuticals: controversy
Hawking Poison
Desperate US prisons look for lethal drugs from India. Should we market death?
COMMENTS PRINT

Sodium Thiopental

  • What Short-acting barbiturate used as an anaesthetic. First of a standard three-drug protocol used in the United States to execute prisoners sentenced to death. Lethal dose (up to 5 grams) used to render prisoner unconscious, after which a paralytic and a toxic agent injected in sequence.
  • Why Shortage of sodium thiopental in the US after sole domestic supplier, shut production in 2009, citing lack of raw materials. Demand low, outside of prisons in the US.
  • How Initially, US prisons able to import it from Britain, but ban imposed by Britain, other European countries, after human rights groups protest. Mainstream drug companies reluctant to supply. Therefore, some prisons are turning to India.

***

It all started with a mundane phonecall in August, received by the Noida office of a Swiss-Indian drug company called Naari. The caller, a Calcutta-based Indian businessman called Chris Harris, wanted samples of a drug called sodium thiopental to dispatch, he explained, to Zambia for registration by the country’s drug authorities. It was a perfectly plausible request. The drug, though largely replaced by better anaesthetics in the West, is still used widely in the developing world. Accordingly, Naari dipped into its stocks and sent vials containing 485 grams of sodium thiopental to Harris in Calcutta in end-September; and waited for the large order that he said would follow.

A few weeks later, the firm’s Indian officials were stunned when an investigator with the London-based charity, Reprieve, which campaigns against the death penalty, called to tell them where those samples had really gone. Not to Zambia, but the American state of Nebraska; not for medicinal use, but to execute convicts by the chosen American method, lethal injection (see infographic).

Surprise turned to outrage when they learnt from the investigator, Maya Foa, that Naari had even been named as the supplier of the drug in a press release issued by Nebraska’s Department of Correctional Services (NCDs) on November 3. “We’re not in the business of helping to execute people, we were lied to and cheated,” says a spokesman for the company. The prison paid $5,411 for the chemicals—over 15 times what Naari would have ordinarily charged Harris for them. But Harris hadn’t paid at all. By selling Naari’s free samples to Nebraska’s execution machinery, apparently desperate for drugs, the small-time middleman had made—yes—a killing.

Foa, who’s working with Naari on strategies to prevent the exported drugs being used in executions, says the episode, though shocking, is typical. “It is often the case that manufacturers and suppliers are drawn into this trade unwittingly and have no idea their drugs are going to execution chambers,” she says. That knowledge belongs to perfidious middlemen, key players in a macabre niche of global commerce ominously seeking to widen its footprint in India.

 
 
High US standards for foreign drugs drop dramatically when it involves import of drugs for lethal injections.
 
 
Harris, for instance, has been in assiduous contact with American prison departments, as shown by documents obtained by campaigners through Freedom of Information Act applications. It was he who brokered transactions in which Nebraska and South Dakota bought sodium thiopental in December 2010 and February 2011 respectively from Kayem Pharmaceuticals Pvt Ltd, which turned out to be a two-room outfit in a Mumbai suburb. (Eventually, US enforcement officials did not permit the use of those drugs, due to procedural violations in the import process.) Dipak Shangvi of Ganpati Exim, a Calcutta wholesaler and exporter of drugs, says he was in discussions with Harris a few months ago over supplying the drug to the US, but pulled out quickly when he realised—thanks to a Google search that led him to ask Harris some probing questions—that it was going to a prison. “We are Jains,” he said, by way of explanation.

The intriguing larger question is: why are state institutions in the mighty United States shopping at the murky end of the pharma trade? The answer is, they don’t have much choice. Drug companies, increasingly reluctant to be branded as suppliers of drugs for lethal injections, are distancing themselves from US prisons, which is no small achievement for hyperactive anti-capital punishment groups. When Hospira, the sole producer of sodium thiopental within the US, shut shop in 2009, for a variety of reasons, some US prisons initially managed to source the drug from Britain. (By now, it will not surprise readers to know it came from a company that operated out of the back of a driving school.) However, campaigners put an end to that trade by persuading several European governments to ban it. Many US prisons switched to a single drug called pentobarbital, commonly used to put down dogs, but campaigners won that round, too. In July this year, a Danish company, Lundbeck, the only licensed maker of the drug in the US, bowed to pressure (especially when it took the form of a major investor, a Danish pension fund, selling off a hefty € 5.4 million worth of its shares) and agreed to deny the drug to American execution chambers.

What has made the campaign against lethal injection popular is not just European aversion to the death penalty, but the campaigners’ unrelenting focus on American double standards. The US Food and Drug Administration (USFDA) zealously protects its citizens from the perceived shortcomings of foreign drugs (ask big Indian pharmaceutical firms, which have to jump through many hoops for usfda approval, before their products can enter the US market) but those standards drop dramatically, clearly for political reasons, when it comes to the import of drugs for lethal injections. That’s why consignments arranged by Indian middlemen are able to make it to US prisons.

The tacit rationale seems to be that standards don’t matter for people who will die anyway. But lawyers and campaigners are contesting that cynical argument, both in and outside the courts. They argue that murky supply chains can result in chemicals becoming degraded and lead to torturous and painful deaths. The chilling, oft-cited recent case is of Brandon Rhode, 31, whose eyes remained open until he died, leading a doctor to testify that the imported (from Britain) sodium thiopental injected into him may have “lacked efficiency”.

While campaigners are all set to fight the use of the latest imports for executions, the Indian route is a worry, admits Foa. “We have been very successful; some US states are now in a de facto state of moratorium on the death penalty. This could take us backwards.”

Should Indians care? Opinions are divided, even among those who usually care, reflecting cleavages on the larger question of capital punishment. (There is also a certain exasperation with the blinkered, single-issue vision of western groups.) C.M. Gulhati, usually a trenchant critic of drug companies, sees no case to answer here. “If we execute our prisoners, we really can’t object to Americans executing theirs. There are no legal, clinical or ethical grounds on which we can say, don’t export the drug to American prisons,” he says. Amar Jesani, an expert on ethics, rights and health systems, disagrees: “What is lawful is not necessarily ethical. Section 377 was not ethical, the death penalty is not.” Pointing out that doctors in America do not, by consensus, administer lethal injections, he says: “If they don’t participate in killing, pharmaceutical companies shouldn’t either. They should be named and shamed when they do.”

Interestingly, Dilip G. Shah, secretary general of the Indian Pharmaceutical Alliance, takes much the same tack. Dismissively, he says, “This is a niche segment, dominated by unscrupulous small operators looking for easy money. None of the large pharmaceutical companies would touch it. They wouldn’t want to be associated with killing people.” And why, he asks, should the industry compromise on its reputation for relatively small gains: “The volume is nothing—are there that many people on death row?” For campaigners, that last argument might work best, in persuading India to turn its back on this sordid trade. Self-interest usually gets more done than ethics.

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