Measles epidemic @ Bangladesh (June 2026)

To hear things like a measles epidemic in Asia is quite an eyebrow- raiser.  The turmoil for patients and stigma for a nation due to epidemic is certainly challenging.  Immunization shots are vital to avoid diseases like measles and create individual and herd immunity (resistance to disease).  When health care systems and the general economy go sluggish, there rises the problems of epidemics.  Proactive vigil is as important as prompt action in matters of healthcare to avoid disturbing incidents such as a measles epidemic.

Another vital point to note is that of under-nutrition: a severe risk factor compounding the mortality rate is malnutrition. Additionally, disruptions to public health campaigns in 2025 meant that many children missed their scheduled Vitamin A supplementation rounds. Vitamin A deficiency heavily increases the risk of severe illness, blindness, and death when a child contracts measles.

Why this measles epidemic in Bangladesh?

Before the epidemic, Bangladesh's coverage slipped to roughly 86% for the first dose and 80% for the second dose. This minor-looking percentage drop created a quiet accumulation of completely unvaccinated ("zero-dose") children over 4 to 5 years. Once the virus was reintroduced, this pool of vulnerable children acted as fuel for the explosive outbreak.  Public health requires a strict 95% vaccination coverage rate of both doses of the Measles-Rubella (MR) vaccine to maintain herd immunity.

It is said the trinity of HEALTH, WEALTH AND WISDOM are the real pursuits of humankind.  In the case of current measles epidemic in Bangladesh, health focus has taken a toss.

Why this episode of measles epidemic is dangerous in Bangladesh?

Measles does not just cause a rash and fever; it actively destroys the body's defenses. It induces "immune amnesia," wiping out a child's previously acquired antibodies to other diseases, leaving them vulnerable to other infections for months or years.

Take a lesson from this epidemic measles @ Bangladesh and let us all focus on proper healthcare practices, because ill-health knows no political borders: from Dr. Sunil S Chiplunkar M Pharm PhD MBA PGHDRM 

Momentum @ Community-Led Clinical Influence

There is a new trending that is rolling on like a juggernaut, which many MNCs and other big companies are latching on to very stickily - and experiencing fiery sales growth!  The trending phenomenon is COMMUNITY-LED CLINICAL INFLUENCE.

The concept of community-led clinical influence is based on real-world evidence that clinicians experience daily, thus leading to peer-driven professional advocacy for a therapy or product.  

This "Community-Led Clinical Influence" approach is best illustrated with success of Shy NM toothpaste:

A prime illustration of the COMMUNITY-LED CLINICAL INFLUENCE in modern dentistry is the market trajectory of Shy NM toothpaste. Formulated with Calcium Sodium Phosphosilicate (CSPS), Shy NM is specifically engineered to target dentin sensitivity and facilitate enamel remineralization. The clinical footprint of Shy NM has expanded primarily through the active endorsement of dental professional communities, institutional faculties, and regional practitioner peer groups who actively champion its underlying bioactive glass technology.

The clinical influence for Shy NM operates through decentralized, grass-roots professional circles. Dentists regularly exchange real-world patient outcomes, share case studies in localized forums, and discuss product efficacy on peer-to-peer networks. 

When a respected clinician witnesses how effectively Shy NM occludes open dentinal tubules to offer sustained, long-term relief to dentin sensitive patients, their organic advocacy carries immense credibility within their professional circle. This decentralized validation creates a resilient, high-trust loop that conventional marketing simply cannot replicate.

Pharma companies are going thick into the game of this collective grassroots promotion

GSK is deploying this approach of 'community-led clinical influence' for their antibiotic therapy promotion, DRL is doing it for a wide range of products, and so are Torrent and Glenmark that are knee deep into promoting products through the 'community-led clinical influence' strategy.

Thanks for reading this blogpost by Dr. Sunil S Chiplunkar M Pharm PhD MBA PGDHRM

The big three in trouble

The Middle East conflagration with its world-wide ramifications is slowly & surely affecting health delivery.  The prominent factor of health delivery is accessible and affordable stock of medicines in the pharmacy.  Input costs for manufacturing generics is zooming up, as it is generics have lower margin, and add to the boiling fire there is a dilemma of higher shipping costs.  Hence, contraction of demand leading to negative impact on economies of scale further complicates matters in generic production and distribution, and all countries are affected - Middle East countries and others.

The big three

Manufacturing of generic pharmaceuticals involves using excipients and the big three excipients are: 

a) magnesium stearate that is present in 50% to 60% of oral dosage forms as a lubricant and as an overall excipient of tablets and capsule

b) MCC or microcrystalline cellulose that is used as binder, diluent and filler to hold the tablet matrix together

c) And we have finally, lactose (monohydrate/anhydrous) used as a bulk filler to make up the volume and weight of tablets

The production of magnesium stearate depends heavily on vegetable fats/oils and upstream chemical solvents, while MCC (microcrystalline cellulose) relies on specialized wood pulp and chemical reagents. The escalation of the Middle East war has heavily disrupted global oil, gas, and energy markets. This has translated directly into a 200% to 300% surge in raw chemical material prices within compressed timeframes, directly shrinking the profit margins of generic manufacturers who operate under strict government price controls.  Western Europe (led by companies like DFE Pharma in the Netherlands and Germany) is the central global hub for high-grade pharmaceutical lactose. Severe trade tensions and disruptions around the Persian Gulf and the Strait of Hormuz have heavily penalized input materials for the global dairy industry.  All this has affected generics manufacturing, buffer stocks of 2 to 3 months has saved the situation, however supply constraints, high price of new stocks is squeezing the margins of generic manfacturing - and this will have its toll on medicine availability from the pharmacy of the world: India.  No country will be spared from this ill effect of Middle East war on medicine availability including USA and advanced countries.  

India provides 20% of world's generics, 45% of generics in USA, 25% of all medicines of UK, 50% of medicines in Africa and 50% to 60% of the world's vaccines.  Generics from India are a life line to all the 200 countries of the world.  This high volume of generics production and distribution to the world depends on manageable raw material costs, efficient logistics and judiciously priced energy costs.  Besides, important medicines under price watch of NPPA are called scheduled drugs - and they have heavy margin squeeze.  The answer to all these issues is for the policy makers to keep an eagle eye daily, on the supply and price situation of APIs, intermediates and excipients including the big three (magnesium stearate, MCC and lactose), so India can seamlessly provide affordable generics to its citizens and the world.

As per newspaper reports India’s pharmaceutical exports dropped over 23% by early 2026. Trade bodies estimate that these disruptions could cost Indian drugmakers between $300 million and $600 million.  If there is supply problems there is also a looming danger of widespread factory shutdowns and severe global medicine shortages.  Quelle catastrophe ! (What a catastrophe!)      

 Thanks for reading, written by - Dr. Sunil S Chiplunkar M Pharm PhD MBA PGDHRM