From inhalers to planet savers

Oct 3, 2013

The non-CFC MDI inhalers will help the 7 million asthma sufferers at very low cost, thereby significantly reducing nation’s health budget. Photo: UNDP Bangladesh.

When an asthma patient is gasping for air, the last thing on their mind is probably the ozone layer but interestingly while their inhalers provide relief for them, its usage in a small way actually affects the whole world. 

In Bangladesh, around 7 million people suffer from asthma attacks resulting in missed work and school and increasing health care expenditures. One effective treatment is aerosol medication, delivered into the nasal passageways by a Metered Dose Inhaler (MDI). When first developed, MDIs used ozone-depleting chlorofluorocarbons (CFCs) to propel medication into the nasal passageways.

In simple terms CFCs and other chemicals destroy the ozone layer, potentially making every inhaler an environmental time bomb.

Since 2007, UNDP has assisted Bangladesh eliminate CFC usage at three locally-owned manufacturing enterprises by using ozone-friendly alternatives. This initiative has helped Bangladesh eliminate 76.3 tonnes of CFCs (measured as ozone-depleting potential) while preserving local jobs and employment.

More importantly, the non-CFC MDI inhalers will help the 7 million asthma sufferers at very low cost, thereby significantly reducing the burden on the nation’s health budget and increasing national worker and student productivity.

Bangladesh signed the Montreal Protocol on Substances that Deplete the Ozone Layer and committed to phase-out of ozone depleting substances (CFCs). However three pharmaceutical companies, Beximco Pharmaceuticals, Square Pharmaceutical and the ACME Laboratories Ltd. were producing CFC based MDIs and their consumption of CFCs was slowly increasing and by 2005 it was difficult to control the growth of CFC consumption as per Montreal Protocol obligations.

With this in mind Bangladesh requested Montreal Protocol Parties into their 18th MOP in 2006 to request the Montreal Protocol Multilateral Fund for technical and financial assistance. Bangladesh also requested the Parties to the Protocol to allow additional CFCs in order to continue CFC based production for the Transition period.

The Montreal Protocol Parties requested the Montreal Protocol Multilateral Fund to award a technical project for the conversion of CFC based MDIs into environment friendly HFA based MDIs and requested Implementation Committee of the Montreal Protocol to consider additional amount of CFCs in the transition period for smooth supply of these important live saving medicine. This essentially bought Bangladesh some time to catch up with the rest of the world.

Following to the decision of 18th MOP in November 2006, the Executive Committee of the Montreal Protocol Multilateral Fund approved two projects: 
(1) Phase-out of CFC consumption in the Manufacturing of Metered Dose Inhalers in Bangladesh to the tune of US$ 2.77 million implemented by UNDP; and 
(2) Transition Strategy for the Phase-out of CFCs in the Manufacture of MDIs to the tune of US$ 70,000.00 in July 2007 to be implemented by UNEP.

Under UNDP’s ‘Phase-out of CFC Consumption in the Manufacturing of Metered Dose Inhalers in Bangladesh’ project all the three companies were provided with the required HFA based new formulations; equipment for HFA based MDI production; and incremental operating costs for the price protection of converted products. 

Considering the urgency of the smooth supply of lifesaving drugs and to comply with the Montreal Protocol provisions, Government of Bangladesh signed a memorandum of understanding with the beneficiaries which stated that they would accomplish their respective activities on their own. As per their progress the government would provide money through UNDP under direct payment request as outlined in the MOA

Under this agreement Square Pharmaceuticals converted 9 of its CFC based products, Acme laboratories Ltd. converted 6 and Beximco Pharmaceuticals converted their 10 formulations into environmentally friendly products and launched them into the market.

Out of the three companies, Beximco Pharmaceuticals started their activities soonest after the project was approved and completed all products by 2010 and stop CFC based production by end of 2010. ACME Laboratories Ltd stopped CFC based production by the end of 2011 and Square Pharmaceuticals stopped by December 2012.

In 2012 the then Additional Secretary and Director General, Ministry of Environment and Forests, Government of Bangladesh, Mr. Monowar Islam said, “The successful completion of the project has been extremely timely and gives the government confidence to take up more challenging tasks. The support received from the international community has been invaluable to the government as well as the industry.”

“Once upon a time, there was a system in this plant on this site that used a gas called Chlorofluorocarbons (CFCs) to manufacture Metered Dose Inhalers (MDI). For the benefit of future generations, this production facility stopped using CFCs.”

Those are the first lines of a plaque that was erected to commemorate the successful phase out of CFCs in the Manufacture of MDIs in Bangladesh by Beximco Pharmaceuticals. The plaque may not stand the test of time, but its message will resonate with future generations for years to come.