The Domino Effect linking a painkiller and vultures to India’s mortality rate

The Merriam-Webster dictionary describes the Domino Effect as “a cumulative effect produced when one event initiates a succession of similar events”. While a fluctuating mortality rate is not exactly alarming, a sharp, atypical hike deviating from previous year’s records demands a deep dive into what may have motivated it. The expiry of a painkiller patent followed by its own insidious manifestation of the Domino Effect — potentially leading to a hike in deaths in India, makes for a riveting case study.
As per a Macrotrends report, India’s mortality rate, or death rate this year has seen a hike of 0.770 per cent from 2023. The numbers to be exact are 7.473 per cent and 7.416 per cent respectively. Why this spells out a cause for concern is the fact that the growth rate in mortality has seen a significant hike from the trends harboured in previous years, the highest growth rate of this being 0.500 per cent noted between 2018 and 2019. What then, instigated this sudden jump?
The answer to the above posed question has a simple response — diclofenac. Keeping it simple, diclofenac is a painkiller. It also doubles up as a component in pain relief medication such as sprays and gels. Diclofenac, in it’s authentic form, enjoyed the status of being a trusty painkiller in the first 2 decades of its usage. What stirred the pot however, was its patent expiring back in 1993. Up until then, its production and distribution was effectively regulated by pharma company Novartis.
The patent expiry was seen as a golden goose opportunity for several smaller pharma establishments, leading to a boom of diclofenac’s sub-par generic production. As a matter of fact, the rate at which diclofenac flooded the markets, greatly dropped its market price, by almost 90 per cent to be exact. One does not really need to highlight what these statistics represent when it comes to the quality of the production.
Before the dominoes snaked around to making its dent on the country’s mortality rate, diclofenac’s demise of production value also left a bloody mark on livestock. As mentioned earlier, diclofenac is a painkiller. It didn’t take long after the drug’s market boom for it to emerge as the go-to choice when it came to treating livestock ailments, particularly joint pain. This cost-effective and timely hack seemed to be working just fine, till the bigger picture came into frame.
Back in 2006, several reports unanimously linked the alarming death toll on vultures in South Asia to the rampant use of diclofenac for livestock. A multi-authored report from America’s National Library of Medicine for instance, affirmed, “Three endemic vulture species Gyps bengalensis, Gyps indicus and Gyps tenuirostris are critically endangered following dramatic declines in South Asia resulting from exposure to diclofenac, a veterinary drug present in the livestock carcasses that they scavenge”. It additionally reported, “Vultures die from kidney failure within days of exposure to diclofenac-contaminated tissues”.
To understand the dire consequences of diclofenac 2.0’s market reign, it is worth mentioning that while the vulture population in South Asia stood at a neat 40 million around the 1980s — thus, pre-diclofenac 2.0 — the number recorded back in 2017 was as jarringly low as 19,000. More recent data suggests that these numbers have dropped to between 5,000 and 15,000, contingent on locality.
Rounding up the cards on the table thus far looks something like this — diclofenac’s patent expires; a mass produced variant floods the markets nestling its way into livestock; vultures start dying by the millions. How then, does all of this link up?
Coming back to the scavenging squad, vultures for as predatory as their legacy is, are a natural, yet indelible part of mortality and sanitation cycles. For long, they served as the primary agent ensuring an effective ‘disposal’ of rotting carcasses. More than a system, this was an effective specimen of Mother Nature’s well-oiled machinery. Feasting on dead carcasses which carried remnants of diclofenac wreaked havoc on the vulture population which in a very short span decimated by the millions.
All too soon, the impact of this was felt on the ground human population. How? By a speedy removal of rotting carcasses, vultures were essentially curbing the spread of pathogens, viruses and diseases. With the vulture population significantly decimated, rotting carcasses lay around for a significantly longer. Arrangements to deal with the predicament have included makeshift landfills some distance away from human-populated stretches or worse, water bodies. What this does, is enable a much easier spread of pathogens, viruses and diseases, which however little, does ultimately impact the mortality rate of the population.
The answer is yes and no. Diclofenac’s quality demise may be held directly accountable for butchering India’s vulture population, but the Domino Effect that appears to have been at play essentially hints at a glaring lack in sanitation drives. The news of the endangerment of vultures is not new and dates back almost 2 decades. Why then, has there been no effective resolution to ensure a manual carcass disposal symptom?
A mortality growth rate which in the first decade of this century was in the negatives, has slowly inched its way up to almost reach a full percent of growth. Vulture deaths and lack of sanitation systems may not be the only cause but it does without a doubt account for more than a few bloody drops in the ocean.
Do you think India has a chance at stabilising its mortality growth rate?