By Roney M Lyndem
The decision by the Meghalaya Health Care Association (MHCA) to align with a nationwide protest against online pharmacies may appear, at first glance, as a stand for public safety. However, a closer look reveals that many of the concerns raised are either overstated, selectively framed, or overlook the evolving healthcare realities of a country like India—especially in underserved regions such as Meghalaya.
- National Protest Participation: A Unified Stand, But Not a Balanced One
The MHCA’s participation in a nationwide protest led by the All India Organisation of Chemists and Druggists (AIOCD) reflects solidarity but not necessarily objectivity. The AIOCD represents traditional brick-and-mortar chemists whose economic interests are directly challenged by digital platforms. While their concerns deserve consideration, they cannot be the sole lens through which public healthcare access is evaluated.
Public policy must prioritize patient welfare over professional protectionism. A protest, no matter how widespread, does not automatically validate the arguments behind it. In fact, resistance to technological shifts has historically accompanied every major advancement, from telemedicine to digital payments. Yet, society has ultimately benefited from embracing them with proper safeguards.
- “Unregulated Online Sale”: A Misleading Oversimplification
The claim that online pharmacies operate in a completely “unregulated” environment is misleading. While it is true that India is yet to finalize a dedicated e-pharmacy law, this does not mean a legal vacuum exists.
Online pharmacies are still governed under the existing Drugs and Cosmetics Act, 1940 and the Drugs and Cosmetics Rules, 1945, which apply equally to offline and online sale of medicines. These laws clearly mandate:
* Sale of prescription drugs only against a valid prescription
* Licensing requirements for pharmacies
* Proper storage, handling, and record-keeping
Many established e-pharmacy platforms already comply with these requirements by:
Requiring customers to upload prescriptions before dispensing medicines
Employing registered pharmacists to verify orders
Maintaining digital audit trails, which are often more transparent than manual records in physical stores
Double tested medicine to ensure a dual-layered quality assurance process intended to combat counterfeit or substandard drugs.
Procurement of drugs from WHO-GMP certified manufacturers to ensure quality like Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) which is offering quality generic medicines at 50-90% lower prices than branded alternatives.
The issue, therefore, is not the absence of law, but the need for clearer, updated guidelines and stricter enforcement across both online and offline sectors.
- Public Health Risks: A Question of Enforcement, Not Medium.
The MHCA’s concerns about public health risks such as fake medicines or misuse of prescription drugs are valid in principle, but flawed in attribution. These risks are not unique to online pharmacies.
Counterfeit drugs and improper dispensing have long existed within the offline retail ecosystem. Numerous studies and regulatory raids across India have exposed unlicensed chemist shops, sale of medicines without prescriptions, and poor storage conditions.Multiple NEWS outlets has also time and time again reported on incidences of fake and counterfeit drugs. For example, there has been uproar over the Fake ORS scam in india but yet this product continues to flood the markets without a single voice against it by any of the pharmaceutical sector/suppliers etc.
In contrast, digital platforms often introduce greater accountability, including:
Electronic prescription validation and free doctor consultations.
Automated alerts for drug interactions
Centralized inventory tracking
Customer data records for traceability
Rather than dismissing online pharmacies as inherently unsafe, the focus should be on strengthening regulatory enforcement across all channels.
- The Legal Ambiguity: A Governance Gap, Not a Justification for Opposition
It is true that the legal framework for e-pharmacies in India is still evolving. The Madras High Court has, in the past, called for clearer regulations, and the central government has released draft rules that are yet to be finalized.
However, this transitional phase should not be used as grounds to halt progress. Instead, it underscores the urgent need for the government to:
Finalize and implement comprehensive e-pharmacy regulations
Establish uniform standards for prescription verification
Create accountability mechanisms for digital platforms
Blocking or opposing online medicine access does not solve regulatory gaps. It only merely delays solutions while continuing to disadvantage patients who rely on these services.
- Prescription Drugs and Verification: Strengthening, Not Eliminating Access
A key concern raised is the alleged sale of Schedule H and Schedule X drugs without proper verification. This is a serious issue, but again, not exclusive to online platforms.
The solution lies in strengthening prescription protocols including:
Mandatory digital prescription uploads
Integration with licensed telemedicine consultations
Verification by registered pharmacists before dispatch
Use of e-prescription systems linked to verified doctors
In fact, online platforms are uniquely positioned to enforce stricter compliance through technology, something that is far more difficult to monitor in fragmented offline settings.
- The Role of Online Consultation: Expanding Safe Access
One of the most important developments in modern healthcare is the integration of telemedicine with e-pharmacy services. Patients can now:
Consult qualified doctors online
Receive legitimate prescriptions digitally
Order medicines with proper documentation
This model is particularly crucial in regions like Meghalaya, where access to specialists and even general practitioners can be limited. For elderly patients, and for those with serious illnesses or individuals with mobility issues who are not residents of Smart City Shillong, online consultation combined with medicine delivery is not a luxury it is a necessity. I personally can vouch for this as someone with no near and easy access to medication needs and who buys medicines every month for various medical needs.
- The Real Issue: Accessibility vs. Protectionism
At its core, the debate is not about safety versus risk. It is about accessibility versus control.
Traditional chemist associations argue from a position of preserving existing systems, but these systems have not adequately served remote or marginalized populations. In many parts of Meghalaya, timely access to essential medicines remains a challenge due to:
Limited pharmacy networks outside urban centers
Irregular stock availability
Lack of home delivery options
Online pharmacies bridge this gap by ensuring:
Doorstep delivery
Wider availability of medicines both Branded and Generic Versions
Price transparency and competition
Opposing these services without offering viable alternatives risks reinforcing existing inequalities in healthcare access.
The Way Forward: Regulation, Not Rejection
The path forward is neither blind acceptance nor outright opposition. It is balanced regulation.
India needs a robust, enforceable framework that:
Recognizes e-pharmacies as legitimate healthcare providers
Ensures strict compliance with prescription laws
Penalizes violations—both online and offline
Integrates digital health services into the broader public health system
Rejecting online medicine sales altogether is not only impractical, it is counterproductive in a rapidly digitizing world.
The MHCA’s concerns highlight real issues, but their approach risks addressing symptoms rather than causes. The focus should not be on resisting technological change, but on shaping it responsibly.
In a state like Meghalaya, where geography, infrastructure, and accessibility remain persistent challenges, online pharmacies, when properly regulated, can become a powerful tool for improving healthcare delivery.
The question is no longer whether online medicine sales should exist. They already do. The real question is whether we will regulate them effectively or allow fear and coercive resistance to deny people access to the care they need. The future of healthcare will not be decided by resistance to change, but by how effectively we govern it.
(The writer is an experienced counsellor and social activist advocating for accessible healthcare, and brings personal insight as a regular user of online medicine services and can be reached at roneymlyndem@gmail.com)
