Day One: Setting the Scene
It was the morning of 26th of January 2020. The lobby of the Mandarin Hotel in Bangkok was buzzing with the chatter of old friends meeting after a long time, punctuated by loud laughter and the warmth of kindred souls swirling around in the same space.
These were the folks who had come from all around the world – 175 people from 34 countries- to attend the ISIUM’s first International conference. A board at the entrance of the hotel spelt out the title and theme of the conference: ‘People Improving the Use of Medicines: What We Know & Don’t Know’.
The local Bangkok organising committee, the staff of Thai Drug System Monitoring and Development Centre (DMDC) and members of the Faculty of Pharmaceutical Sciences , were visible everywhere making sure the world famous flag of Thai hospitality was flying high. Comfortable rooms, superb food, excellent internet access, background documents, stationery, great facilitators to conduct the sessions: they had everything covered.
Unnoticed by all the delegates though, there were two extra participants who had managed to slip into the conference. This was a pair of undercover agents – the famous detective Herlock Sholmes and his friend as well as deputy, Dr Whatsup. What were they doing here at a meeting of serious academics, health professionals, community mobilisers and researchers? What mysterious crime could they be possibly trying to solve?
Well, unknown to most members of the conference organising committee, a few ISIUM Board members (the most wicked amongst them) had recruited Sholmes and Whatsup to spy on the proceedings and send in a secret report. More than half of all medicines are not prescribed properly, they said, and many more used wrongly, or when not needed, causing serious side effects and, in the case of antibiotic resistance, antibiotics were failing to cure infections. Their mandate was to find out who or what is responsible for irresponsible use of medicines, which was resulting in needless deaths, ailments and rising costs for both health systems and patients.
Rational use of drugs requires that doctors prescribe medicines only when very essential and in the right dosage to patients, who in turn are supposed to adhere to the instructions . Simple as it sounds, the matter was actually quite complex – with vast amounts of very critically important medicines being misused or abused routinely. There was enough research and evidence to show the benefits of rational use of medicine but no one fully understood why this was not used by health practitioners, managers or patients themselves.
In order to get to the answer Sholmes and Whatsup would have to attend every session of the conference, the plenaries, workshops, oral presentations, poster sessions, … and even eavesdrop on delegates gossiping! It was a tough assignment but the detective duo had survived much worse in the past – like full day seminars with speeches so boring that even the speakers fell asleep mid-way!
This conference looked much more lively in contrast, thought Sholmes to himself, adjusting his hat, while observing the participants from a distance. Funnily enough, no sooner had this very comforting thought struck him, that he actually dozed off. The cool ambience of the hotel air conditioning had overwhelmed his normally alert senses.
It was Dr Whatsup who woke Sholmes up with a little nudge, ‘Pssst, how on Earth are we going to find any answers if you keep snoozing like this?”. The opening session of the conference was underway and they both snuck into the auditorium, trying not to be too conspicuous, which was difficult, especially because of Sholmes’ insistence on wearing a hat and long cape all the time, even while in sultry Bangkok.
 Social distancing was still a very distant concept in those days.
To be continued…