ISLAMABAD: Minister for Parliamentary Affairs Azam Khan Swati Tuesday said that total of 61 cases of look-alike and sound-alike brand of medicines were reported in last six months to Drug Regulatory Authority of Pakistan (DRAP). During the question hour in the Senate, the minister said action for change of these brand names were taken by registration board of DRAP in light of mechanism devised by the board in 242nd meeting. He said that it described that if brand names/packaging design or color scheme of two products resemble, then later registration holder was bound to propose alternate names/packaging material for approval as one of condition of registration. The minister said but in some cases, later registration holder does not propose alternate names/packaging material. Azam Swati said the board decided that in such cases DRAP would issue one reminder within 15-day time period and then manufacturing of the product would be stopped after approval of Chairman Registration Board. He said that stoppage of manufacturing would be till approval of new brand ame/packaging material, adding that list of such cases was prepared wherein firms were intimated for necessary rectifications regarding brand names, packaging designs and color schemes. The minister said there were approximately 65,000 human medicines registered so far. It was practically not possible to regulate color, shape and size of medicines. He said typhoid fever was an endemic disease that had always affected people and cases of typhoid were reported from health facilities throughout the country via the District Health Information System (DHIS). Azam Swati said around 7,16892 cases of typhoid reported through DHIS during the three years in 2016, 2017 and 2018. He said that typhoid fever was normally sensitive to broad spectrum antibiotics available across the country. Since December 2016, the province of Sindh has been facing an outbreak of a Drug Resistant (XDR) typhoid fever. The minister said this particular variant of typhoid was resistant to the drugs which were commonly used to treat typhoid fever. The XDR variant has acquired genetic resistance to these drugs and was only sensitive to macrolides and carbapenem based antibiotics. Hence it was not the case that drugs were not properly curing the disease, rather the resistant variety of the bacterium was resistant to the standard drugs used for treatment, he added. He said the ministry had been involved in supporting the DoH, Government of Sindh in managing this outbreak since August 2018 and have organized multiple World Health Organization (WHO) missions of subject matter experts to analyse, characterize and assess the ongoing outbreak.