**Public Outcry Over Ineffective Generic Drugs Sparks Government Response in China**

As the debate unfolds, doctors and patients alike express distrust in a healthcare system pressured by financial constraints and an ageing population.

Public anger has erupted in China following alarming reports from doctors about the diminishing effectiveness of generic drugs commonly used in state hospitals. The country's drug procurement system, which prioritizes cost-cutting by approving predominantly domestic generic manufacturers, is being held responsible for this decline in drug safety. As a response, government officials assert that perceptions of drug ineffectiveness stem more from personal anecdotes than objective assessments. This has done little to alleviate the concerns of the public, already wary of a healthcare system grappling with the pressures of an ageing demographic.

The controversy ignited last December when the government released a list of nearly 200 companies authorized to supply medications to state hospitals, most being producers of generic pharmaceuticals. In January, a viral video featuring Zheng Minhua, a Shanghai hospital director, intensified the discourse. Zheng discussed alarming issues, including ineffective antibiotics, anesthetics, and laxatives, resonating with the public and prompting many to share their negative experiences on social media. However, this discourse has faced censorship on popular platforms like Weibo.

Reports of patients opting for original medications instead of generics echo the growing distrust among consumers. As the desire for higher-quality imported drugs surges, many see these as the safer choice, further complicating sales of standard generics. Censorship has also limited discussions around potential systemic issues, including an inadequately resourced healthcare sector.

The 2018 drug procurement system was designed to save costs for state health expenditures by allowing local governments to solicit bids for medicines, thus creating a competitive environment favoring cheaper generics. Critics worry this can lead manufacturers to compromise drug quality, impacting patient safety. Some industry doctors have expressed that extremely low bids, like those for medications priced under one cent, raise legitimate questions about the safety and effectiveness of those products.

Calls for reform have emerged, with stakeholders advocating for stronger drug quality control measures and better standards for drug approval and manufacturing. While authorities acknowledge challenges in this procurement system, framing the situation as a public health concern rather than a political one, the divide between public perception and governmental reassurances continues to widen.

Experts stress that while affordable generics are vital, preserving safety and efficacy must be paramount to prevent a crisis of trust so prevalent in the current healthcare landscape. In the face of a worsening healthcare crisis, public sentiment suggests that savings from cheaper drugs are insignificant in comparison to the potential risks posed by substandard medications, reflecting a critical awareness within the public regarding their health choices.