Two of India’s biggest drug companies are alleged to be giving inducements to “quack” doctors of gifts and cash to encourage them to prescribe vast amounts of antibiotics, fuelling the rise of drug-resistant superbugs around the world.

Undercover reporting by the Bureau has revealed that Abbott and Sun Pharma — whose products and devices are sold and used in more than a hundred countries, including in the US and by the NHS in the UK — promote antibiotics to healthcare practitioners who often have no formal medical training. It is illegal to sell antibiotics to quack doctors in most parts of India, but the law is rarely enforced. There are no restrictions on promoting the drugs to them.

These so-called quacks, who can be the only healthcare provider in their impoverished communities, often go on to prescribe antibiotics incorrectly. By offering incomplete or simply unnecessary treatments, they unwittingly speed up the creation of superbugs that kill tens of thousands of babies in India alone each year. An Abbott salesman suggested he knew the drugs might be misused, but he was motivated purely by profit.

A Sun Pharma salesman told an undercover Bureau reporter that quacks and real doctors were given high value gifts to encourage them not to switch to a competitor. These ranged from gift cards, medical equipment and fridges to televisions, travel and cash. Sales representatives would also offer extra pills or money as an incentive to buy more antibiotics, encouraging potentially dangerous overprescription.