Chapter 2598: Investigation (25)

The methods for stealing drugs proved remarkably diverse. Beyond the sophisticated scheme of using outside hospital prescriptions to obtain publicly funded medications from the main hospital, countless other tricks existed. The simplest involved the pharmacy warehouse keeper colluding with two cleaning staff—they would steal drugs directly from the pharmacy and smuggle them out using medical waste bins to bypass inspection.

When Zheng Mingjiang first heard of such practices, her eyes widened in disbelief. The approach seemed utterly brainless, lacking any imagination whatsoever.

"Didn't they worry about inventory shortages?"

"Of course they did," Wu Mu said. "And their solution was equally simple."

"How so?"

"After removing the actual drugs, they left the original packaging and instruction sheets behind, then substituted whatever junk happened to look similar from the outside. That's why they avoided bottled oral solutions, injections, and liquid preparations." Wu Mu shrugged. "The people doing inventory checks only verify that the count looks right. Nobody opens every box to inspect the contents."

"This is... this is absolutely outrageous!" Zheng Mingjiang struggled to process what she was hearing. "But once these fakes get distributed to patients—people could be seriously harmed!"

"Swallowing fake medicine won't kill anyone. At worst, the patient's family assumes the treatment isn't working. Even if they mention it to the doctor, the physician will just conclude that the medication wasn't suitable for the condition. Even back in the old timeline, no medicine was guaranteed to work."

"I really overestimated things," Zheng Mingjiang said with a bitter smile. "And underestimated them at the same time. I thought once we established proper rules and regulations, the system would be airtight."

"Rules are made by people, and people are never airtight." Wu Mu had witnessed plenty of such schemes. Ultimately, even the best systems required humans to implement them. Given the Senators' limited numbers and packed schedules, merely enforcing regulations at all was an achievement; thorough enforcement bordered on impossible.

Consider the scale of operations at Provincial and Port General Hospital: two or three Senators overseeing hundreds of naturalized medical workers, processing over a thousand outpatients daily while managing more than a hundred inpatients. That it functioned normally at all was remarkable.

Moreover, the Senate's dual-track system—separating public healthcare from commercial healthcare—created massive price disparities for the same drugs. This gap had become fertile ground for every imaginable form of corruption. With profits so tempting, drug losses weren't a question of whether they occurred, but of scale.

"I raised this with Dean Shi previously," Zheng Mingjiang said. "Our dual-track pricing system is bound to cause problems. We'd be better off implementing uniform pricing alongside a medical insurance system for naturalized employees. At minimum, that would eliminate the arbitrage opportunities." She shook her head. "The current setup creates too much room for exploitation. When profits reach a certain threshold, people will risk their heads for them."

Days of interrogation expanded the number of implicated individuals—both naturalized employees and ordinary citizens—into the hundreds. Some had repeatedly registered fake appointments to obtain prescription slips. Others specialized in purchasing drugs prescribed to naturalized citizens. Still others conspired with nurses to skim medications from inpatients or submit fraudulent claims.

The deeper Zheng Mingjiang dug, the colder her heart grew. She had assumed that major institutions like Provincial and Port General Hospital, with Senators directly in charge, would maintain far stricter compliance than smaller facilities. Cases of theft and diversion should have been rare.

Reality proved otherwise. Large institutions meant high patient volumes, massive drug consumption, and byzantine accounting. Staffed by hordes of undertrained administrators who existed primarily to fill positions, these organizations actually bred larger problems than their smaller counterparts.

We traveled to this new timeline, risking death itself, and in less than ten years every form of corruption has already taken root. Confronting these elaborate schemes, Zheng Mingjiang found herself doubting her mission for the first time: What exactly are we doing here?

The more reports she reviewed, the more discouraged she became. Her determination to "investigate to the end" began wavering. She dreaded imagining what would surface once audits reached Lingao General Hospital and the Logistics Health System, neither of which had yet been examined.

But retreat was no longer an option. The only path forward was continued investigation—cataloging every problem, then developing remedial measures based on the vulnerabilities discovered.

No system is perfect once and for all. She had always dismissed that phrase as a resigned compromise with entrenched dysfunction, believing that with sufficient determination to start fresh, anything could be corrected.

Now she understood: a blank canvas might invite unlimited possibilities, but no design could account for every flaw.

All she could do was mend the fence after the sheep had scattered—drafting a comprehensive legal framework for this timeline: Drug Administration Law, Good Clinical Practice guidelines, Measures for Drug Registration, Measures for Drug Production Supervision, Good Supply Practice for Pharmaceuticals, Measures for Drug Advertisement Review, and Measures for Drug Inspection Administration.

Zheng Mingjiang understood that laws, as part of the superstructure, had to align with current productive forces and relations. Otherwise they would exist only on paper, breeding endless complications. In the old timeline, China's drug administration—a regulatory body in a developing nation—had modeled itself on the FDA, Japan's Ministry of Health, and Europe's EMA from the very beginning. Officials constantly invoked "international standards" and took pride in copying FDA regulations, to the point that the abbreviation SFDA became mockingly known as "Stupid FDA."

Drafting regulations appropriate for this timeline, regulations that would actually serve their purpose, would not be easy. It could only be accomplished gradually.

Beyond regulatory work, she was preparing several educational articles for general circulation. When Wang Liang returned to Lingao, he had taken with him all the "miracle medicines" she had collected. The drug analysis reports had since arrived in Guangzhou. The antibiotics were primarily sulfonamides, followed by Penicillin V—consistent with current production capabilities.

Sulfonamides were one matter, but penicillin belonged to the beta-lactam class of antibiotics. Based on antimicrobial spectrum and resistance patterns, penicillins could be categorized into narrow-spectrum, enzyme-resistant, broad-spectrum, anti-Pseudomonas broad-spectrum, and anti-Gram-negative varieties. Narrow-spectrum penicillins were represented by injectable Penicillin G and oral Penicillin V.

Penicillin G was natural penicillin, extractable from Penicillium culture fluid. Chemically stable with potent antibacterial effects, it readily crossed the blood-brain barrier during inflammation, making it a commonly used antibiotic in the old timeline. However, it degraded rapidly in water and couldn't withstand heat. Taken orally, stomach acid and digestive enzymes destroyed it, resulting in low and erratic absorption—hence its use was limited to injection. Penicillin V, obtainable through precursor fermentation, shared the same antimicrobial spectrum as Penicillin G. Its key advantage was acid resistance and reliable oral absorption, though food could interfere with uptake. The drawback was susceptibility to penicillinase, rendering it ineffective against most Staphylococcus aureus strains and unsuitable for serious infections. As for Amoxicillin—another widely used broad-spectrum oral penicillin from the old timeline—it was a semi-synthetic antibiotic that exceeded the Senate's current manufacturing capacity.

Traditional medicine in this era lacked any concept of dose-response relationships, yet practitioners understood that dosage mattered greatly—hence the old saying, "The secret not passed down lies in the dosage." Though they possessed a rudimentary grasp of pharmaceutics, pharmacokinetics lay entirely beyond their comprehension. They had no way of knowing that converting injectable penicillin to oral form wouldn't achieve the necessary blood concentration.

Then there was the matter of drug resistance. Many Senators dismissed it as a premature concern, but inadequate dosing and abbreviated treatment courses didn't merely fail therapeutically—they actively promoted selection pressure on bacterial populations, accelerating resistance emergence. When a single packet of antibiotics cost a tael of silver, few could afford proper treatment, let alone multiple consecutive days of medication. These were major dangers lurking on the horizon.

After days of interrogation, the Luofu Medicine Market's "Lushi Powder" case finally came into focus. Following the Political Security Bureau's covert arrest of Lu Renjia, investigators at last pieced together the complete picture.

As director of the Nanhai County Health Center, Lu Renjia was nominally responsible for basic medical guarantees within the county but effectively controlled all of Nanhai's healthcare operations. This authority provided him an ideal platform for manipulation.

Lu Renjia had recognized the enormous market value of "Australian medicine" early on. From the moment he assumed the directorship, he had begun pilfering drugs for private sale. However, while he held administrative authority over all health institutions in Nanhai, the only facility he directly managed was the County Health Center itself. The drugs he could siphon were limited, keeping his operation small-scale.

Everything changed once he connected with Quan Youde.

By all rights, Quan Youde—a man from Huizhou Prefecture—should have had no connection to Lu Renjia whatsoever. But Quan had cultivated the relationship by presenting himself as a "medicine merchant," gradually winning Lu's acquaintance.

Initially, Quan dangled high rebates as bait, asking Lu to show "consideration" when awarding tenders for proprietary Chinese medicines and raw materials. As their dealings multiplied, the two became drinking companions, then eventually "sworn brothers."

They all follow the same playbook, Zheng Mingjiang thought. Zheng Xiaoyu and He Jun. And now Lu Renjia and Quan Youde—the pattern is identical.

Lu Renjia came from poverty, but his grandfather had belonged to a once-prosperous family that subsequently declined. Though Lu had never experienced a single day of comfort himself, he had inherited many of his grandfather's outdated beliefs. The one he took most to heart was the ancient maxim: "There are three forms of unfilial conduct, of which the worst is to have no descendants."

After being rescued by the Senate in Guangzhou and relocating to Lingao, Lu had attended health school, become a physician, and eventually risen to senior cadre status. Yet resentment toward his family situation never faded.

His wife was a nurse, matched to him by a Senator during his service at Bairen General Hospital. They had two daughters together, and their domestic life was reasonably content. Still, the absence of a son remained a persistent wound. Moreover, his wife wasn't particularly "obedient" to him—a source of ongoing irritation. When Lu transferred north to Guangzhou, he had wanted his family to accompany him, but his wife felt the children wouldn't have access to good kindergartens there. She refused to relocate and remained at Bairen General Hospital.

(End of Chapter)