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E-DRUG Subject: article on the BMJ on donations
Dear E-druggers,
On behalf of Philippa Saunders and with permission of the BMJ I post the
article on drug donations published July 3.
Best greetings,
Mark Raijmakers
[Moderators comment Thank you Mark!]
BMJ 1999;319:11 (�3�July�)
News
Donations of useless
medicines to Kosovo
contributes to chaos
Philippa�Saunders , London
Reports are emerging from the World Health
Organisation (WHO) and Pharmaciens Sans Frontieres that quantities of
unrequested and unusable medical drugs,
contributing to the postwar chaos.
Despite the WHO's best efforts to control drug supplies, a pattern of
inappropriate donations, familiar in many other crises, has again emerged.
Additional resources
will have to be found to sort and dispose of what amounts to a stockpile of
chemical waste.
It seems that in every humanitarian disaster drug donations take on a life
of their own; a cyclical
pattern emerges which is resistant to disciplined procedures and defies
common sense. As soon as
any disaster reaches our television screens, drugs that fail to meet the
most urgent, or any, real
health needs are dispatched. They arrive in small and large boxes, often
without any indication of
the contents; some are even half used. They may lack labelling, or be
labelled in a language that
cannot be read in the region. Some are out of date or nearing their expiry
date.
Why does this happen repeatedly in every emergency? The WHO reports that a
similar picture
was true after Hurricane Mitch. The answer may be that one of the first and
most understandable
responses to scenes of human misery is to send medical aid. The desire to
respond quickly
overrides good practice.
Governments come under political and media pressure to be seen to be
actinghalf of the
unusable drugs in the Kosovo crisis were sent by governments. In the postwar
situation aid
agencies, small charities, and church groups continue the flow of medicines
in an effort to help
reconstruct health services, and so the pattern is perpetuated. The tax
rebates that some
governments make available to companies for charitable "gifts in kind" may
in some cases
encourage poor quality donations.
The WHO Interagency Guidelines for Drug Donations, developed three years
ago, are beginning
to have some impact on this longer term aid.
Philippa Saunders is manager of the Essential Drugs Project, an organisation
which supports
rational use of drugs in developing countries (email: edp@gn.apc.org).