E-drug: BMJ on HAI/MSF/CPT Amsterdam meeting (cont'd)
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Dear colleagues,
To my opinion MSF should not rush into far-reaching decisions on
drugs which should be more or less "added" to the WHO Essential
Drugs List for compulsory licensing. Understandably MSF has mainly
the acute emergency situation in mind, but that is only part of the
picture. WHO has been very reserved about the introduction of the
fluoroquinolones and the cephalosporins because of the immense
danger of increasing bacterial resistance. Nobody can and will check
whether azithromycin is used for other indications than trachoma,
whether fluoroquinolones are used for other diseases than shigellosis
and resistant tuberculosis. Most certainly there will be widespread
misuse with the consequences mentioned earlier. Already during the
first trials with ofloxacin a high degree of resistance was noted, and
fluoroquinolone resistance in Gram negative bacteria is rapidly
increasing. Also there is no reason why ofloxacin (with a high degree
of CNS side effects) should be preferred over other fluoroquinolones
except that the manufacturer started trials with his drug for that
indication. Another issue is that by trying to alleviate the suffering of
AIDS patients attention is deviated - at immense cost - from malaria
which is still a much more serious enemy. There are just four scientific
centres in the world - Amsterdam, Oxford, Lagos and Bangkok, where
serious malaria research is performed.
So, colleagues in MSF, please discuss these issues with the Essential
Drugs Committee and do not take decisions on your own - other
interests may be at stake.
Kind regards,
Leo Offerhaus
Koedijklaan 1a, NL-1406KW Bussum, The Netherlands
Phone: +31-35-6923288. Fax: +31-35-6923290
E-mail: LO@EURONET.NL CompuServe: 71530,15
Eur J Clin Pharmacol ONLY:
POB 75552, NL-1070AN Amsterdam, The Netherlands
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