# E-DRUG: Conflict and drugs **URL:** \ **Category:** e-drug\ **Created:** [September 24, 1999, 10:48pm UTC](https://talk.edrugplus.org/t/e-drug-conflict-and-drugs/6099 "1999-09-24T22:48:12Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![Ahmad\_Danish](https://avatars.discourse-cdn.com/v4/letter/a/a9a28c/32.png) [@Ahmad\_Danish](https://talk.edrugplus.org/u/Ahmad_Danish)\ **Post date:** [September 24, 1999, 10:48pm UTC](https://talk.edrugplus.org/t/e-drug-conflict-and-drugs/6099/1 "1999-09-24T22:48:12Z")
E-DRUG: Conflict and drugs -------------------------- Dear E-druggers, I attach below a short report that I have prepared previously about the drugs and drug use during conflict in Afghanistan. Political instability and conflict that affected the whole health system not only intensified the previously existing problems but brought new and unique difficulties. CONFLICT AND DRUGS: Afghanistan, once having a relatively satisfactory drug supply system, faces unique drug-related problems that begun in the early eighties with the soviet invasion and worsened in recent years with the progress of political instability and fighting. Although some reports on various war-born health problems have been published, few has been written on drugs. Despite the presence of legislation, the registration system, and the national list of essential drugs, many drugs of different qualities are pouring into the country because the public drug supply has collapsed, local manufacturers have been damaged, and the number of registered importers has decreased. The influx of drugs (ranging from good quality to substandard or even to spurious and counterfeit) is mainly maintained by individual merchants who import drugs according to market needs (sometimes according to orders of individual prescribers). The quantity of imported drugs varies from less than hundred US Dollars worth in bags to several thousand dollars worth cartons .The great numbers of products in different quantities not only increase the prices but it makes prices control and regulation difficult. Only part of the imported drugs is inspected and supposed to get permission from the ministry of health. The damaged quality control laboratory in Kabul has been partly restored recently, but due to its limited capacity and the large numbers of products with different quantities, it is very difficult to get and test samples from all the imported drugs. It should be mentioned that not all parts of the country have been under the control of the central governments during the past twenty years. Private sector that provides drugs to the majority of the population seems to be the most affected area and less attentions has been paid upon. In the public sector, drugs are mainly supplied by scattered and decentralized donations. It is believed that some organizations provide effective, safe and good quality drugs at reasonable prices, others face difficulties in this domain (1).There are few up-to-date drug information sources in national languages. Not all prescribers, especially in the private sector, have access to Afghan National Formulary published in 1996 which is an unbiased drug information source in national language. WHO and UNICEF have organized several workshops on rational drug use, but there is no regular continued education program in this field. It is worth mentioning that most of the activities on the essential drug program and rational drug use have been done with the assistance of WHO and UNICEF. But the problem is too extensive to be solved by a single organization. The magnitude of the misery due to the silent bullets, i.e., harmful drugs and or irrational drug use, remains unrevealed under the blasts of real bullets. These problems that are as important as other war-born problems like landmines and refugees; require more international attentions. May be donor countries, relevant international organizations and drug industries find possibilities to alleviate drug-related problems during conflicts and political instabilities. Reference:1 - Agency Coordinating Body for Afghan Relief. Report of working group on harmonization & improving drug supply and use by the aid community in Afghanistan .Peshawar, 1996. Although the issue is very difficult to deal with but in order to generate discussions I ask for any experiences or suggestions in improving drug use and especially in improving the supply of quality drugs in the private sector during continuous conflicts. The some problems may be seen more or less in other countries that face conflicts. Thank you Dr. A. F. Danish , Former Associate Professor in Pharmacology, Faculty of Medicine, Kabul, Afghanistan. Email: afdansih@hotmail.com -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.