This press release on drug donations may interest you. Please send comments
or ideas for further action to Mr. Bas van der Heide at email
wemos@antenna.nl
kind regards, Wilbert Bannenberg
EMBARGOED FOR 8 SEPTEMBER
HEALTH: Drug Donations May Not Be Appropriate Aid
An Inter Press Service Feature
by Judith Perera
Sept. 8 (IPS) -- Collections of unused drugs sent to developing countries
and Eastern Europe as aid are often not appropriate and sometimes
dangerous, according to two letters in today's British Medical Journal. One
letter by Bas van der Heide, a project officer with the Wemos Foundation
in Amsterdam, and Erik Schouten of Medecins Sans Frontieres (MSF) in the
Netherlands noted that technically the export of unused drugs issued to
patients and returned to pharmacies is illegal under European Union law.
However, there are many loopholes in the legislation and many NGOs, with
the best of intentions, have launched campaigns to collect these and then
send them abroad as aid. "Long experience with these donations has shown
that the distribution of unused drugs that have been collected is
inappropriate," says the letter.
"People want to help rather than wasting drugs," says Bas van der
Heide, "but this is not the best way to deal with the drug problems faced
by developing countries or Eastern Europe. There are better ways for
willing doctors and pharmacists to use their efforts."
There are plenty of examples of how drug donations can be counter-
productive for recipient countries. Last November, for example, a Dutch MSF
team in Djibouti faced with a serious cholera epidemic received a drug
donations from a French NGO. "These were mainly anti-diarrhoea drugs which
are not used for cholera where the main problem is dehydration," explains
van der Heide. But among the 100 unsorted and partly expired drugs in the
consignment there were no oral rehydration solutions or intravenous fluids.
The only useful drugs were a few antibiotics -- 12 co-trimoxazole tablets.
However a lot of valuable time was lost sorting through the drugs and later
disposing of them.
Another example occurred in Lithuania in 1993 when 11 women were
temporarily blinded as a result of taking a drug provided as part of a
donation. The drug was an anti-helminthic veterinary product which had
mistakenly been used to treat a gynaecological condition called
endometriosis. The drug had arrived without proper product information and
doctors had tried to identify it by matching the name on the box with names
on leaflets for other products.
But this is not just a recent phenomenon. After the 1976 earthquake
in Guatemala some 7,000 boxes of mixed drugs arrived. It took 40 pharmacy
students over six months to sort all these and in the end only 10 per cent
were found to be relevant to the country's needs.
The extent of the problem became clearer in 1991 when a French
organisation, Pharmaciens Sans Frontieres organised a campaign to collect
unused medicines for use in international aid programmes. Over 4 million
kilograms were collected from over 4,000 pharmacies in France and a massive
sorting operation was organised in 88 centres. Of the total only 20 per
cent were found to be useful. The others were either expired or
inappropriate and 80 per cent were burned. It would have been cheaper to
simply buy badly needed essential drugs direct from suppliers and this is
now what PSF does.
When pharmacists in the Netherlands started a similar scheme last year
the Wemos Foundation contacted them and explained the situation. Wemos, a
Dutch NGO established in 1981 to promote health and development, has been
campaigning hard fro European legislation to prevent the export of
substandard drugs.
WHO has drawn up guidelines for drug donations. These stipulate that
donations should be based on a specified need of the recipient and should
be on either the national or WHO list of essential drugs. They should be
of good quality and have at least a year to go before expiry. They
should not be drugs returned unused to pharmacies or doctors' free samples,
and they should be properly packaged and labelled.
The main problem now is to explain the situation to small NGOs and
discuss other ways in which they can help, says Bas van der Heide. The
issue has been discussed in the Dutch parliament and the government has now
stated explicitly that the collection of unused drugs for donation is not
acceptable. He hopes that other European governments will follow this
example.
There is also a problem on the demand side, he adds, with some countries
not specifying accurately what they need. However, other countries have
a drugs policy in place and drug donations which do not follow WHO
guidelines do not help them to implement those policies. "Developing
countries have many needs apart from drugs, and it may be better to do
other things. Supplying drugs requires a lot of experience to properly
assess a specific request and a pharmacists needs to be on hand to dispense
drugs properly."
Wemos, Amsterdam (Organisation for Health and Development Issues)
Visits: Nieuwe Looiersdwarsstraat 15,1017 TZ Amsterdam, Netherlands
Mail: Postbus 1693,1000 BR Amsterdam, Netherlands
Tel. +31.20.420.2222 Fax. +31.20.620.5094
e-mail wemos@antenna.nl
Wilbert Bannenberg, public health consultant
CHD - Consultants for Health and Development
Brederodestraat 5, 1054 MP Amsterdam, The Netherlands
tel +31-20-6854659 fax +31-20-6891233 email wilbertb@xs4all.nl