E-drug: Re: No Free Lunch (cont'd)
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Hi all
An aside in the very interesting interchange between Peter and Tanya
- in his last mail Peter stated:
I do not doubt that you have good intentions. What I doubt is whether it is
possible for anyone to be unbiased.
Is that not the clue to the resolution of this debate? I agree - it
is probably not possible for anyone to be unbiased, but would add
"regardless of site of practice". If we look at the "conceptual family
tree" of marketing on the MaLAM site, we see that sponsorship is but
one of a myriad of activities that make up the family of
"advertising". Any health professional who makes decisions about drug
therapy, but especially those who practise in drug information
centres, should learn to "overcome promotion", learn to recognise
"methods of influence". Working in a state-sponsored setting does not
immunise one against the effects of drug company marketing, it merely
removes one easily identified source of such influence. Surely the
answer lies in the systemic design of the centre (such as quality
assurance and peer review systems) and the way in which that system
is put into operation?
Apart from merely enjoying the debate, I must emphasise that this is
not an inconsequential matter, at least not in South Africa. We have
limited resources, one of which is the Medicines Information Centre
(where Tanya works). We face a difficult choice - do we build a drug
information system on existing frameworks, or do we start from
scratch? We have reasonably good telecommunications infrastructures,
so a central facility can be useful to most health workers. Should
the State support the MIC, perhaps reducing and eventually
eliminating its reliance on drug company sponsorship? Or should it
embark on the difficult task of building a state-supported system
from scratch, in a climate of scarce financial and human resources?
As always, there are purist and pragmatic possibilities. My own
feeling is that, in Africa, we need to be pragmatic.
regards
Andy
Andy Gray
agray@pixie.udw.ac.za
[Note from moderator: Good to hear from you again, Andy! I have some
sympathy with your pragmatism, which, unfortunately, we have to live with
sometimes. To convince the State that it would be cost-effective to sponsor
such activites is sometimes not so easy. But, I wish we could come to
another form of 'sponsorship' which is not linked to one company, e.g. a
small government tax on drugs to be used for information and educational
activities. Only 1% would be a lot although still be only 10-20% of what
companies spend on promotional activites in Norway. Kirsten Myhr]
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