Bitter Pills:Medicines & The Third World Poor | Page 10

market is flooded with an assortment of vitamin tonics, cough and cold remedies,
and other expensive combination products, when single- ingredient, basic drugs
like penicillin and chloroquine are in desperately short supply.
The first-hand experiences of OXFAM colleagues and friends throughout the
Third World have made us forcefully aware of the problems. Very few of the
poor benefit from the potential of modern medicines. Valuable drugs developed
decades ago could be used to prevent unnecessary suffering and death. But through
their uncontrolled sale and promotion in many poor countries, medicines often
do little good and can be positively harmful.
OXFAM's commitment to the relief of suffering made it our duty to investigate
the problems and publish our findings with the aim of pressing for action to benefit
the poor. This report is based on the experience of OXFAM field staff, project
workers and friends in many very different countries. But what emerges is a striking
similarity in the problems worldwide. The report also draws on a wide range of
both published and unpublished material in addition to research carried out by
the writer in North Yemen, India and Bangladesh.
A doctor in Bangladesh told OXFAM that he is acutely aware of three contrasting
but equally tragic situations. There are patients he cannot help who are dying of
diseases for which there is no drug treatment. Secondly, the poorest, who cannot
obtain treatment or drugs, die of diseases that are curable, and often preventable.
Thirdly, and seemingly paradoxically, some poor families make sacrifices and
even go without food to buy unnecessary drugs, when the 'medicine' they need
is food.
Rich and poor could benefit from new drugs to treat incurable diseases. But only
the poor are denied the life-saving drugs available to the rich. This report attempts
to unravel the complexities of the medicines issue. The focus throughout is on
the needs of the Third World poor.
Chapter 1 assesses the role of medicines in creating better health. Chapters 2 to
6 highlight the special problems in the distribution, production and marketing
of drugs in developing countries. Chapter 7 focuses on traditional medicine which
remains the major source of health care for most of the world's population.
Chapters 8 and 9 describe constructive initiatives to improve health and the supply
and use of essential drugs both at project level and on a wider national and
international scale. These and the following chapter are concerned both with
attempts to rationalise drug policies to benefit the majority and with obstacles
to change. Chapter 10 also examines attitudes and policies in the major drugproducing nations and their impact on drug needs and policies in developing
countries. Finally, in Chapter 11, we put forward OXFAM's suggestions on action
that is urgently needed to benefit the Third World poor.