Bitter Pills:Medicines & The Third World Poor | Page 123

number of Indian states. One research institute in India found that 690 out of
822 salmonella strains they were able to identify were resistant to at least one
antibiotic and some were resistant to three or more. An outbreak of drug resistant
disease led to the closure of the entire paediatric unit of a hospital in Bangalore,
and another strain of salmonella, resistant to five antibiotics, lasted 20 months
and killed over 80 babies in Delhi hospitals. (129)
The most serious epidemics of drug-resistant disease to date have been reported
from Central America. In 1969 an epidemic of Shiga dysentery killed 12,500 people
in Guatemala and 2,000 more in El Salvador. The disease was resistant to
chloramphenicol, tetracycline, streptomycin and sulphonamide drugs. Three years
later there was an outbreak of typhoid affecting over 6,000 people in Mexico.
As with the strain of typhoid reported in India that year, the drug of choice,
chloramphenicol, proved useless. At the start of the epidemic there was a high
fatality rate with one in seven dying before doctors realised that trying to treat
the sick with chloramphenicol was futile.(130)
The growing scale of antibiotics resistance has alarmed the experts. At a conference
in 1979 the Dean of the London School of Hygiene and Tropical Medicine called
for action:' 'The widespread use of antibiotics, even by quite poor people in poor
countries must be discouraged by controlling their availability, as individual
benefits are likely only by chance and disadvantages to the community are a
certainty." (I3I)
Much of the onus falls on Third World governments to introduce controls, but
little can be achieved without the active cooperation of the rich world. This fact
was highlighted by US experts in the aftermath of the Mexican typhoid epidemic.
They attributed part of the onus for the deaths caused by drug resistance to
manufacturers who had been promoting chloramphenicol for trivial uses. In a
statement to the US Senate, Professor Lee of the University of California stated
his belief that "the problem is related to the promotional practices of the drug
companies. It is serious and it can affect not only the residents of the countries
involved and all those who visit there as well, but people who have never travelled
to Latin America." (U2)
Drug resistance can provide manufacturers with an incentive to carry out further
research to develop new products.(133) But to the consumer - above all the poor
Third World consumer - drug resistance is disastrous, because it push es up the
cost of life-saving treatments. The threat of drug-resistant disease emphasises the
impossibility of shifting responsibility for responsible drug marketing entirely
on to the shoulders of Third World governments.

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