Bitter Pills:Medicines & The Third World Poor | Page 132

of cheap drugs to the people most in need". (l0) The remainder will be sold on
the open market. This raises a major problem for GPL in trying to prevent
middlemen from stealing the advantages intended for the poor by jacking up
the prices. According to Dr. Chowdhury cases of retailers charging more than
the maximum retail price for GPL products have already been reported. He
comments: "A lack of confidence in anything that comes from Bangladesh itself
is part of our sad colonial heritage, and pharmacists, having heard something
of Dutch financing, charge excessive prices claiming that this is a new 'Bilati'
(European) medicine." ""
The team at GPL are well aware that past attempts to promote the use of cheap
generics have failed because doubts about their quality are easily whipped up in
the minds of doctors and patients. GPL has its own sales representatives to promote
its products to doctors and pharmacists, but priority is also given to the need to
popularise wider health issues. This is done through the health project's monthly
magazine, "Mashik Gonoshasthaya", printed on its own presses. The magazine
is written in simple Bengali and aims to be lively and informative. It covers many
health issues including appropriate non-drug treatments and warns against the
socially damaging effects of existing drug sales and over-medication. 15,000 copies
of the magazine are distributed each month.
A drug company's success depends to a great extent on its reputation with doctors.
So there are plans to invite doctors and pharmacists to visit Savar to see for
themselves that GPL drugs are produced in a modern, efficient factory. This will
be an extension of visits arranged in the past for groups of medical students with
the aim of exposing them to village reality and the radical approach to health care
adopted at the People's Health Centre. This is all tantamount to a vist to Mars
for most middle class medical students after the secluded anatomy sessions at
medical school, but it is crucial in influencing the attitudes of the country's future
doctors to accept a new direction in health services to benefit the mass of the people.
The drug factory is an exciting new venture. Local drug company managers that
we interviewed in 1980 told us that they did not see GPL as a threat to their market
because the potential demand for drugs is so great, with the planned expansion
of primary health care facilities. Certainly, if it is to succeed and offer a model
for voluntary agencies in other countries to follow, GPL will need to count on
the active goodwill of the rich world manufacturers who are in a position to threaten
its future viability.
GPL has already experienced the problems of trying to challenge existing market
power. In 1981 the Government invited manufacturers to quote their prices to
supply ampicillin. In the previous year, a local state-owned manufacturer supplied
the drug at 99 paisa a capsule. In 1981 GPL tendered to supply ampicillin at 93
paisa, based on raw material prices quoted to them by a local trading company.
The day after GPL had submitted its bid, the trading company revised its quotation
for the raw material which would have allowed GPL to supply the finished drug
at 5 to 17 paisa less.
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