Bitter Pills:Medicines & The Third World Poor | Page 169

CHAPTER 10
HELP OR
HINDRANCE?
The Rich World's Response
"The 'haves' are rarely willing to relinquish their control and their
resources and share them with the 'have-nots'." (The Brandt Report)
THE BRANDT REPORT has documented the inflexibility of rich world
institutions in the face of the problems confronting the Third World poor. (1)
Poverty is condemned but it is also tolerated. Rich world interests oppose changes
in the world economy that might offer some hope for the poor, but challenge
the dominance of the rich. Poor people are central to any analysis of the problems
of the Third World. But when it comes to the solutions, the poor are almost
invariably shifted backstage. Their interests tend to be lumped together with those
of Third World governments and the powerful people in their societies, who may
be as unenthusiastic about change that threatens their position as their counterparts
in the rich world.
The solutions to the problems affecting the poor that concern us here - the lack
of essential drugs and harmful marketing practices - cannot be separated from
these wider political and economic issues. But in this chapter we focus on rich
world attitudes in relation to Third World drug policies and the role of rich world
governments, manufacturers and international and non-governmental
organisations.

INTERNATIONAL ORGANISATIONS
The UN agencies most actively involved in helping to plan and implement drug
policies appropriate to the needs of developing countries are WHO, UNCTAD,
UNIDO and UNICEF.<2) Apart from the fact that these organisations have their
headquarters in Geneva, Vienna and New York, it may seem strange to include
them in a chapter on the rich world's response to the Third World's needs.
After all, developing countries far outnumber developed nations amongst the
157 member states of WHO. But their inclusion here is appropriate.
The UN agencies are in the unenviable position of having to perform a balancing
act in response to the conflicting demands and pressures imposed on them by very
different governments. Their policies are, however, unlikely to succeed unless
they are backed by the economic muscle-power of the rich industrialised countries.
WHO officials are acutely aware that where health issues overlap with industrial
and trade policies the whole area rapidly becomes a political minefield. They have
to bear in mind that major drug producers may be few in number, but they can
162