Bitter Pills:Medicines & The Third World Poor | Page 170

control the purse strings. Over half the total annual WHO budget is made up of
contributions from just half a dozen leading drug manufacturing countries (the
US, West Germany, Japan, France, Britain and Italy). The United States alone
contributes almost a quarter of WHO's entire budget. <3)
The other obvious weakness inherent in the UN system is that WHO and other
agencies can do little more than make recommendations. If governments choose
not to act on them, UN agencies can do nothng besides issue polite reminders.
For example, Dr. Halfdan Mahler, Director General of WHO, pointed out to
member states attending the 1980 World Health Assembly that they were not
making good use of the technical assistance available to them to serve their people's
most pressing needs. (4)
Thousands of pages of enlightened analysis of Third World drug problems have
been written and filed away in cubic metres of reports. Similarly countless
resolutions urging governments to act on WHO recommendations have been
adopted by the World Health Assembly, but never translated into action. Not
surprisingly all the paperwork and the resolutions have made almost no impact
on the lives of the Third World poor. In some developing countries shortages of
essential drugs are becoming more acute despite the false impression created by
government reports to WHO that everything is under control.
WHO has traditionally concerned itself with the technical and professional aspects
of drug use. It has played an important role in disseminating drug information.(SI
But its focus of attention on drug policies shifted in the mid-seventies, soon after
Dr. Mahler became Director General. WHO then grasped the nettle and began to
emphasise the underlying social and economic issues. For example, in addressing the
World Health Assembly in 1975, Dr. Mahler denounced inconsistent standards in
drug marketing practices between developed and developing countries as "unethical
and detrimental to health". (6)
Dr. Mahler went on to point out that WHO had already made " a significant
contribution towards assisting countries in improving drug quality, safety and
efficacy". But he stressed that "It is now important to assist countries also in
formulating and implementing national drug policies. The question is not merely
technical, but also political and ethical, involving governmental responsibilities
as well as the global social responsibility of the parmaceutical industry with regard
to both the availability of existing essential drugs and the development of better
ones." (7)
These wider social and economic issues have always concerned the relatively newer
UN agencies, UNCTAD and UNIDO, which were set up during the 1960s expressly
in response to problems generated by the growth of trade and industry. (8)
UNCTAD has worked closely both with individual governments and at regional
level in documenting the problems and drawing up new drug policies to counteract
them. UNCTAD officials emphasise the need for poor countries to sever their
dependence on monopoly suppliers. They advocate bulk-purchasing on
competitive tender; revision (or suspension) of patent restrictions, and less
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