Bitter Pills:Medicines & The Third World Poor | Page 173

market whims. Some thought that a policy whereby individual countries made
agreements with manufacturers on a one-to-one basis also ran counter to some
of the key aims of the Action Programme, above all the need to build up collective
self-reliance through local production and regional cooperation. <24) The
consensus reached in discussion on the Action Programme indicated that WHO
should give less priority to Geneva-based discussions with industry and concentrate
on its role as a "catalyst" for positive new policies in the Third World itself.(25)
This was summed up in the strongly-worded resolution passed by the 1982 World
Health Assembly which urged that the Action Programme should be enforced
' 'in its entirety'' and that WHO's Regional Offices should see that the programme
is "vigorously pursued" in developing countries. |26)
The fact that delegates wanted the Action Programme to be implemented "in
its entirety" is crucial in ensuring future progress on a WHO code of marketing
practice (WHO was mandated to start work on a code in May 1978). A number
of delegates wanted to know why no progress had been reported on the code.
Countries of very different political complexions pressed for what the Chilean
delegate described as "dynamic legislation... as a defence against certain unethical
practices of some producers". (27) Cuba, Burundi, Romania, and Samoa all
raised the question of a WHO code. But the most forceful intervention on the
need for a WHO-sponsored international code was made by the Dutch delegation.
The Netherlands urged that a code was necessary "to prevent serious problems
in which the good name of our organisation (WHO) might be at stake", having
previously cited problems including "misinformation, incorrect advertisements,
ineffective products, the introduction of inappropriate technologies and ... a
possible move from essential drugs to non-essential drugs in the programme".(28)
Although a number of delegations g ave priority to the need for a code, immediate
prospects of a code being introduced at the May 1983 World Health Assembly
are not good. Senior WHO officials make no secret of the fact that influential
member states are firmly opposed to any international regulations on drug
marketing. The organisation is still feeling the shock waves after the adoption
of the International Code of Marketing of Breast-milk Substitutes in 1981 in the
face of strong opposition from the United States.(29) WHO officials feel that a
code on drugs would be too much of a political hot potato for the organisation
in present circumstances. Some see the 'threat' of a WHO code as a useful Sword
of Damocles to encourage industry's cooperation. Their fear is that attempts to
push through a code would encourage such fierce opposition that the future of
the entire Action Programme might be in jeopardy. It is a gamble they will not
take without concerted pressure from more member states than have so far pushed
for a code publicly.
For its part, the US Government has left no room for doubt about its views on
the matter. During the discussion at the 1982 World Health Assembly the US
delegate strongly objected to a draft resolution on the marketing of breast milk
substitutes. (This was put forward to improve enforcement of the 1981 code.)
The Americans were particularly unhappy with a reference stating that the code
"was designed to regulate these marketing practices", (our emphasis) The US
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