Bitter Pills:Medicines & The Third World Poor | Page 175

In most developing countries controls are notoriously weak - if not non- existent.
As a result patients and consumers in poor countries are left highly vulnerable
to questionable practices. The full extent of the problem is impossible to gauge
because governments of exporting nations are reluctant to release details of exactly
which products get exported where. (39) Trade secrecy is well defended by
governments and manufacturers alike.
When questioned about the different standards applied to drug exports, rich world
governments advance essentially the same arguments. For example, successive
British Governments have all stressed that factors such as disease patterns, climate,
diet and the availability of health services vary so much from one country to another
that regulatory decisons taken in Britain would have little relevance to the
requirements of developing countries. Consequently, as a civil servant explains,
"The United Kingdom has long argued that the only effective and appropriate
method of controlling the safety and efficacy of medicines is for the less developed
countries to develop their own procedures for control".(40)
Does this mean that if a British manufacturer goes on marketing an unsafe drug
after it has been removed from the hom e market, the British Government feels
under no compulsion to do anything? And would this apply even to the marketing
of drugs with known toxic side-effects in poor countries where they will inevitably
be sold without a doctor's prescription? When these questions were raised in the
British Parliament in 1979 Government spokesmen were adamant. "It is for the
governments of the Third World to decide whether they will permit that to happen
... there is a limit to what Her Majesty's Government can do." (4I)
The response was negative, albeit realistic in view of the difficulties for a national
government in attempting to control the activities of transnational companies.
But the absence of export controls is also presented in a positive light - in terms
of the need for exporters to respect each country's right to choose. In the words
of a spokesman for a former British Government, "Is it not reasonable to question
whether we have the right to deny a foreign government the right to make their
own decision on the basis of their own expertise on the circumstances prevailing
in the country?" (42) A corollary to this freedom of choice argument is that policy
statements usually imply that developing countries are also opposed to tighter
export controls.
The arguments sound persuasive. After all, interference smacks of neocolonialism . But looking at the argument in the light of the needs of poor countries
it is not true that people in the Third World are happy with the existing situation
where the onus falls on them to sift out hazardous and ineffective drugs. In fact
there is a growing body of Third World opinion urging exporting nations to take
an active role in safeguarding the health of people in developing countries. One
illustration of this is the j oint'' Declaration on the Export of Hazardous Substances
and Facilities" issued by participants from nine developing countries who attended
an international seminar in Malaysia in 1980. The Penang Declaration urges that
"there should be no distinction between domestic and foreign consumers; so that
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