Bitter Pills:Medicines & The Third World Poor | Page 181

AID AGENCIES
Amongst ECHO'S biggest customers are aid agencies such as OXFAM,
particularly when emergency drug supplies are provided in disaster situations,
but also when drugs are supplied as part of the main core of small-scale
development work. Recently, as we have seen, some of the biggest European aid
agencies, notably NOVIB, have put up funds to help create self-reliance in drug
supplies with the building of Gonoshasthaya Pharmaceuticals factory in
Bangladesh. Aid agencies are also compaigning for drug policies to benefit the
poor.
But there is also a negative side to aid agencies' involvement in drug supply. Like
manufacturers, some have created problems by exporting a mass of drugs that
poor countries do not want, or need. The problems have been particularly acute
in disaster situations where human and physical resources are stretched to the
limit. For example, during the disastrous floods in Bangladesh in 1974, a motley
collection of medicines and samples, scrambled together by generous and wellintentioned donors, poured into the country. The physical effort of picking
through the drugs to sort out the useful from the useless was a sheer waste of the
overworked doctors' time. A former Director of Drug Administration in
Bangladesh stresses that this sort of philanthropy which remains blind to real need
can be positively harmful.(74)
OXFAM staff and health teams experienced a similar situation during the height
of the Kampuchean emergency in 1979, when random drug donations from all
over the world created chaos. (75)
But it is not only in emergencies that unsolicited gifts of medicines can cause serious
problems. According to a Government official in Upper Volta, "The most
uncontrolled section of imported medicines are the gifts from governments and
aid agencies. These gifts are accepted without quibble or question and of course
many of them will be, at the very least, inappropriate. There are also problems
for the nurses or dispensers in actually administering these free medicines, since
they come from various countries of origin, and of course have differing strengths.
There may also be the temptation for the nurses to hand out these free medicines
to patients, not because they are suitable treatments, but because they are all that
is available." (76)
HEALTH PROFESSIONALS
Individuals and groups of health workers, nurses, doctors and pharmacists in
developed countries are increasingly expressing concern over the scale of the
problems faced by their counterparts in poor countries. Many come up against
similar dilemmas in their everyday work - particularly the heavy dependence on
drugs which is perpetuated by promotion and patient demand.
One example of a group of health professionals which is taking an active interest
in the specific problems of drug use in developing countries is the International
Pharmaceutical Federation (known as FIP). FIP has set up a special Third World
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