Bitter Pills:Medicines & The Third World Poor | Page 187

was decidedly hostile. An industry statement described the WHO initiative as "illadvised and counter-productive". IFPMA did not mince its words in declaring
that industry was "strongly opposed to the concept of a generally applied and
restrictive essential list". According to IFPMA, if essential drug lists were taken
up by governments they would "result in substandard rather than improved
medical care and might well reduce health standards already attained".(92) But
in 1979 IFPMA gave its qualified approval to the concept of limited lists for
developing countries. This retraction of its earlier position followed after IFPMA
received assurances from WHO that there had never been any suggestion that
a single list should be universally applied, or that the WHO model list would not
be updated to include useful new drugs as they came on to the market.(93)
Despite its initial opposition IFPMA has since taken an active interest in the WHO
Action Programme on Essential Drugs and negotiated with WHO on behalf of
its members. IFPMA continues to stress that "to focus attention on prices without
giving proper attention to quality is a disservice to developing countries".<94) It
has offered 3-6 months' training courses in drug quality control to trainees from
developing countries on behalf of its members. To date only six candidates have
been trained, one more is being trained and nine more traineeships are under
discussion.(95) These places have not been taken up with the alacrity that industry
expected, which may reflect reluctance on the part of some developing countries
to have their officials develop a prediliction for the products of the brand-name
producers.
THE IFPMA CODE
The IFPMA International Code of Pharmaceutical Manufacturing Practice
includes some very positive statements on the "Obligations of Industry" in the
preamble, which is almost as long as the code itself.(96) But the code is so loosely
worded that there is a real danger it may only serve to legitimise existing
unacceptable standards of promotion in developing countries. For example, this
is the case even with such reasonable-sounding statements as: "Particular care
should be taken that essential information as to pharmaceutical products' safety,
contra-indications and side effects or toxic hazards is appropriately and
consistently communicated subject to the legal, regulatory and medical practices
of each nation", (our emphasis)(97) This loads responsibility onto Third World
governments, rather than manufacturers, to take measures to ensure that there
is always a full disclosure of information.
A further illustration of the weakness of the IFPMA code is the short paragraph
on samples, reproduced on p. 179 alongside the corresponding section from the
Association of British Pharmaceutical Industries (ABPI) Voluntary Code.
Reservations about the IFPMA code were expressed even by some IFPMA
members. The Swedish manufacturers association, LIF stated: "The code is
unclear, unstructured and does not go far enough".(98) It is weakest in the area
of monitoring and enforcement which is limited to industry personnel acting as
"judges in their own cause". (99)
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