Bitter Pills:Medicines & The Third World Poor | Page 193

problems that arose has been provided by Dr. Sanjaya Lall of the Oxford Institute of Economics and Statistics and the late Professor Bibile of the University of Sri Lanka and former Chairman of the State Pharmaceutical Corporation. (128) In 1973 the Government of Mrs Bandaranaike announced its new "34 Drug Programme" under which the State Pharmaceuticals Corporation (SPC) would centralise procurement of the chemical intermediates needed for local formulation of 34 drugs. A central aim of the new policy was to cut down on the high transfer prices manufacturers were paying for imported raw materials. <1291 From the outset the US Pharmaceutical Manufacturers Association were resolute in their opposition to the new policy. On 10 May 1973 their President, Joseph Stetler, wrote a six-page letter to Mrs Bandaranaike raising detailed objections to the new policy. Mr Stetler stated: "These actions, if implemented, would effectively destroy operations of the modern research-based pharmaceutical industry in Sri Lanka by removing all business incentives and internationally respected property rights. By so doing, the plan would call into question the Government's attitude toward any future private investment in the country." (l30) (our emphasis) Lall and Bibile claim that: "A widespread ... campaign of denigrating low-cost supplies was launched. And a second source of opposition, the private practitioners, were drawn into the campaign. Reports were made of drugs being ineffective, substandard or toxic, but little hard evidence was produced." (l31) According to Lall and Bibile seven small local producers responded favourably to the new programme but all five foreign subsidiaries initially showed resistance. Glaxo was the first to accept the programme in principle; Pfizer the last. In Pfizer's case at least this agreement was a different matter from practical cooperation in implementing the policy. Lall and Bibile quote the then Managing Director of the SPC: ".... the SPC made an urgent appeal to Pfizer to make tetracycline capsules required in the cholera epidemic (in 1974) and offered quality tested raw materials and capsules."(l32) Pfizer was asked to use raw materials purchased by SPC from a reputable supplier - the leading West German manufacturer, Hoechst. Lall and Bibile attribute Pfizer's reluctance to agree to this arrangement to the fact that they had been importing tetracycline from their parent company at almost five times more than Hoechst's price. (133) According to the Managing Director of the SPC, the outcome of the resulting delay during the cholera epidemic was "that the Hoechst tetracycline lay unused in SPC stores and Pfizer equipment lay idle, while capsules had to be airlifted to the country at enormous expense".(l34) Subsequently, the SPC and the Ministry of Industries recommended that Pfizer should be nationalised to ensure its compliance with the new policy. But powerful bargaining counters were brought into play. According to Lall and Bibile, "The reaction of the US was swift, and as it turns out, decisive in preventing such a measure. The US Ambassador personally intervened with the Prime Minister in the matter, and .... we can only speculate as to the nature of his intervention .... The Chairman of the SPC was ordered to 'continue negotiating' with Pfizer; no further disciplinary action was taken."