Bitter Pills:Medicines & The Third World Poor | Page 201

CHAPTER 11
HEALTH NOW
Action for Change
OXFAM has no intention of leaving this report to add to the cubic metres of
analysis of the problems. It was written to highlight the distortions in drug
marketing as they affect the world's poor and to show that there are positive
solutions. But above all its purpose is to press for urgent action, and to demonstrate
that meaningful changes are conditional on attitudes and actions in developed
and developing countries.
An executive of one leading manufacturer gives his diagnosis of how changes can
be made to happen: "Health care has to be a partnership between drug suppliers,
governments and the medical profession, all acting in concert for the patients'
benefit. It is difficult to achieve this because of problems with each side of the
triangle. Provided dialogue takes place and there is understanding, tolerance and
a general desire to be helpful on all sides, a great deal can be achieved, but it will
nearly always be slow - too slow for many people." (l) Particularly, it must be
added, for the Third World poor. But the triangle has also to be opened up to
involve the patients - ordinary people as groups and individuals all have a crucial
role to play in pressing for action.
What follows is a prescription for some of the more feasible changes that need
to be made by governments, international and non-governmental organisations
and manufacturers.

THIRD WORLD GOVERNMENTS
Political will is the key determinant of success. It is obviously unrealistic to expect
manufacturers voluntarily to make either major changes in their current marketing
practices or special concessions to the needs of the poor, in situations where
governments are giving business interests priority over the health needs of their
people.
The exact measures that governments need to implement will vary a great deal
from one country to another depending, among other things, on what has already
been achieved. But the crucial policy options identified by many governments
and adopted by a few need to be acted on by all.
1. PREVENTION AND PRIMARY HEALTH CARE
Governments need to give preventive and primary health care services clear priority
over costly hospital building projects and conventional cure-orientated medical
training. A reallocation of health resources to benefit the poor majority has to
be put into deeds as well as words.
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