Bitter Pills:Medicines & The Third World Poor | Page 203

revenue could be used to pay for the provision of independant drug information.
- Government departments responsible for administering and enforcing drug
policies should be adequately staffed and financed and their rulings should
be upheld by other ministries.
3. TRAINING
Governments will inevitably face opposition in implementing these drug policies
unless they concentrate on winning over the country's doctors as firm allies. This
can only be done if doctors and health workers understand what is at stake and
what governments hope to achieve. The best approach is to influence the attitudes
of health workers during training. Training should be refocussed and firmly rooted
in social and economic realities so that, instead of being taught curative approaches
to rich world diseases, Third World medical students learn their country's needs.
During training doctors and paramedics should be encouraged to concentrate on
prevention and appropriate non-drug treatments. All prescribers should also
receive a firm grounding in the economics of drug prescribing and the critical need
always to try the least expensive first-line treatment first. All health workers should
be sent manuals with advice on standard treatments for common health problems.
Efforts can also be made to influence the prescribing habits of practising doctors
by encouraging them to take part in refresher courses, and sending them regular
circulars on cost- effective prescribing.
4. HEALTH EDUCATION
Health authorities can use schools, the health services, community organisations
and the mass media to put over basic health education and challenge people's
dependence on drugs. For example, the message needs to be put across that it
makes more sense to spend money on a diet of nutritious local foods than to buy
imported vitamins. Health educators could usefully learn from commercial
advertisers to put their message across in a lively and compelling way.

RICH WORLD GOVERNMENTS
Governments of developing countries are far more likely to succeed in
implementing new drug policies if they can count on the goodwill and active support
of rich world governments, particularly those of the major drug producing nations.
1. Rich world governments should increase their financial support to UN
programmes that are designed to cater for the needs of developing countries,
especially important initiatives such as the WHO Action Programme on
Essential Drugs.
2. Having voted unanimously in support of the May 1982 resolution urging
that the WHO Action Programme on Essential Drugs be implemented "in its
entirety", rich world governments should make sure that it is. In particular
they should not try to obstruct WHO from acting on mandates they have already
given it such as the need to start work on the development of an international
code of drug marketing practices.
3. The British and other major drug producers should actively support European
initiatives to improve cooperation between the regulatory agencies of developed
and developing countries. They should, for example, back the proposals of
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