Bitter Pills:Medicines & The Third World Poor

for the needs of the majority of their members - the world's poorer nations. 3. WHO in particular should resist pressure to abandon its clear mandate to develop a UN-sponsored international code of drug marketing practices. 4. WHO should look for more allies in attempting to implement difficult programmes, both within the United Nations system and amongst nongovernmental organisations. In the interests of balance, it would make sense to give official NGO-status to bodies such as Health Action International so that the needs of the world's poor are represented alongside those of industry. NON-GOVERNMENTAL ORGANISATIONS Non-governmental organisations are in a unique position to help set up a productive debate on solutions to the problems of drugs in developing countries. 1. NGOs should make use of their special access to information to publicise examples of constructive policy initiatives being undertaken in both developing and developed countries to provide an incentive to others to follow suit. They also have a duty to make the public aware of obstacles to changes that could benefit the poor. 2. They should take every opportunity to cooperate with other NGOs, international agencies, professional groups, trade unions, industry and governments in pursuing constructive solutions. 3. Aid agencies and other charities should stop giving 'aid' that is not wanted and only supply Third World countries and projects with drugs that they specifically request. 4. Aid agencies, including OXFAM, should continue to fund community health projects that encourage self-reliance, avoiding high-technology medical options wherever possible. More should be done to support grass-roots research into problems related to the use of drugs in poor communities and into creating awareness of positive alternatives to medicines. OXFAM and other agencies should continue to allocate funds to improving the supply of essential drugs. MANUFACTURERS We focus on the contribution that can be made by drug producers based in the rich world. Action is of course just as urgently needed on the part of smaller national producers in developing countries whose marketing practices are often far less scrupulous than the major transnational drug companies. 1. Manufacturers should do nothing to obstruct attempts by Third World governments to introduce new drug policies designed to safeguard and promote better health, even when these conflict with industry's immediate interests. 2. Manufacturers should be consistent in the standards they apply worldwide - irrespective of loose controls in developing countries. Marketing practices that would be unacceptable in Europe and North America should be seen as equally unacceptable in developing countries. Companies should abandon the tired old arguments that inconsistant standards are not 'illegal' because a Third World country's laws make them permissible. Instead, rich world manufacturers should take a lead in encouraging higher ethical standards in 198

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