Bitter Pills:Medicines & The Third World Poor | Page 241

Chapter 6
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Yudkin, 1980, op. cit. Of course manufacturers do not agree: "Novalgin (dipyrone) is still
an irreplaceable analgesic having a wide therapeutic profile encompasing excellent analgesic,
spasmolytic, antiinflammatory and antipyretic activity". (Dr R. W. Timmers and Dr C. G.
Roepnack, Hoechst, West Germany, personal communication, 22 March 1982.)

95

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96

In early 1982 an expert advisory committee proposed that pyrazolone products such as dipyrone
should be placed under prescription only regulations. This was subsequently altered to apply
to injectables only. (SCRIP No. 679, 29 March 1982.) 70 manufacturers and 162 products
are affected by the new proposals. Decisions on a further 1,000 plus combination products
areawaited(SC7?/PNo.685,19 April 1982). Hoechst objection: "The authorities justify these
measures by saying that there are grounds for believing that ... metamizole (dipyrone) can
cause agranulocytosis and shock. We have repeatedly pointed out that the available data do
not in any way justify measures as severe as those the BGA is now requiring. Reliable figures
on the - much overestimated - frequency of the adverse reactions will be available next year
from the Boston study on agranulocytosis and aplastic anaemia." (SCRIP No. 689, 3 May
1982.) Also Timmers and Roepnack, personal communication 22, March 1982, op.cit.

97

Dr. K. Balasubramanian, UNCTAD, "Drug Policies in Third World Countries", paper
presented at the International NGO Seminar on Pharmaceuticals, Geneva, 27-29 May 1981.

98

Brudon, op.cit., pp. 195-6.

99

Hoechst have sent us the product inserts for Novalgin (for Bangladesh) which contain a warning
in red in English: "The drug may cause fatal agranulocytosis." From our research drug-sellers
had no idea of any safety warnings. 'Agranulocytosis' meant nothing to most.

100

Dr. H.K.M. Hye, while Director Drugs Administration, personal communication, 10 August
1981. Novalgin a nd other dipyrones are included in the drugs recommended for withdrawal
in the 1982 Expert Committee Report: "Evaluation of Registered/Licensed Products and Draft
National Drug Policy, May 11, 1982", Dacca, Bangladesh.

101

I'riscilla Annamumhodo. OXIAM, "Medicines in Upper Volla". Ouagadougou, 1980. (mimeo)

102

Dr. Tony Klouda, OXFAM Medical Adviser Tanzania, personal communication,
11 September, 1981.

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104

Dr. Ann Hoskins, op. cit., p. 10.

105

Institute of Development Studies Health Group, Health Needs and Health Services in Rural
Ghana, Volumes 1 and 2, IDS in collaboration with ISSER, University of Ghana; NHPU,
Ministry of Health, Government of Ghana and Department of Community Health, Korle Bu;
IDS, Brighton, June 1978.

"Drugs for Human usecontaining Dipyrone", Federal Register, 1976, quoted in WHO
Drug Information Bulletin, January-March 1977.
Martindale: "Its (dipyrone) use is justified only in serious or life-threatening situations
where no alternative antipyretic is available or suitable." (p.191)

Dr. Hassani, private practitioner and director of Norwegian SCF clinic, Ibb.ininteview
with the author, September 1980.
Dr. Ann Hoskins, British Organisation lor Community Development, discussion paper
from the BHS Drug Committee on the problems of drugs in Yemen, May 1981, p. 10.

106

Ibid.

107

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108

Dr. Mira Shiva, Voluntary Health Association of India, personal communication, 24 August
1981.

Mohammed Nurul Islam, Fisons (Bangladesh) Marketing Manager, in interview with
the author, 26 September 1980.
Dr. H.K.M. Hye, personal communication, 10 August 1981.

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