Bitter Pills:Medicines & The Third World Poor | Page 34

CHAPTER 3

PRODUCERS' MARKET
IN MOST countries, rich and poor alike, drugs are produced and sold by private
business. So even life-saving medicines are subject to normal market forces. In
developing countries the mass of the poor lack purchasing power, so they have
little impact on the dynamics of the drug market. Consequently, the type of drugs
marketed may bear no relation to a poor country's most pressing disease problems.
An Indian doctor puts the problem forcefully:' 'The drug industry, like any other
industry, produces only to the extent that drugs can be sold at a reasonable profit
in the mar ket, irrespective of the needs of the people. The majority of our
population is very poor. It is precisely this poor section that requires more medical
attention and hence larger quantities of drugs. But since these people do not have
money to buy the drugs, the industry... neglects this section of the populace.. .This
happens because the logic of present day society is such that production is geared
to the demand in the market, irrespective of the needs of the people." (l)
Scientists and managers within the industry are acutely aware that poor people
are deprived of vital drugs. Poverty is the main constraint and drug producers
are in no position to end poverty. The pharmaceutical industry acknowledges,
however,that it has "special" obligations "arising from its involvement in public
health". (2) In practice actual marketing policies are inevitably determined by the
demands of running a viable and profitable commercial operation. Companies
have workers to pay and shareholders that want a return on their investment.
A spokesman for the British drug industry did not mince words in explaining the
constraints on manufacturers: "You must understand that the reason multinational companies try to grab back as much profit as possible out of the less
developed countries is frankly because they are suspicious of the future stability
of their operations there." "I would just be talking rubbish if I were to say that
the multinational companies were operating in the less developed countries
primarily for the welfare of those countries... They are not bishops, they are
businessmen." (3)
Bearing in mind that there are business constraints, in this chapter we examine
how far the drugs marketed in poor countries are relevant to public health needs
- ultimately whether the drug market is contributing more to alleviate or to
perpetuate poverty.
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