Bitter Pills:Medicines & The Third World Poor | Page 39

the drugs available are of little importance in terms of essential health care and
they are marketed mainly because they can be sold and not because they benefit
the health of the population." (291
Throughout the Third World there is evidence that drug consumption habits have
been indiscriminately transferred from rich nations to poor. The causes have been
pinpointed by WHO. "In recent years many medicinal products have been
marketed with little concern for the differing health needs and priorities of different
countries. Promotion activities of the drug manufacturers have created a demand
greater than the actual needs." <30)
There are countless illustrations of distorted priorities in the type of drugs
manufactured and imported into developing countries. The value of vitamins and
tonics imported into North Yemen in 1980 was 17.8% of total pharmaceutical
imports. But only 1.3% of the total was spent on importing drugs to treat three
of the country's most widespread diseases - malaria, bilharzia and TB - affecting
an estimated 800,000 people.<3I) On one estimate, at least 65% of all imports are
for non-essential drugs, both placebos and symptomatic treatments for selflimiting conditions. (32)
The WHO Essential Drug List includes one cough suppressant: codeine. On the
drug market in the Philippines there are 162 different brands of cough
suppressants, and under a dozen are based on codeine. Spending on these cough
preparations represented 12% of total drug expenditure in the Philippines
in 1980. <33)
A 1977 report on local production in Sri Lanka by the Chairman of the State
Pharmaceutical Corporation underlines the distortion between what will sell and
what is needed in a market with 97% of local production controlled by just seven
manufacturers, five of them subsidiaries of leading transnationals. "Vitamin
preparations, soluble aspirin and cough remedies accounted for over 50% of
production. They were elegantly presented, heavily promoted and used by the
affluent. For example, the two largest firms made 18 different combinations of
vitamins with or without iron, which were swallowed by the well-nourished who
did not need them. The undernourished could not afford to buy them." IMI

MULTIVITAMIN TONICS
The quantity of multivitamin tonics marketed is just one illustration of the wider
problem of wasteful products that swamp the market in even the poorest countries.
In Nepal a 1980 study found that out of 2,000 different products on the drug
market, 733 - more than one third - were 'tonics'. Anaemia and malnutrition are
major health problems in Nepal, but as the report concluded, "Those who need
iron and vitamins can seldom afford to buy these expensive proprietary
preparations... A few inexpensive preparations of iron and vitamins could
effectively and easily replace the 733 formulations, and enormous savings could
be made as a result." (35)
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