Bitter Pills:Medicines & The Third World Poor | Page 45

digestants, antacids and psychotropic drugs make up 33% of the market. By
contrast, on these estimates, antibiotics, antiparasitic drugs and skin preparations
for treating some of the country's major public health problems together account
for under 23% of the market. (60) Market estimates drawn up for the previous
year by another foreign company set the share of the market for vitamins and
tonics alone at 30%, with a further 8% for tranquilisers, anti-depressants and
sedatives. |6I)
An expert committee reviewing the Bangladesh drug market in May 1982 concluded
that of total drug expenditure in the country, "Nearly one third .... was spent
on unnecessary and useless medicines such as vitamin mixtures, tonics, alkalisers,
cough mixtures, digestive enzymes, palliatives, gripe water and hundreds of other
similar products". (62)

NON-ESSENTIAL AND NOT SOLD IN BRITAIN
An analysis of products marketed by the subsidiaries of two leading British
manufacturers with factories in Bangladesh reveals a product range top-heavy
with drugs that are not relevant to priority needs. Full details of products listed
in the 1981 price lists of the Bangladesh subsidiaries of Glaxo and Fisons appear
as Appendices II and III. Only a quarter (14 out of 56) products marketed by
Glaxo (Bangladesh) Limited and as few as 4 of the 31 products of Fisons
(Bangladesh) Limited are formulations included in the WHO Selection of Essential
Drugs. (631
No less than 22 of Glaxo's range of 56 pharmaceutical products listed in the 1981
product list are vitamins and tonics. Only 3 of these are brands marketed in Britain
and only 2 are basic formulations of vitamin A and vitamin B-complex. Most
of the 19 extra vitamin products they have chosen to market in Bangladesh are
"fruit-flavoured" and "sugar-coated" multivitamins and mixtures of
multivitamins and minerals. Vitamin B12 which is an essential drug has been
promoted by Glaxo in Bangladesh for non-essential uses as a general tonic. ( M |
Of Fisons' 31 products listed as available in Bangladesh in 1981, less than a dozen
are formulations marketed in Britain. Over half are vitamin, calcium and mineral
preparations, only 2 of them single-ingredient preparations of folic acid and iron
dextran that are conside red essential by WHO. There are two antacids; one brand
of aspirin and one of paracetamol; two cough preparations and two inappropriate
antidiarrhoeals - one containing clioquinol - a drug that can have serious toxic
side-effects crippling to the nervous system. (651
Framycort ointment and Framygen Eye and Ear Drops marketed by Fisons in
Bangladesh include neomycin sulphate. But in Britain the formulation of these
products is different, as they contain framycetin sulphate instead of neomycin
sulphate. l661 Some experts have expressed the view that "the rare but potentially
serious adverse effects of neomycin in skin products makes it unacceptable,
particularly because it has not been proven effective in such products". (67) (our
emphasis)
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