Bitter Pills:Medicines & The Third World Poor | Page 47

A number of multivitamin preparations can be highly wasteful because they
contain amounts of vitamin far in excess of what the body can absorb. Commenting
on one multi-ingredient "geriatric preparation" that Fisons has marketed in
Bangladesh, a British Professor of Clinical Pharmacology (who is also a member
of the Committee on Safety of Medicines - the British Drug Regulatory Agency)
expressed the view that it is "inconceivable that Decatone would receive a Product
Licence for sale in Britain". (68) We understand that Fisons (UK) have said that
this product was withdrawn from sale in Bangladesh in 1979, although this has
not been confirmed to us. (691
Another Fisons' product that is not marketed in Britain, but has been widely sold
in Bangladesh, is Digeplex - a liquid preparation of two digestive enzymes and
some vitamin B-complex. The advertisement reproduced here claims that: "Its
vitamin B-complex content will correct the underlying deficiencies which are the
basic cause of digestive disorders. Digeplex gradually helps the patient in building
up the natural emzymes." In the opinion of a British doctor this is a ludicrous
claim with no scientific basis. |70) Another British doctor, Dr. Schweiger, who has
worked in rural Bangladesh, is concerned about the widespread use of Digeplex
for any abdominal complaint. He points out that "Gastric ulcers are already very
common in Bangladesh... do you really want to put pepsin into such an ulcer?
It will only make it worse." (7I)
Commenting on the range of products manufactured in Bangladesh by Glaxo
and Fisons, Dr. Schweiger concludes: "Bangladesh is a poor country and can
ill afford to spend foreign exchange on non-essential items. The nutritional
problems of the poor will not be solved by expensively packaged multivitamins
which will only divert limited resources from other more relevant purchases." |72)
The comments received to date from Glaxo and Fisons on their product range
appear at note 73. However, in our view, these do not provide a full answer to
our criticisms.
Of course, the two British companies, whose product range we have studied in
some detail, are not alone in marketing non-essential medicines in Bangladesh.
Both the locally-owned companies and other foreign manufacturers are selling
products of little relevance to the country's needs.
In terms of sheer numbers of different brands of cough syrups, tonics and other
over-the-counter products, most are marketed by the national companies.(74) But
by value the products that sell best are those of the transnationals. Amongst the
top-selling tonics are Squibb's Verdivitone Elixir and Hoechst's Polytamin Tonic,
the latter described in the May 1982 Expert Committee Report as a "combination
vitamin tonic including vitamin B12 and alcohol; one of the most abused drugs
on the market". (75) Hoechst argue in support of Polytamin that "Bangladesh
is in a chronic state of malnourishment, the vital supply of polyvitamins is essential
in countries where a balanced diet is not available"; and that "The ready-for-use
liquid formulation is essential for those countries where safe drinking water supply
is not available". (76)
40