[e-drug] Medicines advertising on TV (cont)

["Ans Timmermans" <anst@theIRC.org>]

E-drug: Medicines advertising on TV (cont)
---------------------------------------------

Dear Martin and other e-Druggers,

Your perception of this alienation from newly developed drugs does 
not sound unfamiliar.
Although I have originally been trained as a hospital pharmacist, 
just like you, working in humanitarian aid in the past years did also 
place me in a similar situation. I cannot say that I am on top of all 
the latest developed drugs of the so called  'lifestyle'  diseases as 
you put it, but I am more trying to follow what is in the pipeline 
for the more neglected diseases like TB, malaria, childhood 
illnesses, etc.

This is for a number of reasons, of which the most important is time 
constraints of course. Another reason is limited access to unbiased 
information especially in remote areas,  but also by working in the 
public health field, most of these newly developed drugs are not 
relevant to our beneficiaries (at least not for today). They are 
developed for �life-style' diseases, sometimes their extra value is 
too limited to justify their increased price, and they are only 
targeting a minority of people who can afford them.  As a pharmacist, 
I want to know about all drugs that arrive on the market, but as a 
public health worker, I must make a choice of where to invest most of 
my time in.

I do not want to go into the discussion of who the good and the bad 
guys are, since I believe that giving people access to drugs is about 
working on a package of solutions that should be a done from a 
partnership, where the pharmaceutical industry is involved in as 
well. They are as much part of the solution, as of the problem.

However I just want to repeat a few well-known facts from MSF and WHO 
that provide a reason for the focus of my attention.
Of the 1223 new drugs that were introduced between 1975 and 1997, 
only 13 have been specifically developed to treat tropical diseases 
(Background of Access to Medicines Campaign, MSF website), while next 
to HIV/AIDS, TB, malaria and diarrhea are the major killers in the 
developing world.  These diseases are causing death tolls that make 
these diseases next to a health problem/disaster, also an economic 
and social disaster. Although access to drugs is reported to be 
improving, still one third of the world's population lacks access to 
essential drugs. People in developing countries spend most of their 
household budget on drugs, very often bought in the private sector 
with little assurance about drug quality, which is keeping poor 
people in a downward spiral of impoverishment. Many developing 
countries do not have a national drug policy or a functional drug 
regulatory authority to protect their consumers. Less than one third 
of developing countries benefit from effective drug regulation, and 
this against a globalization of the drug trade.

According to a number of surveys in developing countries, 10 to 20% 
of sampled drugs fail quality control tests (WHO Medicines Strategy 
2000-2003).  I think as NGO workers, we should keep on addressing 
these issues to the international community while trying to build the 
capacity of the pharmaceutical system of the countries we are working 
in, and this in an atmosphere of collaboration with all partners and 
recognizing each other's strengths and limitations.

To get back to your question whether these drugs are essential or 
not, in short I would say that technically, according to the WHO 
definition of essential drugs, they are not essential for the world's 
population since they are not satisfying the health care needs of the 
majority of the population and they are not available at all times or 
in the appropriate dosage forms. However, if you look at essential in 
a particular setting with a particular disease pattern, level of care 
and training of health care workers and financial resources 
available, these drugs may become essential for certain groups of 
individuals, so I guess it depends on the level of care you wish or 
you can afford to provide to individuals without taking away 
resources to treat larger groups of the population you are serving.

Nevertheless, I always appreciate any suggestions from other 
e-Druggers for how to be updated of new drugs on the market in the 
most time-efficient way,

Best wishes,

Ans Timmermans
Pharmacist
International Rescue Committee
www.theIRC.org
"Ans Timmermans" <anst@theIRC.org>
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