Pubdate: Mon, 02 Dec 2002 Source: Sun.Star Cebu (Philippines) Copyright: 2002 Sun.Star Contact: http://www.sunstar.com.ph/ Details: http://www.mapinc.org/media/1690 Author: Isolde D. Amante OVER THE COUNTER AND INTO THE WOODS THERE is another sort of drug problem, the one that won't be licked by sending pushers to death row or searching jail visitors' every cavity for smuggled packets of shabu. That other drug problem has many faces, including this: each day at one private hospital's intensive care unit (ICU), the nurses hand out two lists, both of them grim, to the patients' families. One is a partial billing statement; the other, a shopping list of drugs and medical supplies the patient needs for the next day. As these families are already anxious to begin with, the practice might strike some as callous. I found it pragmatic and, in its way, kind. Drugs from the hospital's pharmacy are, in nearly all cases, 30 to 40 percent more expensive than those in the surrounding drugstores. When the ICU bills can run up to P30,000 a day, families without money to burn welcome the chance to buy the same drugs for lower prices outside the hospital. But here's the catch: how do you know your drugs are real? The World Health Organization (WHO) estimates that one in every 10 drugs is fake. There are documented cases of meningitis vaccines found to contain nothing but tap water, or a paracetamol syrup whose active ingredient was industrial solvent. In 1995, researchers gathered close to 1,400 drug samples from 473 drug stores in the Philippines and found that eight percent of the drugs were fake, while 11 percent of the drug stores "wittingly or unwittingly"displayed these useless drugs on their shelves. In theory, only drugs that are essential, safe and effective should be allowed in the market. But the experience in developing countries has shown international market forces, left unchecked, do not guarantee that health needs are met. Consider how affluent societies are awash in non-essential medicines that are supposed to restore sexual vigor, inflate breasts or vaporize fat, yet faceless thousands in poorer countries die for want of safe drugs against malaria and tuberculosis. According to United Nations Development Program statistics, the Philippines belongs to the bracket where 50 to 79 percent of the urban populations have access to essential drugs. This places us in the same boat as Myanmar and Laos, but well out of the league of Vietnam and Indonesia's 80 to 94 percent, or Brunei and Singapore's 95 to 100 percent. Still, there may be hope for us yet. Two years ago, the Department of Health began an importation program that sought to make available, at least in government hospitals, branded medicines that were cheaper because they were bought wholesale -usually from countries that held access to medicine as more important than the patent protection demanded by multinational drug companies. (For this program, the health department promptly got dragged to court by the Pharmaceutical Health Care Association of the Philippines.) There are many things that can be done by communities, starting with local health boards and media. These include helping the Bureau of Food and Drugs (Bfad) by disseminating regular advisories on banned or fake medicines. Along with the private sector, these health boards can consider investing in local testing facilities, where consumers can bring complaints about drugs they've purchased but found ineffective. (The lack of inspectors and testing facilities is an old Bfad complaint.) Pharmaceutical companies, beyond organizing PR-friendly medical missions, can be required to reinvest a portion of sales into research and development, particularly on "neglected" diseases. This, of course, will require a concerted consumer lobby. (The founder of a local company that produces generic drugs once remarked that the opposition mounted by the pharmaceutical industry to the Generics Law was much greater than when the Marcos regime tried to place medicines under price control.) The National Bureau of Investigation 7, in its raid last week, accomplished more than just protecting consumers from useless and potentially harmful drugs. It reminded us to pay attention to the other drug problem - just as profitable as the trade in illegal narcotics, but perhaps an even larger public menace. - --- MAP posted-by: Derek