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.
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MAP posted-by: Derek