The Pharmaceutical Journal
Vol 270 No 7249 p680
17 May 2003

This page
Reprint
Photocopy

PDF* 62K

  The industry
  Medicines management
  The Register
  CPD
  Supplements

Letters to the Editor

The industry

Conditions in the developing world could deteriorate

From Dr N. D Harris, FRPharmS

Umesh Patel in his letter “Lucrative me-too drugs a priority” (PJ, 10 May, p648) is taking an all-too-common, simplistic view of the pharmaceutical industry. Apart from the fact that “me-too” drugs provide a useful income flow to fund research, they also help to drive down prices, to everyone’s benefit.

More importantly, I have serious reservations about the way in which aid to developing countries, including non-profitable orphan drugs, is currently approached.

When an effective antimalarial vaccine is available and delivered in the fairly near future, I am afraid that no one will have done any real planning for the consequences. The fundamental problem is that defeating malaria and other infectious diseases, and providing clean water, safe and adequate food supplies, etc, will produce a dramatic increase in the demand for currently scarce resources. This is because the greatest impact will be on children and the elderly, who are the most vulnerable sections of any society. These groups are also the principal consumers of special medical and nutritional care.

Clearly, the preservation of life and improving its quality are highly desirable outcomes, but the increase in the proportion of young, fertile individuals in the population will inevitably rapidly lead to a massive population increase, ultimately doubling every 20 years, if the demographers are right.

Unless there is a major investment in the whole infrastructure — doctors, nurses, teachers, houses, food supplies, transport, etc — simultaneously with effective administration of any public health measures, the only outcome will be even more people living in misery. Although this cannot be a reason to deny improvements in public health, it seems likely that the total investment required will be much greater than that of relatively simple measures such as malaria eradication and the provision of clean water.

I am a natural optimist, not a doom merchant, but unless we foresee the consequences of any intervention and manage change carefully there will be a desperate deterioration in conditions in the developing world — our present famines will pale in comparison. I have seen no indication of a debate on these issues or, notably, on how the resources will be provided.

Norman Harris
Emeritus Reader in Pharmaceutics,
King’s College London

Defending the indefensible

From Mrs P. M. Armstrong, MRPharmS

Defending the indefensible From Mrs P. M. Armstrong, MRPharmS I was appalled by what I saw on the recent Channel 4 documentary “Dying for drugs”. However, I was even more appalled by the editorial comments in defence of the pharmaceutical industry in your issue of 3 May (p602).

We all know that the pharmaceutical companies make huge profits and, indeed, only concentrate their research in areas where they know that a “breakthrough” or a “me-too” drug in a large market will bring in large profits. To defend the exploitation of poor, sick people in developing countries was nauseating. Using victims of disease as guinea pigs for their new drugs and then denying them the life saving treatment they have been used to test is inhumane. We are supposed to be a caring profession. How can we in conscience defend the excess profits made by these companies, when so many sick people cannot afford the drugs that could make them well?

Of course, having clean water and better housing, cancelling debt and eliminating corruption would vastly improve the health of those people. This is a political requirement and not an excuse for the bully-boys to cream off more profits. The fact that GlaxoSmithKline could halve the price of Combivir in 63 countries the next day tends to prove the point against them and in no way shows any philanthropy.

It was ironic that the top news item on the facing page of The Journal said that 76 per cent of a 50-member panel of pharmacists believe that the price of emergency hormonal contraception in this country is too expensive for teenagers.

Patricia Armstrong
Salisbury, Wiltshire

Send your letter to The Editor

Next Topic (Medicines management)