Drug donations cause health and economic problems
Inappropriate donations hinder the work of health staff |
In an emergency situation, drug donations are useless — they cause additional public health problems for the affected population and economic problems for the country, a report by the humanitarian organisation Pharmaciens Sans Frontières (PSF) concludes.
Shortly after the tsunami in South-East Asia, PSF reported that tonnes
of inappropriate medicines were arriving in the region (PJ, 5 February
2005, p139). Between 20 May and 20 July 2005, it carried out a survey,
funded by the World Health Organization, to assess the usefulness of
drug donations for the population living in the tsunami-affected districts
of Aceh Province, Indonesia. The survey targeted health centres, hospitals,
pharmaceutical warehouses, ports and airports, and national and international
non-governmental organisations.
Although no drug requests had been made, the survey revealed that 4,000
tonnes of drugs were received for a population of two million. Drugs
were donated from 53 Indonesian organisations, 48 international organisations
and 39 foreign governments. Of the drugs donated, 60 per cent were not
on the national list of essential drugs, 70 per cent were labelled in
a foreign language, and 25 per cent had an inadequate expiry date.
Excessive quantities of appropriate drugs, such as oral rehydration salts,
dextromethorphan and tetracycline, also arrived and, based on the current
rate of consumption, will not be used before their expiry dates.
Storage capacity in the province was greatly reduced by the tsunami and
nearly half of health personnel died. The survey found that this has
led to drugs being stored in offices, corridors, patients’ rooms
and outside in courtyards and sheds. “Such conditions of storage
cannot guarantee the quality of drugs. In addition, overcrowding greatly
hinders the work and movements of health staff and patients in hospitals
and health centres,” says a report of the survey results.
Waste disposal is a further issue. The survey revealed that about 600
tonnes of donations need to be destroyed due to inadequate expiry dates.
The PSF estimate that the cost of disposal will be about €2.4m.
The PSF acknowledges that many organisations are trained and prepared
for immediate action after a disaster, but says that in the post-emergency
phase technical support should be provided by pharmaceutical experts
to the health authorities of the recipient countries. “The objective
is to assess what the actual needs for drugs are, as well as drug storage
needs, drug distribution needs, and training needs for local health professionals,” it
says. The PSF recommends that good drug donation practices should be
mandatory for all donor organisations. The “Guidelines for drug
donations”, published 10 years ago by the WHO, should be included
in the national drug policy of countries and should be internationally
regulated as a public health protection measure, says the report. |
The
Pharmaceutical Journal
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