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Contributions from
the Column
Studies and reports
World Bank: Only poor countries have reformed
State-centricity is the problem
Deciding on the Food Aid Convention’s future
“Poor choices for poor countries”
02/2005 |
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[ German pharma exports ]
“Poor choices for poor countries”
The German pharmaceutical industry was the world’s top exporter in 2003, with exports valued at more than 21 billion Euros. Since the mid-1990s, German drug manufacturers have nearly doubled the volume of drugs they export. While it is true that only a very small share goes to the poor countries of Africa, Asia and Latin America, a disproportionate number of the drugs supplied to developing countries, or manufactured there by German companies, are of no help at all. Based in the German town of Bielefeld, BUKO Pharma-Kampagne is an independent NGO concerned with health policies. According to a recent BUKO study, 39 percent of German medications sold in poor countries are unnecessary, dangerous or do not meet basic criteria for rational drug use.
The document analyses and evaluates the range of drugs offered by 33 German companies in 46 countries. Three quarters of all of the drugs classified as unnecessary or dangerous were not available in Germany, and some of them were even banned. German drug laws do indeed prohibit the export of drugs, which are considered questionable in Germany. But there are several legal loopholes. According to BUKO, manufacturers can simply relocate production abroad or export semi-finished, unpackaged products. BUKO states that 85 percent of the products sold abroad by German manufacturers bypass export controls. In turn, the control authorities in most developing countries are said to be too weak to monitor the drug market.
BUKO’s study contains many examples of questionable drugs, with which German companies make money in developing countries. Almost half of the products criticised are “combination medicines” that compound several active ingredients. Many drugs contain up to twenty different substances. BUKO compares this to Germany, where combinations of more than three active ingredients are deemed to be irrational and are ruled out by health insurance providers. According to BUKO, vitamins and energy supplements particularly often contain combinations of active ingredients.
The gulf between rich country standards and the marketing practice of German companies in developing countries is particularly striking in the case of painkillers. For example, BUKO stresses that drugs containing metamizol have been banned for a long time in many advanced nations, including Britain, the USA and Canada because of dangerous side effects. In Germany, metamizol may only be prescribed in the case of otherwise “uncontrollable” pain. Boehringer Ingelheim, a manufacturer, has replaced metamizol with paracetamol in its product Buscopan compositum a long time ago, BUKO reports, but is still selling the dangerous version in poor countries. Aventis is even marketing its metamizol-based drug Novalgin for children and babies in India, BUKO complains, whereas Bayer is said to sell a fruit-flavoured aspirin in Brazil specifically for children: Aspirina Infantil. In Germany, however, the packaging information clearly states that Aspirin should only be given to children “if all other medicines have failed”. (ell)
Further information:
http://www.bukopharma.de/English/english/poorchoices.htm
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