More on why donated drugs don't work

by Alanna Shaikh · 2009-01-15 06:08:00 UTC
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(photo credit: erix!)

I want to talk a little bit more about why donated drugs aren't the solution to improving global health. In the post where I brought it up, I mentioned the mismatch between supply and demand. The drugs we have leftover in developed countries are not the one that the developing world desperately needs. And when a recipient country is sent unnecessary drugs, safe disposal becomes a burden.

This isn't the only reason, though, that donated drugs aren't necessarily a good thing. It's the most obvious reason, so I highlighted it in my last entry. I think, though, that the most important reason not to depend on drug donations is about capacity.

A functional health system needs a steady drug supply. Medical care requires pharmaceuticals. They are as essential to the system as trained health care providers. You can't run a health care system based on sporadic donations. You need to have reliable sources of pharmaceuticals, a procurement system to purchase them, and a logistics structure to ensure that the drugs get to the facilities that need them.

Donated drugs can actually prevent a pharmaceutical supply system from getting established. Because they are free, there no incentive to stop using them. If a hospital is getting free shipments of Tylenol, they have no reason to start paying for locally produced acetaminophen. Ministries of Health don't budget properly for drugs if they are getting them for free.

In addition, providers and patients may assume international drugs are better, because of the more attractive packaging. American Tylenol in shiny red and gold boxes will be more appealing than generic Indian acetaminophen in bland white packaging.

There are ways to use drug donations well. They are an excellent source for expensive, rarely used drugs with clear protocols. Oncology drugs are one example of that. Carefully managed drug donations can serve as a temporary solution until a pharmaceutical procurement system is in place. Drugdonations.org has some advice on what careful management should consist of. And, of course, if a donor can commit to providing donated drugs forever, then sustainability isn't an issue at all.

Alanna Shaikh
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