Issues of life and death - January, 2003
Medical debate in the humanitarian world.
When a crisis hits the world stage, it’s easy to reach, with the best will in the world, for a donation of medicine. Surely this is an ideal response? Or is it?
“We consider a gift of donated medicine a poison gift”, said a medical worker recently. “If the manufacturer doesn’t want to make it available for his customers, why should we want to do so for people in need?”
Strong words. Are they fair?The World Health Organisation reports, “Of all drug donations received by the WHO field office in Zagreb in 1994, 15% were completely unusable and 30% were not needed.” Others cite similar outcomes of donated medicine.
A solution – WHO Guidelines
One of the most respected guidelines for drug donations is published by the World Health Organisation (WHO). Revised in 1999, these guidelines have been successfully implemented in a number of developing countries. They are also recommended by many international medical organisations. The Journal of Humanitarian Assistance, a medical journal, says that the WHO guidelines helped reduce the percentage of unusable donations from up to 50% to an estimated 10% in 1994.
The date issue
That is no light claim. Yet not everybody agrees with the WHO guidelines. Some have reacted against them.Their stipulation on expiry date, for example, has raised eyebrows in certain quarters. They recommend twelve months as a minimum time before expiry date. A large pharmaceutical association (IFPMA) states that"the guidelines set unnecessarily specific requirements for the remaining shelf-life at time of receipt of donations which, if rigidly applied, could mean the loss of a large proportion of valuable donations from industry." In fairness, the WHO guidelines do, in fact, also allow for exceptions. To quote,“An exception may be made for direct donations to specific health facilities.”
Practical advice on managing drug and medical product has also been documented by a medical donations network (PQMD). These guidelines are consistent with the WHO guidelines, simply providing more detailed information.Other groups are calling for more standards to be developed.
World Health Organisation (WHO) – Guidelines for Drug Donations .
“Many other organisations including UNICEF, UNHCR, the Red Cross, the World Council of Churches subscribed [to the WHO guidelines]”, according to WEMOS (see the section in their website on Pharmaceuticals:
Others who recommend the WHO guidelines include Interaction ), New Zealand health authority, and Drug Donations ).
The Partnership for Quality Medical Donations