Drug Dumping

Drug dumping occurs when useless or dangerous pharmaceutical products are donated to developing countries, especially after a humanitarian disaster. Aid workers argue that medical staff can spend up to 70% of their valuable time sorting out the donations.

The scale of the problem

One-third of the world's population has no access to essential medicines. In the poorest parts of Africa and Asia, this figure rises to 50%. This year alone there will be over 40 million deaths in developing countries, and a quarter of these will be due to acute respiratory infections, diarrhoeal diseases, tuberculosis and malaria – all conditions which can be cured if only the medicines and healthcare were available.

US Tax regulations

US tax legislation is designed to encourage pharmaceutical companies to make ‘gifts in kind’ to the developing world. However, this often acts as an incentive for inappropriate donations, and even for the pharmaceutical companies to pursue their own interests, often at the expense of the healthcare of the developing world.
Compliance with the World Health Organisation guidelines for essential drugs is not included in the criteria for deciding tax break eligibility.

What is going wrong?

• Medicines which are mainly used by the poor are withdrawn from production as there is no profitable 'market' for them - it is much more profitable to develop new treatments for baldness and impotence than it is for African sleeping sickness.
• Large-scale donations to charities from pharmaceutical companies may be made for a number of reasons. A product may not be selling well; the company may want to get rid of unwanted stock; products may be ending their shelf-life. Donating these drugs allows the company to avoid the expensive process of disposal.
• Donated drugs are often not relevant for the emergency situation, disease pattern or level of care. They may be unfamiliar to local health professionals, and may not comply with locally-agreed drug policies.
• Many donated drugs arrive unsorted and labelled in unknown languages, wasting charity workers' valuable time in sorting and translating.
• The quality of drugs is not guaranteed: they may have expired, or be free samples.
• Donor agencies sometimes ignore local administrative procedures for receiving and distributing medical supplies.
• Drugs may be donated in the wrong quantities and stocks may have to be destroyed, which is wasteful, time-consuming and expensive.

In conclusion, many donations of drugs are made based on the needs of the pharmaceutical companies, not on the needs of the recipients, and may have a negative rather than a positive effect.

A success story

Merck's Iverectin Donation Programme:
Since 1998, Merck & Co have donated Mectizan to over 25 million people in 31 countries to treat onchocerciasis (river blindness), through a programme with the World Bank, WHO, many NGO's and the UN. It has been hailed a success because of its sustainability, and the company has said that it will continue the programme until the disease is eradicated.

The tax system should be amended to reward companies for these kind of long term, WHO-led, sustainable donations.

Some failures

• “We estimate that 50% of the drugs coming into Albania donated by non-medical organisations are inappropriate or useless and will have to be destroyed. We are very concerned that some pharmaceutical companies are using this humanitarian crisis to get rid of unwanted stockpiles.” WHO press release on 30/06/99.
• In Eritrea in 1989, during the war of independence, seven truck loads of expired aspirin tablets arrived, which took six months to burn. (Source: Drug Donations
• 70% of medical aid sent after the Venezuelan floods of 2000 had to be incinerated as they were dangerous and inappropriate. (Source: British Medical Journal, 06/2000)
• During the Sudanese famine, inappropriate medicines sent in the aid effort included contact lens solution, appetite stimulants and expired antibiotics. Furthermore, the labels were written in French – a language not spoken in Sudan. (Source: Drug Donations
• East Timor’s underfunded healthcare system relies heavily on foreign aid, however donor recipients receive machinery that is highly inappropriate, too expensive to operate, requires unavailable additional technology and specially trained staff. Dili National Hospital has received products to treat cancer and cardiovascular diseases which rarely affect the Timorese, simply because they are out of date by Western standards. Conversely, the equipment is too modern and the people are not trained to use it, so there is lots of expensive equipment that cannot be used. (Source: New Internationalist Magazine)
• It is not just medical aid that is sent inappropriately; a doctor working in a hospital in Malawi was shocked when the hospital he works in was ‘donated’ three boxes of breast implants! (Source: War on Want)

What you can do

See War on Want's document outlining recommendations that would help the problem. For example, tax credits should be geared towards providing the medecines actually needed on the ground; and UK pharmaceutical companies that intend to take advantage of deductions in tax bills due to donations should list the donation publicly on their annual accounts.
Lobby your MP about these issues. Write to pharmaceutical companies, demanding that these recommendations are implemented. If they do not support War on Want's recommendations, use your consumer power and boycott their products - most pharmaceutical companies also make shampoos, soft drinks etc.