Opinion: Local drug production in developing countries; Obama's PEPFAR changes

Sep 5 2009

Local Drug Production Doesn't Increase Access, Undermines Quality

The international community focuses on lowering drug prices as a means of improving access and "today its idea is local pharmaceutical production ... But while the German Government and other countries' aid agencies are helping fund small firms in Africa, they have failed to undertake any serious cost benefit analysis to determine the efficacy of such a policy," Roger Bate, a fellow at the American Enterprise Institute, writes in a New Ledger opinion piece. Although a drug industry can often be "a source of national pride, as well as a political opportunity," a majority of "developing countries do not have the local conditions necessary to tackle drug production" with the "exception of countries like India, South Africa and perhaps Nigeria," Bate writes.

To illustrate his point, he describes the situation of a new drug factory in Uganda, which is "struggling to get production going and is already asking for tariff protection, an extended tax holiday and further cash injections." According to Bate, "there are no simple solutions to improved access, other problems still need to be tackled more urgently - regardless of whether drugs are imported or made domestically," concluding that "[i]n the mean time, the donor community indirectly and African governments directly are undermining drug quality through their push for local production" (Bate, 9/1).

Obama's 'Realistic' Changes To PEPFAR

In new guidelines for 2010, President Obama's PEPFAR team "opened the way to linking AIDS work with strengthening of health systems generally, taking into account the development of human resources, maternal and child health, family planning and access to it for women, gender equality, malaria and tuberculosis, food and nutrition, education and local economies," which is, "in short, a holistic and realistic policy. It will matter because the United States is the world's largest contributor to HIV/AIDS relief, and Bush [administration] restrictions have had a deadening effect on many international programs," U.N. correspondent Barbara Crossette writes in the Nation.

Some developing country policies have left "grassroots women's health work ... desperately short of money and supplies. An estimated tens of millions of women who want contraceptives are unable to get them, or may have no choice beyond crude sterilization or unsafe abortion," Crossette writes. She quotes Wendy Turnbull, a senior policy research analyst at Population Action International, who said, "This is just a start … There is a lot of damage to undo. There is a lot of reinterpretation that needs to happen" (Crossette, 9/1).