Posted by: afedorova | 11/22/2010

NO ONE WANTS YOUR UNUSED VIAGRA: How medical donations can be more trouble than help

Every year, companies and private individuals donate tons of drugs and medical equipment with the aim of helping people who lack access to medication and care and/or people struck by a disaster. While it is true that the needed drugs and medical supplies can and often do save lives, unregulated and mismanaged donations often cause more trouble than help.

Many countries lack quality medicines and medical supplies. Medical donation is one way of getting medicine to those who can’t afford it and are in urgent need. When well managed, such donations can be extremely beneficial. The Merck and Co., Inc. Mectizan Donation Program to fight river blindness and the Johnson & Johnson donation of Mebendazole to treat and prevent soil-transmitted helminth infections are great examples of successful medical donation programs.

Medical donations are also necessary when a natural disaster strikes and the need for medical care and treatment rises exponentially. However, disaster response is a largely unregulated industry and medical donations to disaster-stricken areas often lack the careful management of thoughtfully planned programs, at times causing more problems than they relieve.

In 2004, in the aftermath of the Indian Ocean tsunami, the world demonstrated great generosity and the donations flowed – everything from partially used ointments, prescription medicines, and drugs near expiration to books, clothes and toys. A French aid organization, Pharmacists Without Borders conducted a study of this “second tsunami” in Indonesia. Their findings showed that, although officials did not request medicines, 4,000 metric tons were received. Some were potentially beneficial, e.g., there were multiple-year supplies of antibiotics, but there were also palette loads of drugs unknown to health care providers. Seventy percent of it was labeled in a language that locals did not understand. Eighty-four percent of the facilities where drugs were being stored lacked air conditioning, rendering the contents unusable. A large depot near Aceh’s airport, in the north of Indonesia, was so overwhelmed that mountains of pricey pharmaceuticals were dumped outside to rot under the monsoons and tropical sun.

This is not a new phenomena. Other disaster-stricken areas, which were shown on television and heavily publicized such as the Armenian Earthquake of 1988 or the Bosnian War, also received massive shipments from around the world – most of which were never used.

Veronica Arroyave presented a case study of the medical donations to Haiti at the 2010 American Public Health Association Conference in Denver. She clearly pointed out that, despite clear WHO guidelines on drug and medical equipment donations, boxes of ‘unidentified stuff’ and expired medication have been pouring into Haiti, causing blockages in the supply chain delivery mechanisms for essential medicines. On the other hand, many of the needed donations were held at the Haitian customs delaying their delivery. Ms. Arroyave works for the Partnership for Quality Medical Donations, a membership alliance that works towards improving medical donations and advancing medical product donation standards. She argued that clear standards need to be issued and adhered to when dealing with medical donations to secure efficient delivery of medicines to those who are in urgent need of them. In addition to the WHO guidelines, countries need to set up their own disaster response and donation structure systems.

So the next time you might want to donate that open cough syrup or an unused Viagra, think twice!


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