WHO criticised for ignoring drug dumpingBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7109.623f (Published 13 September 1997) Cite this as: BMJ 1997;315:623
The World Health Organisation has hit back at accusations that it is ignoring the problem of substandard drugs being dumped in the developing world.
Dr John Dunne, the former director of the WHO's division of drug management and policies, makes the allegation in an article in a new journal, Drug Quarterly, which he also edits (Drug Quarterly 1997;1(2):39-41). He says that the WHO has failed to react promptly to questions of impropriety in one of its offshoot publications, Market News Service (MNS). The MNS was set up by the WHO in 1992 to provide information on prices of drugs and raw materials for developing countries.
Dr Dunne said that many of the drugs listed by the MNS are of questionable provenance from unknown suppliers and that the publication makes no pretence at quality control. The task is left to buyers, who often cannot undertake adequate testing. He said that the WHO should be taking the lead in preventing unacceptable trading practices in supply lines instead of concentrating on promoting local production of essential drugs through the MNS. He added: “It is operating as a non-commercial broker promoting the supply of starting materials through unregulated middlemen to fledgling companies in developing countries.”
Drug dumping, in which low quality drug ingredients are dumped on developing countries, is a recognised problem. One of the more tragic consequences of the practice was the disaster in Haiti last year when 70 children developed renal failure because of a lethal contaminant, diethylene glycol, in locally manufactured medicines. There have also been cases where drugs contain too little, or even none, of the labelled active ingredients.
Jonathan Quick, director of the WHO's action programme on essential drugs, said that he agrees with Dr Dunne that drug dumping and quality assurance are large problems that need to be tackled: “But Dr Dunne's article misunderstands and misrepresents the issues.”
He said that the WHO had set up a working group in February to tackle the problems that he acknowledged existed within the MNS and that these were currently being worked on. But he emphasised that the MNS exists purely to provide information on prices and contacts about drugs for developing countries and does not guarantee the quality of the products. “We always could do more, but it is a question of resources.”
The WHO has changed its work structure to increase the emphasis on quality, and since June there has been a full time coordinator of drug regulation and quality assurance capacity. “We are putting a big effort into working with governments to oversee good manufacturing practices,” said Mr Quick.