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Hazardous drugs in developing countries

BMJ 1997; 315 doi: (Published 13 December 1997) Cite this as: BMJ 1997;315:1557

The market may be healthier than the people

  1. David B Menkes, Senior lecturera (
  1. a Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand

    The international pharmaceutical market shows substantial regional differences in availability and promotion of drugs.1 This variation depends on affluence, health requirements, capacity for local manufacture, and the restrictions which countries may impose to control dangerous or inappropriate use of drugs.2 3 Because of their limited industrial base, most developing countries import most of their drugs, and transnational corporations are adept at exploiting variations in such markets.1 Commercial interests may conflict with public health needs in developing countries,4 5 6 particularly when people are poisoned due to inadequate restriction of pharmaceutical use, misleading advertising or labelling, or frankly bogus products.

    Promotion of unsafe drugs in the developing world has long attracted criticism, particularly when products have been banned or restricted in the country of manufacture.3 5 Pharmaceutical adverts, labelling, and package inserts in developing countries often show the twin problems of exaggerated indications and minimised adverse effects.1 5 6 Drug exports from the United States to developing …

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