E-drug: USA Today on donations (cont)
Thank you for responding to my E-mail to you. To recap since I did not
send my original message to the list, I was concerned that the approach
seemed to be one of discouraging (or prohibiting) drug 'recycling',
whereby unused drugs for HIV are collected and distributed by a small
number of organizations in the West to people with HIV/AIDS in the
developing world. I suggested that in our concern over the worst excesses
of drug donations, we were likely to throw this 'baby out with the bath
It appears that this is indeed the intent, which I fear leaves me very sad-
-although clearly from your tone, we're going to have to agree to
disagree. The one area where I'm sure we agree is that it should not be
necessary, in an ideal world. Nevertheless, until we have solutions to
access to treatments for all, I find it somewhat distressing that there is
pressure to eliminate a voluntary system which is saving lives--not a huge
number, no doubt, but any little helps.
Yes, sustainability is a challenge, although I believe that the
organizations which arrange this pay considerable attention to this, and
attempt to ensure that no patient starts using 'recycled' drugs without a
guarantee of sustainability for a reasonable period.
But let's be clear: sustainability is a huge challenge for many using
formally-obtained drugs in the developing world. This can arise because of
lack of foreign exchange, breakdown of ordering and supply systems, and
frequently because patients (and their families) have used up all their
limited resources, sold all their possessions and mortgaged their future
and that of their children. Is this a better alternative?
My own belief is that instead of identifying all the obstacles to saving
lives (as we seem to have been doing for the last five years in regard to
access to AIDS treatments), we should be searching for creative solutions
using whatever resources are available. If recycling can be done
effectively and safely (and I believe there is good evidence that it is
being so done), should we not be looking for ways to extend and improve
this process both to include more patients and to improve safety and
Chris W. Green (firstname.lastname@example.org)
Tel: +62-21 846-3029 Fax: +62-21 846-1247
[Chris, you do accept sustainability as a problem but there is also
the issue of quality control of drugs from unknown sources and
Also, could the donor/collector's satisfaction outweigh the real
benefits of the activity? Another issue is the ethics of people
collecting drugs in excess their own requirements. This artificial
inflation of a donor country's requirements creates additional
burdens on the taxpayers.
Instead of varying types and quantities of drugs, surely procurement
of drugs chosen by the target country from reliable sources with
donated funds would be more sustainable and cost-effective. BS]
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