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[e-drug] Recycling of medicines in the US (2)

E-DRUG: Recycling of medicines in the US (2)

While I understand the intent of the Moderator, the fact is that we 
accept double standards even within the double standards. For example, 
is it not double standard to accept that d4T/stavudine is a standard 
element of antiretroviral therapy in the developing world, while it 
would be difficult to find a doctor in the West who would touch this 
drug with a bargepole. The WHO guidelines still recommend a second-line 
combination of ddI and tenofovir, a combination which is contra-
indicated in the West.

I must say I find it difficult to support the approach which seems to 
say: "better they die than we give them recycled drugs."  If they are 
informed of the situation (are many people in Africa aware of the 
problems with d4T?) and the risks, seems to me we should support it, 
and (like clinical trials in developing countries), find ways to 
regulate it.

Sorry, I've made this point before in this forum, so I know there is 
little support for it (quite the reverse!). But 'needs must go who the 
devil doth drive...').

Now, if you folk can come up with a way so that this approach is no 
longer needed, I'll support you all the way! But please don't just 
wring your hands and wish it away...

[It was not the moderator's intention to start a discussion on choice of 
therapies (cheap vs. expensive?). Of course one should not accept less than 
optimal therapy, when there is documented differences in benefit/risk profile. 
However, I cannot understand how collecting used medicines can help getting 
better therapy for chronic diseases to people. Moderator]


Chris W. Green (wartaaids@gmail.com)
Jakarta, Indonesia
Tel: +62 (21) 846-3029
Blog: Adventures with HIV in Indonesia

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