Healthy Skepticism Library item: 17974

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Thawani V
Guarding the Great Guardian
NetRUM Newsletter 2010 Jun; 3:(2):2
http://groups.yahoo.com/group/netrum

Full text:

I am privileged to have been funded by WHO to attend International Conference on Improving Use of Medicines (ICIUM) at Thailand in 2004, International Course in Promoting Rational Drug Use in the Community (PRDUC) at Jaipur in 2005, two WHO – UNICEF Technical Briefing Seminars (TBS) at WHO HQ Geneva in 2006, 2007, and WHO – HAI TBS at New Delhi in 2008. WHO has sponsored me for attending other meets and seminars after that. We understand that WHO has limited manpower and lots to do. Hence it needs others to carry forward their work. Hence it has always been our endeavor to be the “force multiplier” for WHO.
We have done a baseline study on hospital waste management for WHO and also a multicentric WHO-HAI funded survey on medicine pricing. We have conducted courses in RUM and trainers’ workshop on integrating clinical pharmacology, concept of essential medicines and rational medicine use into UG curriculum in collaboration with WHO SEARO. Currently we continue to help other institutions like IIHMR Jaipur and Kathmandu University Nepal, in conducting WHO funded RUM courses.
The desire to pay back WHO through work, stimulated us to plan a field project during a RUM course, where the participants did market survey for finding use of WHO name and emblem on the ORS brands. All was not found to be well, and we published the output of our clones “Are ORS brands in India using the name of WHO judiciously?” (Indian Journal of Pharmacology 2006; 38:439-41).
The guardian at receiving end
Medicine promotion is known to be responsible for irrational use of medicines. The worst scenario is where the WHO’s name or emblem is misused in medicine promotion. Having tasted success in ORS brands, we decided to guard the guardian in this respect. We searched the WHO sites for any previous work in this area, wrote E-mails, approached database on medicine promotion (www.drugpromo.info) and searched libraries. Those who replied were regretful that nothing has been so far documented on it. This strengthened our resolve to dig our heels deep in this issue.
We started hunting for medicine packaging, promotional material and websites containing WHO name or emblem. The first find was a table-top pen stand gift with claims about an anti-rabies vaccine (ARV) being WHO recommended. Since this was our first find we immediately reported it to WHO SEARO to taste the waters, if our contention that such promotion was wrong was correct and also to check what action is taken by WHO in such cases. What we collected was that WHO sent the company a ‘standard letter’. Excited at the kill in first fire, we requested for a copy of the ‘standard letter’. Instead we received an appreciation letter on behalf of Regional Director, WHO SEARO “for safeguarding the integrity of WHO reputation in medicines”.
We were on cloud nine, motivated to forge ahead with grit and determination. And within a year we had > 60 instances in our kitty. These included many branded ARVs, all claiming to be recommended by WHO, another vaccine claiming to be the only WHO approved pentavalent combination and an artemisinin combination therapy for malaria claiming to be WHO recommended. We found many advertisements in medical journals and web sites with pharma companies claiming to be WHO GMP certified, some using WHO emblem, one even claiming that it had more than 100 WHO certified products. One company made the announcement that it is setting up “state of art WHO GMP compliant formulation plant”. Another company used punch lines like “nearly half of India’s population will suffer from heart ailments” and “India will have 100 million heart patients” with credits to WHO for these statements.
We were shocked to find that in ORS products, 12 different claims were made in the name of WHO. We also got hold of a poster jointly brought out by nine ORS manufacturing Indian pharma companies, with WHO name in the poster, declaring that a child remained backward because his parents did not have the right knowledge to treat loose motions. Yet another company advertised its combo product of ORS and symbiotic with WHO emblem. We found that pharmaceutical companies were not the only black sheep using the WHO name and logo. Others also made merry with promotional overkill, since the monitoring of promotion in the name of WHO is not done. Mosquito repellant liquid, bottled water had WHO emblem as well as “WHO recommended” written on packaging.
While most of the companies using WHO name and emblem were of Indian origin, the indulgers also included giant transnational companies from developed economies. On enquiring from personal contacts in the countries of the origin of these companies it was collected that they do not do such medicine promotion there. Hence it is obvious that they are also washing their hands while the water of Ganges continues to flow freely in India! Based on our finds, we published the paper “Monitoring misuse of the WHO name and emblem in medicine promotion in India” (Indian Journal of Medical Ethics. Jan-Mar 2009, VI (1), 10-14.)
Based on the material collected, we have made a PPP which is used in training for raising the awareness about medicine promotion and need for vigilance. The effort is to motivate the astute, alert and observant to participate in continuous surveillance of medicine promotion and convince them that reporting is our moral obligation. We are belling the cats and are aware that WHO is making the bells sound loud! Ours is purely a voluntary effort without any conflict of interest. The guardian can rest with assurance that it is being guarded in medicine promotion in India. We will make sure that our work is disseminated so that others take the cue. May this baton be handled and handed over with enthusiasm, hence this exposition.