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Healthy Skepticism Library item: 2974

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

Yudkin JS.
Provision of medicines in a developing country
Lancet 1978; 1:810-812


Abstract:

In many developing countries the money spent on drugs could often be used more effectively to prevent disease. A large proportion of the drug budget of one developing country is spent on expensive proprietary preparations for use mainly in the larger hospitals, draining resources from health care in rural areas. A major factor in determining the country’s expenditure on drugs is the promotional activities of pharmaceutical companies; the number of drug company representatives in the country is proportionately five times that in Britain. Many drugs are promoted for diseases for which they are not indicated and in which their use may be hazardous, and information on side-effects and contraindications is inadequate. Information supplied by drug firms to health workers in different countries must be standardised and the purchase and use of drugs in Third-World countries made more appropriate to their needs.

Keywords:
*analysis/developing countries/quality of prescribing/promotion costs and volume/quality of information/Medical Index of Monthly Specialties/MIMS/commercial compendia/EVALUATION OF PROMOTION: COMMERCIAL DRUG COMPENDIA/EVALUATION OF PROMOTION: GENERAL QUALITY OF INFORMATION/INFLUENCE OF PROMOTION: ACCESS TO ESSENTIAL DRUGS/INFLUENCE OF PROMOTION: PRESCRIBING, DRUG USE/PROMOTION AND HEALTH NEEDS: PROMOTION IN DEVELOPING COUNTRIES/PROMOTION AS A SOURCE OF INFORMATION: DOCTORS/VOLUME OF AND EXPENDITURE ON PROMOTION

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909