Healthy Skepticism Library item: 3225

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.
Use and misuse of drugs in the Third World.
Dan Med Bull 1984 Nov; 31:

Abstract:

The main determinants of health in the under-developed world are social and not pharmaceutical. The existing health care system in many third world countries is biased towards curative services for urban areas while the mass of rural poor are deprived of even the essential drugs. The main constraint to improving pharmaceutical planning is the prescribing habits of the doctors and this in turn is determined mainly by the unbridled promotional activities of the pharmaceutical industry. Polypharmacy and the prescribing of useless or dangerous drugs for unjustifiable indications not only consumes scarce public resources but also diverts private resources in wasteful directions. Rational pharmaceutical policy must begin with a control on the activities of the pharmaceutical industry but a change in medical attitudes is an essential component of appropriate drug use.

Keywords:
*analysis/developing countries/promotion costs and volume/sales representatives/regulation of promotion/commercial compendia/ dangerous drugs/ Ciba-Geigy/Glaxo/Organon/anabolic steroids/dipyrone/EVALUATION OF PROMOTION: COMMERCIAL DRUG COMPENDIA/EVALUATION OF PROMOTION: COMPARISON BETWEEN DEVELOPING AND DEVELOPED COUNTRIES/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/REGULATION, CODES, GUIDELINES: COMPLIANCE, SANCTIONS, STANDARDS/REGULATION, CODES, GUIDELINES: DIRECT GOVERNMENT REGULATION Developing Countries* Drug Utilization Humans Substance-Related Disorders*

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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