Much emphasis in the policy sphere has been placed on the delivery of generic and cheap
drugs to the developing world. Increasing the flow of drugs into poor countries is important, but it only addresses part of the problem of developing-world disease and treatment. An equally important issue is ensuring the distribution of safe drugs to the sick people who need them. While disputes around the legality of certain generics from countries like India and Brazil persist, actual procurement models remain particularly problematic. (By procurement, I refer to adrug’s ability to actually arrive at a point of service and a patient’s ability to actually reach the point of service.)
These procurement problems are evidenced by the emergence of technologies like Minilab, developed by Merck’s Global Pharma Health, and Sproxil—both developed to detect counterfeit drugs, estimated by the World Health Organization to amount to 25% of drugs in the developing world. An estimated 700,000 people are killed every year because of counterfeit malaria and tuberculosis drugs; many thousands more take ineffectual counterfeits believing them to treat illness.
While pharmaceutical companies are not the sole parties to blame when drug supply chains break down, they certainly play a role by relying almost completely on local aid and governmental organizations to distribute drugs. Where governance and regulatory structure are inadequate, law enforcement is weak and corruption is rampant, drugs often fail to reach the populations that most need them. See The World Bank’s “A Practical Approach to Pharmeceutical Policy.”
Given recent innovations in Internet, mobile and mapping technologies, the pharmaceutical industry has a unique opportunity to leverage its resources to increase the transparency of drug procurement and distribution in the developing world through user generated reporting and content.
For instance, what if pharmaceutical companies, following a HealthMapor Ushahidi model, tracked on an open platform if and how a mapped health crisis was met with an intended drug response? Or what if a shipment of counterfeit drugs was located in a particular town or region, and consumers and suppliers could tag such incidents to put others on watch? These questions are of course at the cutting edge of technology and corporate responsibility. They involve considerations like security, as drugs are tracked and people are treated. They are tied to greater needs such as the need for a global drug patent database to facilitate access to safe, cheap generic drugs that would help to undercut the black market. The opportunity for user-generated content around counterfeit and authentic drug receipt is not only important for affected populations, but for us, as consumers, so that we can know that drug companies are playing their part as corporate citizens. Adding a visual, locational and real time dimension to a social problem like drug procurement can create a user generated system of accountability for local and international agencies, governments and industry.
There are some non-industry organizations that have made massive strides in pharmaceutical transparency, such as the Access to Medicines Index, funded by the Gates Foundation. That index measures factors like licensing, philanthropy, research and development and pricing by company, offering companies the opportunity to benchmark their responsibility efforts against those of their competitors. Another organization, the GAVI Alliance, breaks down vaccine distribution by country and by drug (Gates is again a funder).
The fact that counterfeit drugs have become such an epidemic is a testament to the fact that many people in the developing world are not receiving treatment. Additionally, these people are even able and willing to pay for drugs, albeit at a below market price. I am not suggesting greater aid, I am suggesting greater transparency in the disease treatment system, which happens to be driven by industry, large international donors and governments. By helping with capacity building around the procurement process, pharmas could cut down on annual losses from counterfeit sales and increase transparency and accountability in an oft-criticized industry.