PHA-Exchange> WHO and the drug companies

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WHO and the drug companies

>Unhealthy influence. There is a danger that WHO's new partnership with 
drug companies will skew its health policies
Sarah Boseley, Wednesday February 6, 2002, The Guardian
Just 18 months ago, the lid
was lifted on a piece of commercial espionage<BR>and covert
manipulation that would not disgrace the pages of a John le
Carré<BR>blockbuster. Tobacco companies had penetrated the innermost
sanctums of the<BR>World Health Organisation. Philip Morris, the
largest cigarette manufacturer<BR>in the world, admitted paying
scientists to turn up at WHO meetings to which<BR>the company had been
refused entry, but insisted nothing it had done
was<BR>improper.<BR><BR>But documents that came to light during tobacco
litigation in the United<BR>States suggested that this calculated and
well-financed strategy went beyond<BR>ordinary lobbying. A WHO report
said tobacco companies "sought to divert<BR>attention from the public
health issues raised by tobacco use, to reduce<BR>budgets for the
scientific and policy activities carried out by WHO, to pit<BR>other UN
agencies against WHO, to convince developing countries that
WHO's<BR>tobacco control programme was a 'first world' agenda carried
out at the<BR>expense of the developing world, to distort the results
of important<BR>scientific studies on tobacco and to discredit WHO as
an institution."<BR><BR>Tobacco companies rose from being the object of
suspicion to public enemy<BR>number one in the eyes of Gro Harlem
Brundtland, WHO's director general, and<BR>her staff. The infiltration
should have been a salutary experience for a<BR>benign organisation,
but there are fears that the lessons may not all have<BR>been learnt.
Tobacco may have been locked out but pharmaceutical companies<BR>now
sit at the top table. There is a world of difference between the
two<BR>industries, it will rightly be argued - tobacco is a killer,
medicines save<BR>lives. But they have something fundamental in common:
their duty to their!
<BR>shareholders, to make money.<BR><BR>Brundtland and her closest
advisers deserve admiration for their determined<BR>efforts to spend a
lot more money on health in the developing world.<BR>Brundtland's
macro-economic commission on health, chaired by Harvard<BR>economist
Jeffrey Sachs, last month said a further $8bn a year was
needed.<BR><BR>It's an enormous amount of money to raise from reluctant
donor governments.<BR>Brundtland is convinced of the need to have the
private sector on board.<BR>Microsoft's Bill Gates, with his donations
of billions of dollars to vaccine<BR>development, has done more than
anybody to make this policy look a winner.<BR>But the pharmaceutical
companies that have agreed to donate some medicines<BR>to poor
countries and cut the costs of others are not acting purely out
of<BR>selflessness.<BR><BR>What's in it for them? Most obviously, there
is the global fund for Aids, TB<BR>and malaria set up by UN secretary
general Kofi Annan, which has a purse now<BR>worth close to $1bn which
will be spent on medicines and preventive measures<BR>such as condoms
and mosquito nets. The model for the fund is the Global<BR>Alliance for
Vaccines and Immunisation (Gavi). Save the Children Fund UK<BR>recently
publicly warned of conflicts of interest within Gavi, which
has<BR>vaccine manufacturers sitting on the board.<BR><BR>The
pharmaceutical industry has lobbied hard for seats at the global
fund<BR>table too. Brundtland is very much in favour of public private
initiatives<BR>such as Gavi, which forge ahead (thanks to Gates's
money) in a way UN<BR>agencies cannot and get things done.<BR><BR>That
could lead to tears, say some WHO staff and outside observers.
They<BR>fear this new reliance on corporate drive and cash is already
in danger of<BR>skewing health policy towards vested
interests.<BR><BR>It is most noticeable in the continuing struggle over
the absence of drugs<BR>to treat people dying of Aids in Africa.
Activists and organisations such as<BR>Médecins sans Frontières would
like to see WHO !
back the use of generic<BR>drugs - cheap copies of the expensive
patented medicines produced by<BR>big-name pharmaceutical companies.
WHO has preferred to negotiate price-cuts<BR>with a handful of the drug
giants, which are still higher than generic<BR>prices.<BR><BR>The
macro-economic commission was also strongly against generics. One of
the<BR>papers commissioned for its discussions by WHO argued that
prices were not<BR>the block on the wider use of essential drugs in
developing countries,<BR>blaming corruption and lack of healthcare
infrastructures instead. The paper<BR>was written by Harvey Bale, head
of the International Federation of<BR>Pharmaceutical Manufacturers
Associations, with help from Adrian Otten of<BR>the World Trade
Organisation.<BR><BR>The potential for conflicts of interests has been
noted within WHO. The<BR>executive board has discussed guidelines for
staff. But rules on free<BR>lunches are irrelevant when would-be
persuaders are regulars in the staff<BR>canteen. Drug companies,
baby-milk manufacturers or the big food<BR>corporations - they would
all like a bit of influence at WHO. Brundtland may<BR>be right to
harness their money and energy in the cause of health, but she<BR>will
have to persuade her critics that it is she who is sitting in
the<BR>driving seat.
Sarah Boseley is the Guardian's health 
editor.>sarah.boseley at guardian.co.uk<