WSWS : News & Analysis : Europe : The Balkans
Pharmaceutical companies dump
useless drugs in Albania
By Debra Watson
3 July 1999
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The World Health Organization (WHO) has charged
that Western pharmaceutical companies are dumping
tons of unusable surplus and expired drugs into
Albania for the Kosovo relief effort, simply to reap
generous tax breaks from their governments and to
avoid paying substantial costs of disposing of
hazardous
waste.
A WHO audit of humanitarian drug donations received
in Albania during May 1999 was conducted in
collaboration with Pharmaciens sans Frontières (PSF).
Indro Mattei, a member of the Swiss Disaster Relief
Unit
working with the WHO Humanitarian Assistance Project
Office in Tirana was one of the two pharmacists
conducting the audit. "We estimate that 50% of the
drugs coming into Albania donated by non-medical
organizations are inappropriate or useless and will
have
to be destroyed. We are very concerned that some
pharmaceutical companies are using this humanitarian
crisis to get rid of unwanted stockpiles."
In April 1999, the Albanian health authorities relaxed
import controls to speed up the entry of urgently
needed
drugs and medical supplies to meet the needs of the
460,000 Kosovar refugees and the continuing needs of
the rest of the Albanian population. Even before the
refugee crisis, the Albanian health care system
depended heavily on drug donations, being able to cover
only 20 percent of the drug and medical supply needs of
its hospitals.
In December 1997, an article in The New England
Journal of Medicine (NEJM) chronicled similar bogus
drug-donations in Bosnia and Herzegovina from 1992 to
1996. Using a grant from Medecins sans
Frontières-Belgium, Philippe Autier, M.D. from Milan
and Patrick Berckmans, M.D. and Gerard Schmets,
Ph.D. of Brussels investigated rumors about massive
quantities of irrelevant drugs that arrived in Mostar,
Tuzla, Gorazde, Sarajevo, and Bihac, cities that were
key targets for humanitarian assistance.
The authors estimated that 50 to 60 percent of the
27,800 to 34,800 metric tons of drugs and medical
materials that entered Bosnia and Herzegovina between
1992 and mid-1996 were inappropriate. Although
miscellaneous donations of small amounts of drugs
accounted for 60 percent of all inappropriate
donations,
they also documented dumping of large quantities,
which accounted for 35 percent of such inappropriate
donations. They used the example of France to
illustrate
the large amount of medical waste that needs disposal
every year in the industrial countries. In that
country,
they wrote, the 22,500 metric tons of unused medicines
each year equal 40 percent of the annual drugs sold.
"Our investigations nonetheless underscore that
inappropriate medical donations to Bosnia and
Herzegovina were common, as they were to Armenia
and Mexico after their earthquakes, or to Africa during
its food crisis, and to the former Soviet Union.
Individuals and organizations have many reasons for
sending medical supplies to a disaster area. Charitable
gifts may lead to tax deductions and represent a
convenient way to dispose of waste medical supplies
without having to pay for their destruction. Publicity
about humanitarian aid usually promotes the image of
the people or organizations involved." Added to the
cost
of destroying the unusable drugs are health and
environmental hazards, as well as the costs of storing,
handling, sorting, and managing the useless and
unusable medicines.
Apparently the June 1999 WHO alert was issued after
repeated attempts to discourage inappropriate
donations. In a letter replying to the Bosnia study,
published in the May 14, 1998 NEJM, a WHO
representative in Europe revealed that by 1996 there
were about 800 tons of unused drugs in Bosnia and
Herzegovina. The representative wrote that WHO
planned to open a new sanitary landfill in Mostar to
deal with the problem. He reasserted that WHO has
repeatedly addressed the problem of inappropriate drug
donations and the coordination and control of
donations.
The authors of the Bosnia study replied that
experiences
there and in Armenia showed that the development of
guidelines insufficient. They also reiterated the
importance of expiration dates in response to a letter
writer who defended donations of expired drugs. "That
is
an open invitation to send drugs nearing their
expiration date to any area in the world where
humanitarian assistance seems necessary," they said.
"Why should a potential criminal act in one country be
seen as virtuous when other populations are
concerned?"
The authors of the Bosnia study pointed out that a
substantial amount of inappropriate drugs did not fit
into the usual category of expired, inadequately
labeled,
or packaged in such a way that they were rendered
useless. Some Bosnian medical supplies provided as
"humanitarian aid" consisted mainly of prepackaged
medical kits designed for refugee situations in
developing countries and largely useless in Europe.
"Some medicines were provided in excess, whereas there
were shortages of others—in particular, medicines for
chronic diseases common in industrialized countries
(e.g., insulin for diabetes mellitus and drugs for the
cardiovascular system)."
Another doctor from Children's Hospital of Philadelphia
related the following story to the NEJM:
"Unfortunately,
the 'altruism' of Western medical-supply donors has a
Bosnian counterpart. Expatriate and local
entrepreneurs sell medical supplies on the black market
for substantial tax-exempt profits. My most troubling
memory is of a middle-aged man whose elderly mother
we treated for a stroke in Zenica Hospital. This poor
man traded 50 kg of flour for five bottles of mannitol,
which his physicians, who supplied the mannitol,
assured him would cure his mother. Although 50 kg of
flour has little street value in America, it was worth
some 1,250 German marks, well over two years' salary
for a senior physician. More important, 50 kg of flour
can feed a family of four for one month. I will never
forget the look of despair on the man's face when we
told
him that the mannitol was useless."
These experiences are now being repeated among the
Kosovar Albanians, both those in refugee camps in
Albania and Macedonia and those who are returning to
their homes in war-ravaged Kosovo. The rapacity of the
drug companies shows the real attitude of American
and international capitalism towards the Kosovars,
despite the humanitarian pretenses of Clinton, Blair
and other NATO leaders.
See Also:
After the Slaughter:
Political Lessons of the Balkan War
[14 June 1999]
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