Pre-Exposure Prophylaxis or PrEP

Pre-exposure prophylaxis (PrEP) involves putting HIV negative people on antiretroviral drugs (ARV) with the aim of protecting them from HIV infection. This blog looks at some of the pros and cons of PrEP.

Friday, September 30, 2011

Health in Africa: Always a Crisis, Never a Priority

Tanzania and Kenya are both issuing warnings about 'fake' and unregistered drugs. Unfortunately, many people have been led to believe that 'fake', 'generic', 'counterfeit' and even drugs with 'Made in China' on them are all the same; useless. The chances of protecting people from substandard drugs, out of date drugs, those with the wrong ingredients, those with no active ingredients or those with the wrong quantities of ingredients, etc, is now seriously diminished.

The pharmaceutical industry, not short of a few billion dollars itself, wants regulatory authorities and others to protect the industry's profits, so they are in favor of such scare tactics. But they have brought about the situation where people will produce their own versions of drugs and create a thriving black market. Big Pharma has failed to produce drugs at a price that is affordable to those who need them most.

I suppose I have to spell it out that I don't think there's anything wrong with making a profit. But many drugs are developed using public money, in publicly funded institutions. The cost of researching drugs, which is very high, is not entirely borne by the industry. Only the profits are entirely borne by the industry. And the same industry often spends many times more on advertising, lobbying and marketing than they do on research.

There really is a problem with drug supply in East African countries; there are too few of them, many are of the wrong kind, some are fake or counterfeit. But some are generic, that being the best that people in developing countries, the majority of people in the world, can afford. And all drugs, even generic drugs, are overpriced. There is still no true competition, where prices are set according to what the market can bear rather than what the over-subsidized industry can grab.

Pharmaceutical outlets, even many health facilities in East Africa, can be badly run, semi-formal, informal or downright illegal, and are in bad need of regulation. But running around closing them down or curtailing their activities will do little good unless proper facilities are made available to people. The lion's share of health spending in East Africa goes into the pockets of Big Pharma, mostly for branded drugs and products developed with Western needs and economies in mind. There's no shortage of money.

Unsafe drugs are only one of the many risks that East African people face in pharmacies and health facilities. The priority is to improve conditions in these facilities and increase people's access to them, not to increase the amount of donor and public money that helps inflate pharmaceutical industry profits. Drugs are only a part of health care, but only when there are adequate health facilities with enough well trained and equipped staff. Stop using aid money to support pharmaceutical multinationals!

[For more about unsafe health care and cosmetic services, visit the Don't Get Stuck With HIV website]


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