who medicines strategy - libdoc.who.int - World Health Organization

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WHO MEDICINES STRATEGY 2004-2007 | 42Figure 7: Different measures of successWHO MEDICINES STRATEGY> countries with national medicine policies> countries where less than 50% of thepopulation has access to essential medicines> percentage of key medicines available inpublic health facilities> countries with public health insurancecovering the cost of medicinesEO 1.8Ethical practices promoted and anticorruptionmeasures identified andimplemented in the pharmaceuticalsector using the experience ofsuccessful programmes addressingaspects of corruption encounteredin the pharmaceutical sectorRationaleThe ‘medicines chain’ includes many differentsteps starting from R&D and ending with theconsumption of the medicine by the patient.Each step needs to be protected from unethical orcorrupt practices to ensure that patients not onlyhave the medicine they need, but also that themedicine is safe, of good quality, has a fair price,and has not been purchased as a result of unduecommercial influence.The commercial reality of the pharmaceuticalsmarket continues to tempt the many differentactors involved, both in the public and privatesector, to test its ethical limits. This may be theresult of intentional mismanagement by anindividual, but also of the inability of individuals> countries with basic quality assuranceprocedures> countries with national medicine informationcentre.PHARMACEUTICAL INDUSTRYPERFORMANCE TARGETS> new chemical entities launched per year> potential ‘blockbuster’ medicines in thepipeline> annual growth in sales> percentage sales going ‘off patent’> annual sales per product> R&D costs and time> total shareholder returns.
COMPONENTS OF THE STRATEGY | 43to identify and manage in an ethical manner aconflict of interest that may arise while interactingwith other institutions.The gap between public health and commercialobjectives in the pharmaceutical sector is wellillustrated by the way success is measured withinthe public health arena and the pharmaceuticalindustry (Figure 7).ProgressWHO has addressed some ethical practices inthe pharmaceutical sector. These include thedevelopment of ethical criteria for medicinespromotion and advocating that patents shouldbe managed in an impartial way, protectingthe interests of the patent-holder as well assafeguarding public health principles 14 . WHOhas also advocated responsible practices in thedonation of medicines (see also EO 6.7, 7.4).In addition, WHO has initiated a dialoguebetween international experts, NGOs, and theinternational pharmaceutical industry in an effortto work together to fight corruption that hindersaccess to medicine in Latin America and theCaribbean. In 2000, the WHO Regional Officefor the Americas and the World Bank organizeda workshop on ethical business practices,which addressed the issue of corruption in thepharmaceutical sector.Challenges remainingMany examples of corruption and lack of ethicalpractices in the pharmaceutical arena arereported in the press and in scientific journals 15 .They are also highlighted by organizations suchas Transparency International, a non-profit NGOwhich aims to curb corruption 16 17 .Figure 8 summarizes some of the ethical issuesencountered throughout the medicines chain.The results of these unethical practices includereduced quality of health care, shortages ofmedically needed medicines and medicalsupplies, unsafe and poor quality products on themarket, financial losses for health care systemsdue to irrational use of medicines throughunethical promotion, and the undermining ofpublic trust in science.Meeting the challenges 2004-2007Over the next four years WHO will:> work with countries and partners to identifysuccessful programmes which have tackledcorruption and conflict of interest in thepharmaceutical sector.> based on the results obtained, developa programme for public health officialsto enable them to identify and manageconflict of interest in their interactions withcommercial enterprises and civil societyorganizations (CSOs).OUTCOME INDICATORS1999 2003 2007No. of countries with medicines legislation requiringtransparency, accountability and code of conduct forregulatory work> continue to promote the implementation ofethical practices in specific pharmaceuticalsector areas where relevant, relying alsoon guidelines issued by other impartialorganizations.#REPORTING % TARGET#REPORTING % TARGETna na na 84/114 74% 80%
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REFERENCES | 1471Annual report 2000
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REFERENCES | 14912 th Model List of
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