Drug donation: is charity a good thing?

Everyone probably in the better-off nations has drugs in their medicine cabinet which will eventually end up in the garbage. This seems an incredible waste, considering that people in developing countries often have little to no access to medicines, even the most common ones for sour throats and headaches. It would be better, one might think, if surplus drugs could be donated to low-income countries in greater need of them. An organization in the United Kingdom has stepped up to the plate, and has also helped reveal the complicated ethics of drug donation.

As its website states, International Health Partners (IHP) is a non-profit, charitable organization dedicated to providing donated medical aid to communities in the developing world, and acts as a bridge between drug, vaccine and medical suppliers in the developed world and organizations and individuals in low-income countries, especially (but not exclusively) in times of humanitarian crisis. Founded last November, IHP has been successful in sending millions of dollars worth of medications to Pakistan, Angola, the Democratic Republic of Congo, Afghanistan, Cambodia, the Philippines and Romania. Undoubtedly, some good has been done. But critics have argued that some of the major benefactors are pharmaceutical companies, who donate merely to enhance their corporate image while strategically dumping surplus drugs (close to their expiration date) they did not want in ways that can upset their competitors. There are quality control issues. There are issues about dosage for particular populations. And donating drugs may not be very charitable after all if the beneficiaries do not have a health infrastructure that can deliver the medications in a safe, effective and equitable way: medications cannot be simply dropped by helicopter. They are only as good as the doctors who prescribe them, the pharmacists who stock them and the refrigerators they may be stored in.

This may be the crux of the matter. The entire framework of donation seems to assume that there are magic bullet solutions to health problems in low-income countries: just throw some drugs at them. While access to medicine is critically important, drug donation schemes don’t get at the root of health inequities between rich and poor nations, and it is hard to see how they contribute to local capacity-building in the production of medical resources, rather than leaving low-income countries in a relationship of literal drug dependency.