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Finding Fortune in Traditional Medicine

By David South, Development Challenges, South-South Solutions

SOUTH-SOUTH CASE STUDY

Traditional medicines and treatments could help provide the next wave of affordable drugs and medicines for the world. But a phenomenon known as ‘bio-prospecting’ – in which global companies grab a stake in these once-free medicines – has been placing traditional medicines out of reach of Southern entrepreneurs. Pharmaceutical patents (http://en.wikipedia.org/wiki/Patents) taken out by international drug companies are making traditional medicines expensive and inaccessible to the poor.

Indian scientists have identified more than 5000 bio-prospecting patents, worth some US $150 million, taken out by companies outside India.

Now governments in countries like India are moving to protect these recipes and the plants and animals they are made from.

The Indian government has labelled 200,000 traditional treatments as public property and free for anyone to use. These treatments are key parts of the 5000-year-old Indian health system called Ayurvedic medicine (http://en.wikipedia.org/wiki/Ayurveda) – ayur means health in Sanskrit, veda means wisdom.

“We began to ask why multinational companies were spending millions of dollars to patent treatments that so many lobbies in Europe deny work at all,” said Dr. Vinod Kumar Gupta, head of the Traditional Knowledge Digital Library, which lists in encyclopaedic detail the 200,000 treatments.

“If you can take a natural remedy and isolate the active ingredient then you just need drug trials and the marketing. Traditional medicine could herald a new age of cheap drugs,” Gupta told The Guardian..

Currently, it is very expensive to follow the Western approach to developing drugs. A so-called “blockbuster drug” can cost US $15 billion and take 15 years to bring to the market. With patents lasting 20 years, a drug company can have as little as five years to recover its development costs. This helps explain the high prices for drugs.

Unlike traditional healers in the South, multinational corporations can marshal the money, time and legal resources to file patents.

In the past, India has fought expensive and lengthy battles to revoke patents on traditional remedies. One example is the battle over the popular Indian spice turmeric powder (used for healing wounds, among other things). A patent awarded to the University of Mississippi in 1995 was successfully withdrawn after a legal battle by the Indian government.

The Indian government’s move to make traditional medicines and therapies public property promises to unleash a new wave of natural remedies and drugs and to expand the market for Southern health entrepreneurs drawing on traditional knowledge and recipes.

As the world’s economy continues to suffer, finding new ways to earn incomes and spark a whole new generation of businesses will be crucial to recovery.

The World Health Organization (WHO) defines traditional medicine as “the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses.”

The importance of traditional medicines in primary health care can be seen in Asia and Africa, where its usage reaches 80 percent of the population in some countries (WHO). Herbal medicines alone are worth billions of dollars a year in sales. Examples of traditional remedies include antimalarial drugs developed from the discovery and isolation of artemisinin from Artemisia annua L., a plant used in China for almost 2000 years. In 2003, doctors found scientific evidence supporting the use of traditional Ghanaian plants to help wounds heal. Parts of the African tulip tree and the Secamone afzelli are made into pastes which are applied to wounds.

The downside of traditional medicine is the urgent need for better regulation and safety standards. While more than 100 countries have regulations for herbal medicines, counterfeit, poor quality or adulterated herbal medicines are still a major problem.

Herbal treatments are the most popular form of traditional medicine, and are highly lucrative in the international marketplace. Annual revenues in Western Europe reached US $5 billion in 2003-2004.. In China, sales of products totalled US $14 billion in 2005. Herbal medicine revenue in Brazil was US $160 million in 2007 (WHO).

One initiative is ensuring there is a solid future for traditional medicine in India. Charity Bodytree India, set up in 2004 by a group of health, human rights and education workers, addresses issues surrounding access to health care and the disappearing traditional medical practices amongst isolated indigenous communities. Bodytree has established a successful educational programme that trains young people from different indigenous communities to become community health workers and operates programmes of health education for community groups (http://www.bodytree.org/index.html).

Almost four-fifths of India’s billion people use traditional medicine and there are 430,000 Ayurvedic medical practitioners registered by the government in the country. The department overseeing the traditional medical industry, known as Ayush, has a budget of 10 billion rupees (US $260 million).

In the state of Kerala in India’s South, Ayurveda medical tourism has become a good income generator. And it is so popular in the nearby nation of Sri Lanka, hotels can have Ayurveda included in the name.

Indian entrepreneurs are drawing on increasing awareness of the importance of healthy living and rising interest in vegetarian diets – what were once holidays are now health experiences. With global obesity rates rapidly rising, along with the attended diseases like cancer and diabetes, more and more people are looking for a dramatic change to their eating and lifestyle habits to ensure long-term health. And traditional medicine has solutions.

Published: March 2009

Resources

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

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Archive

Combating Counterfeit Drugs

By David South, Development Challenges, South-South Solutions

SOUTH-SOUTH CASE STUDY

Access to good quality drugs is a serious problem across the South. The International Narcotics Control Board estimates that up to 15 per cent of all drugs sold around the world are fake or counterfeit, and in parts of Africa and Asia this figure jumps to 50 per cent. The US Food and Drug Administration estimates counterfeit drugs make up 10 per cent of the global medicine market. The US Centre for Medicines in the Public Interest predicts counterfeit drug sales will reach US $75 billion globally in 2010, an increase of more than 90 per cent from 2005.

Fake drugs are a major cause of unnecessary death and destroy public confidence in medicines and health services. While counterfeit drugs have been on the rise, there is little co-ordinated or effective action to counter this menace afflicted on the sick.

But in Ghana, a solution has emerged that shows a way to guarantee that quality drugs get to the sick who need them. CareShop Ghana uses the franchise model – where licenses are sold to approved vendors who adhere to strict guidelines – to ensure that the quality, accessibility and affordability of essential medicines in and around Accra is guaranteed. CareShop has made deals with close to 300 franchisee pharmacies – often modest operations – who sell over-the-counter drugs.

In Ghana, preventable and curable illnesses like malaria and diarrhoeal diseases are among the leading causes of death. Their treatment pushes many people to financial despair; they can ill afford the extra burden of worrying about counterfeit drugs and the harm they do. Like many countries in the South, Ghana’s public healthcare system is unable to meet these needs and so most people turn to the private sector for help.

An estimated 65 per cent of people turn to licensed pharmacies. But many of these operate haphazard businesses, dispensing expired or counterfeit drugs.

The Ghana Social Marketing Foundation Enterprises Limited (GSMFEL) founded CareShop in 2002, hoping to battle common infectious diseases in poor areas by making sure good drugs get through to the sick.

GSMFEL makes a small profit as the franchisor by selling high-quality drugs to the franchisees. The key to CareShop’s success is imposing standardization on franchisees, so they have to stick to common diagnosis, quality and pricing. They make more money when they adhere to these rules than when they break them. To ensure there is no tampering with the drugs, they are delivered straight to the vendor’s doorsteps, and it is all backed up with health and business training support and branded materials.

The tide can be turned around on fake drugs: in 2002, the WHO reported that 70 per cent of drugs in Nigeria were fake or substandard: by 2004 that figure had fallen to 48 per cent.

Stimulating private sector solutions to African healthcare problems is now receiving an additional boost from a new fund established by the World Bank’s private sector arm, the International Finance Corporation. Launched in 2007, it offers cash and loans totalling US $500 million to commercial healthcare projects in Africa. According to its own statistics, 60 per cent of health expenditure in sub-Saharan Africa is privately funded, and the market, excluding South Africa, is worth US $19 billion.

Published: May 2008

Resources

  • SafeMedicines.org is a website offering the latest reports on fake medicines and is a good place to report incidences.
    Website: http://safemedicines.org/in_the_news/
  • A paper on the global threat of counterfeit drugs: Click here.

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

Categories
Archive Blogroll Today's Seniors

Government Urged To Limit Free Drugs For Seniors

By David South

Today’s Seniors (Canada), May 1993

Another blow may be coming to seniors on top of last August’s cuts to the Ontario Drug Benefit Plan (ODBP). Health minister Ruth Grier has been advised to terminate the policy offering free drugs for Ontario residents over 65. 

Assistant deputy health minister Mary Catherine Lindberg says the 13-page report from the Ontario Drug Reform Secretariat urges the government to replace universal coverage with a system based on income. 

The government argues that fiscal problems, a desire to make wealthy seniors pay, and a need to extend the program to the working poor has driven them to consider the move, while critics argue it will hurt modest-to-lower-income seniors. They say costs could be better contained by keeping universal coverage and attacking the source of escalating costs: pharmaceutical manufacturers and doctors who over-prescribe or misprescribe. 

Concession

If implemented, the cuts will represent a concession by the NDP on the once-sacred principle of universality. Just last year, former health minister Francis Lankin said, “I believe strongly in universality, and we’re not looking at ending it for drug coverage of seniors.”

The proposed plan calls for single people, regardless of age, who earn over $20,000 a year, and families earning over $40,000, to pay a premium of up to $300 for drug coverage. 

Those earning less than that amount will have to pay for their own drugs until they reach a limit tied to their income to become eligible for free drugs. 

The government says this changes qualifying for coverage from age to income-based. 

In a recent interview, health minister Ruth Grier wouldn’t be specific about what plan she would go for. But she agrees with the report’s authors that the drug plan needs reform. 

“While the drug plan makes drugs available in an open-ended way to everybody over 65,” says Grier. “In many cases it doesn’t help the low-income family with parents in minimum wage jobs and has a child needing constant drugs. And when we reform the system we aren’t just looking at how we can contain costs, but also how we can make it fairer. The underlying principle of all that we are doing is equity and fairness.”

The drug benefit plan, which also covers welfare recipients, hit $1.2 billion last year out of an almost $17 billion health budget. That was an increase of 13.8 per cent from 1991, but lower than the 18.1 per cent average for the last 10 years. 

David Kelly at Toronto’s multi-service agency Senior Link suggests the government go after the drug industry for wasting money promoting drugs and duplicating research projects. 

According to the industry advocate Pharmaceutical Manufacturers Association of Canada’s own statistics, drug companies spent $186 million on “marketing” in 1990 while $286 million actually went to research and development. 

The federal government’s own Patent Medicine Prices Review Board, in an internal study leaked to The Globe and Mail, found Canada to have some of the highest drug prices among the seven industrialized nations. 

Anger

Seniors organizations and agencies almost overwhelmingly expressed anger over the report, seeing it as another attack on universality of medicare. They feel the government isn’t being creative enough solving fiscal problems. 

“I strongly disapprove,” says Sara Wayman, chairperson of the Ontario board of Canadian Pensioners Concerned. “The concept of universality when it comes to services is a basic democratic principle we support strongly. People who earn $20,000 a year are still struggling to make ends meet. This would represent a real hardship. 

“We also feel strongly that the high medical costs that everybody is talking about aren’t really due to universality. They are really due to the high cost of drugs, and because there has been a restraint of generic drugs by our legislature.

“They are tip toeing around the medical profession. I hope people will speak out.”

Kelly feels savings could be reaped by taxing back any benefits given to wealthy seniors, while maintaining the universality of programs. 

“The group they are talking about is very tiny,” says Kelly. “And so the cost savings to the government are going to be really minimal. A whole process will have to be set up to decide who gets free drugs, and what you get is another layer of bureaucracy everyone has to go through. Studies have shown this adds to the net costs of government in the long run.”

Creative Commons License

This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022