After several weeks of interviews and investigations into the problems of establishing a national policy on essential drugs in Usuluteca, Dr. Julio Torres, Director of Maternal and Child Services in The Ministry of Health, summoned a panel of parties interested in the development of such a policy. The panel was composed of health professionals, government officials, representatives from private industry, local unions, and farming cooperatives. The main objective of the meeting was to discuss openly each particular interest group’s viewpoints on the subject.
The first to speak was Carlos Sanchez, a representative from a major international pharmaceutical company. He felt very strongly about policies that would be detrimental to his company. If his company’s products were banned or restricted within Usuluteca, the quality of health care within both the private and public sectors\ would be compromised. Mr. Sanchez also insisted that the quality of his company’s drugs was far superior to that of locally manufactured drugs. If the government prohibited the sale of his company’s products, the quantity of drugs available within the country would diminish rapidly, thereby making it difficult to treat disease.
Mr. Sanchez noted that private pharmaceutical outlets were an important source of medical consultation in areas of the country where primary health care was not fully implemented. Certainly, the main benefit of these private pharmacies—the widespread distribution of drugs—outweighed the current problems. Mr. Sanchez suggested that his company could provide more “essential drugs” to the government at lower prices if the government purchased a greater quantity of drugs at one time. He also suggested that essential drugs could be marketed through the private pharmaceutical outlets at reduced prices. In this way, rural villagers would have a regular supply of essential drugs that they could afford, and the distribution of drugs would be more reliable and consistent.
Although Mr. Sanchez had a persuasive argument, Dr. Torres thought that there could be several potential problems with using the private sector as the sole distributor of essential drugs. Perhaps the most serious was that, even if the existing private pharmacies could be persuaded to carry more essential drugs in rural areas, much of the country would still be underserved. Dr. Torres asked whether or not the government could take advantage of commercial outlets other than pharmacies to assist in drug distribution in the most remote areas. He wondered whether the government could provide sufficient incentives to convince traders and merchants who served rural areas to carry some essential drugs.
Ignacio Sepulveda, a licensed pharmacist and President of the pharmaceutical Association of Usuluteca, objected to the sale of essential drugs by local merchants. He felt that the government’s role should be to enforce pharmacy licensing laws within the country, and that too many unqualified merchants were passing themselves off as doctors and making a high profit on the ignorance of consumers. As a highly trained professional, Mr. Sepulveda felt that licensing was the only means of achieving the rational and appropriate use of drugs in the country. The real problem for him was that many non-professionals were able to sell drugs, exacerbating the problems of over-prescribing
A similar view was expressed by a private practitioner, Dr. Roberto Perez:
Because people lack understanding About disease treatment, pharmacists are in a good position to exploit their customers by selling them expensive and occasionally medically-questionable drugs. . . .
- What are policy options available to Usuluteca? What are the advantages and disadvantages of each? Which option(s) is (are) the most feasible for Usuluteca?
- Which problems or issues are still left unaddressed?
- What other policy options would be appropriate for Usuluteca? Who would support or oppose them?