Unethical Drug Promotion
Published By: The Kathmandu Post, 15 March 2007
By: Shivendra Thapa


Today, World Consumer Rights Day 2007 will mark a day of action with this year's headlining theme:  Unethical Drug Promotion.

Consumers are largely unaware about the consumption choices they are forced to make, shaped by corporate motives.  The same goes for pharmaceutical drugs. This global campaign aims to hold governments and pharmaceutical corporations accountable for unethical drug promotion, marketing and advertising practices that are putting profit before consumer health.

Drug promotion can take on many forms. Overt promotion, such as magazine advertisements, free product samples and visits to doctors by medical sales representatives are tried and tested methods of pushing new product lines. There are also more subtle, inconspicuous forms of promotion that don't actually appear to be promoting a product at all. The sponsoring of patient pressure groups, funding disease awareness campaigns and 'ghost writing' journal articles are just some of the ways in which big pharmaceutical companies are marketing their drugs.

Who checks to make sure drug promotion is ethical? The unfortunate answer to this question is predominantly the drug companies themselves. The WHO sets out a global benchmark to judge if drug promotion is unethical but their criterion is not mandatory and does not carry any legal obligation. In Europe, many countries are supportive of industry self-regulation and governments are not highly active in monitoring corporate abuses. In Asia, Latin America and Africa, prevailing issues of corruption and poor governance are added constraints in the monitoring of corporate drug promotion activities.

The first debate we must encounter, as a conscious species, is the question of ethics. What is ethical and what is not and who decides this? And what are these ethics based on? Are they based on social paranoia or awareness through extensive and transparent research? These are onerous questions to answer but must be answered for us to move ahead and become truly conscious consumers.

Pharmaceutical companies like any other business are there to make profits. Therefore, the promotion they undertake on behalf of their products is based on profits too. With so little government or civil society regulation, they have been pushing their products without dispensing adequate information about their side or long term effects. The reasons for this vary and are not always linked with profit motives. The research and experimentation undertaken prior to such promotion is limited to a few thousand people while other substances that the pharmaceutical companies have lobbied against at the national, regional or international level have been researched by thousands and experimented by millions.  As a business, it seems unthinkable and illogical to squash demand and if there is no demand, it must be created by whatever means. Can our ethics be gauged by this? The debate about what is ethical and what is not in terms of drug promotion is contentious but any conscientious human being will understand that pushing products based on paranoia rather than research and transparent social awareness is certainly not ethical.

While we harp about unethical drug promotion by pharmaceutical companies on World Consumer Rights Day, we must not forget about the regulation on all kinds of drugs worldwide because this line between legality and illegality is what has created confusion and paranoia amongst the general masses. The same pharmaceutical companies that advocated for drugs prior to the 1970s (now made illegal under the UN Convention for Psychotropic Substances), before they realized its limited business potential, are the same companies pushing their alternative drugs (in the form of medicinal or prescription drugs) in the market.

It is a well-worn argument that the three most commonly used drugs; alcohol, caffeine and nicotine, are only legal by historical precedent and current economics. No other drugs have had such prolonged detrimental effect on human beings than alcohol and nicotine yet no country in the world has made them illegal. While plant derived hallucinogens like psilocybin mushrooms, which have been used by intelligent archaic societies for millennia for their spiritual, medicinal and meditative properties, have been listed in Schedule I of the UN Convention, banning research on them, thus also curtailing awareness about their actual properties, substances like anti-depressants and other forms of semi-researched drugs are being promoted to consumers by pharmaceutical companies and governments alike.

Nepal's Consumer Protection Act of 1999 established the Consumer Protection Council which is to advise the government on matters relating to the protection of the rights and interests of consumers. The pertinent issue here is how much awareness do consumers in Nepal have regarding their consumer rights and even if they do, how do they define those rights?

Eradication of diseases and medical ailments can destroy the pharmaceutical industry, if their only motive is profit. However, if the motive is further transparent research on all kinds of drugs including acute social awareness about them, the industry can be a partner in developing products that can enhance spiritual and physical wellbeing. Such initiatives can be a basis upon which ethics can be gauged, by giving consumers choice through research, knowledge and awareness rather than through compulsion, paranoia or false advertising.