Promoting women's health

(which represent only 10% of the world"indispensable catalogue" of such disorders and perhaps set up a trans-atlantic . wide pharmaceutical market), the report : project with the American database deplores how pharmaceutical groups have With some 70 documents to plough administered by the US Food and Drug stopped financing research on antithrough during its 95th session (Jan Administration and compiled by the parasitic drugs. It notes that no 16-27), WHO’s 31-nation Executive National Organisation of Rare Diseases. :drug for tropical diseases has been put on Board has its hands full, especially at a In France, "financial and tax relief the market despite the WHO’s Tropical juncture when the whole United Nations should be considered" to encourage the Disease Research Program (1994-95 budsystem is, as repeatedly emphasised, being pharmaceutical industry, and orphan get of US$66-6 million) and the Eurostreamlined in facing up to the winds of Union’s Life Sciences and change. drugs could be manufactured by the Pharpean macie Centrale des Hopitaux, but only on Technologies for Developing Countries Further criticism of WHO’s perforcondition that the unit is properly programme (1991-94 budget of FFr 280 mance to date in this process is sure to be equipped to do so. : million or 40 million ecu). : voiced by major contributors, their unease In commenting on orphan drugs needhardly lessened by the first of a series of ed for the treatment of tropical diseases Marc Gozlan on internal reforms. The

WHOspeak

an

orphan

Promoting women’s

health

Governments should ensure that, at . the minimum, the target of reducing maternal mortality by 50% of 1990 levels by the year 2000 is achieved through safe motherhood and reproductive health programmes, including the treatment of complications arising from unsafe abortion . and other gynaecological and obstetrical: *

The United Nations fourth world conference on women is to be held in September in Beijing, China. The intention is to speed up the actions of the international community towards a fuller of women in all spheres of life. The Beijing conference is only one of a series that since 1975 have been aimed at . improving the rights and status of women. One problem with these past conferences, : according to the Commonwealth Medical Association, which assists and advises national medical associations of developing countries, is that inadequate attention has been given to women’s health. The CMA’s anxiety that the Beijing conference is to be similarly unsatisfactory prompted an international roundtable in London last week. The delegates aimed to develop a concise draft consensus document aimed at ensuring that the health-related part of the document to be adopted at the Beijing conference is sufficiently robust and comprehensive, especially with regard to reproductive and sexual health. : Some of the demands made in the document that the delegates produced after : . three days of deliberations were:

participation

:

emergencies. *

Prenatal

sex

selection, getting

at a very young

age, and other

pregnant

special reports 12-page document that is the end result of meetings by the Development Team on Information and Public Relations Policy says merely what has long been obvious (if not, it seems, to members of the team) as well as long practised, with what resources were available, by the WHO public relations department. This new policy document does, however, strive, in its own unique bureaucratic style, to speak frankly: "WHO in its current communications, both internally and

harmful : externally, encounters two overlapping to help impediments to the development of a

practices should be actively discouraged.

All efforts should be made avoid unwanted pregnancies, but strategic approach. These are: trying to when these occur women should have communicate the same message to differaccess to a full range of safe, affordable ent audiences; and second, the different : components of WHO competing to send services. data should be Sex-segregated collected, different and sometimes competing mesand used for all sages to the same audience ... the (new) analysed, disseminated, of women’s health aspects policies and policy aims to overcome these obstacles : by widening WHO’s approach from pubprogrammes. Government and donor agencies should lic information to ’communications and take the lead in monitoring and evaluating public relations"’. The two last-named are progress in women’s health policies and defined, incidentally, as a "deliberate, planned and sustained information effort programmes. to mutual establish The CMA is based at BMA House, understanding between the Organization and the public, Tavistock Square, London WC1H 9JP, as well as between the various parts of the UK. Organization". Surely a cry from some heart. Sarah Ramsay While the point is made that this "new policy" necessitates new and larger spendnew list contains 22 drugs hitherto outIndia’s revised ing, including "a range of modern comside the price-control system, some of munications techniques and methods", no them having turnovers exceeding 100 milattempt is made to give specific estimates. The Indian government’s policy on drugs lion rupees (about 20 million). ConWisely, no doubt, for an essential element has been given final shape by the formaversely, some of the drugs that have been in that range, the "local area network" tion of a new Drug Prices Control Order. decontrolled had insignificant annual installed in 1986 in the headquarters comThe new order, an offshoot of last year’s turnovers and negligible growth. The govof is already plex buildings, pronounced announcement of the new policy (see ernment also says that for the first time obsolete. The cost of its replacement, Lancet 1994; 344: 878-79), has reduced criteria have been developed to formulate described as "all the more necessary in the number of bulk drugs under governthe price-control list on the basis of a view of the Executive Board’s (previous) mental price control from 142 to 76. The drug’s annual turnover and the state of its decision that highest priority be given to a order’s concession to the pharmaceutical market competition. : management information system" is, The Secretary of the Department of : according to "a very rough preliminary industry’s demand for increased decontrol has dismayed consumer and health groups. Chemicals and Petrochemicals, K K : estimate", in the range of a cool US$6 to Price liberalisation has come a long way Mathur, has advised the drug industry to 7 million. The new system, fibre optics since the drug policy was formulated in exercise restraint on prices so as not to and all, will, however, be fully upgradable, 1978, when 347 bulk drugs were brought provoke a price-control backlash when the as is the case with major computer sysunder price control. The continued list is periodically reviewed. The industry tems installed in the 1990s, and should decontrol of prices since then has been is understood to have agreed to a price last very much longer. Vive les communi’ freeze on the newly decontrolled drugs for cations. strongly criticised. the next six months. But the government claims that the latest change will put almost 50% of the women

drug policy

retail market under

116

price regulation.

The

Sanjay

Kumar

Alan McGregor