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Tremendous Success of the GPHF in Asia "Never before have I seen such a successful project for fighting schistosomiasis" says Dr Lester Chistulo who has for many years been the World Health Organisation’s (WHO) expert for schistosomiasis (bilharziosis) and other parasitic tropical diseases. At the request of the Ministry of Health of Laos, he had come to the capital Vientiane and the Champassak province, together with the WHO’s regional responsible for South East Asia, Dr Palmer, for the purpose of assessing the results of the long-standing GPHF project for diagnosing and treating schistosomiasis. Since this moment marked the expiry of the project financing by the GPHF agreed with the WHO, with an international workshop having been scheduled as a final event, the WHO had asked for the participation of a member of the GPHF Board. Thus, Dr Hilmar Kienzl, in his capacity as the GPHF delegate, witnessed the presentation of the project results direct. The presentation was made both by the Senior Project Manager, Dr Pholsena, Director for Hygiene und Prevention, Ministry of Health of Laos, and by the hospital physicians and health care representatives working in the Champassak project area. The figures presented are all too clear In 1989, the first methodical diagnosis of the population living in the project area showed that on average more than 40 percent (between 8.2 and 94 per cent) of the inhabitants were infested with schistosomiasis germs. Many people suffered from diarrhea and from jaundice with abdominal cramps. Some eventually died of cirrhosis of the liver and bile ducts carcinoma – both long-term consequences of this disease. Thanks to the excellent efficacy of the Praziquantel drug, initially administered every one to two years within a single group treatment programme, a comprehensive educational campaign which particularly addressed schoolchildren, and a special prevention programme addressing the local health care institutions, only 0.5 per cent of the inhabitants were affected by this serious disorder ten years later. This small percentage is the result of infestation rates of up to seven per cent only in five among 21 villages checked. 16 villages, however, were completely free of schistosomiasis mekongi. And the hospitals inspected did no longer report patients suffering from the organic changes and ailments that are typical of this disease. The organisational backup of the WHO in combination with the dedication and commitment of people from Laos – ranging from the Ministry of Health to the health-care representatives of the women’s associations or the schoolteachers – and the long-term funding by the GPHF have illustrated that epidemics of this kind can be overcome almost completely. Prevention Remains a Necessity But the small word "almost" indicates that – because of the population’s low standard of living – the hazard of a new flare-up of such epidemics is by no way completely banned once the enthusiasm for prevention cools down. One of the reasons for this is that the domestic pigs – which their proud owners allow to run free beneath their houses in stilts – carry the germ. These recent findings from research illustrate the complexity of the transmission chain; they also show that the long-term success of such projects requires ongoing supervision and attendance. The difficulty of changing old habits – some of them being hundreds of years old – is shown by the only sporadically successful therapy of opisthorchiasis, a less serious parasitic disease with similar frequency and symptoms that is exclusively transmitted by the consumption of raw fish. Along the whole length of the Mekong this disorder occurs as frequently as schistosomiasis. The health services hoped to "kill two birds with one stone" by administering an appropriate dose of Praziquantel. Immediately after the treatment, the inhabitants were actually free from these trematodas, too, but after some meals containing uncooked fish from the Mekong, the infestation rate rose once again. Thus, any further projects of this kind will focus on changing habits – which appears an easy task at first glance only – with the close co-operation with Thailand’s prevention services being recommended. In the meantime, this now highly developed neighbouring country successfully copes with parasitic diseases although some time ago the situation in the country was comparable to that of Laos. Upon completion of the workshop, the WHO experts expressed their confidence that the exchange of experience on such successful pilot projects will be the basis for further success in Laos and in many other countries, success that will reach far into the future.
Drug Donations for Emergencies / GPHF Presenting new
Project For January, the GPHF has scheduled the official presentation of its new drug donation for emergencies project. After the positive experience of the past year when the GPHF was in a position to provide the victims of the Kosovo conflict and of the earthquake in Turkey with drugs totalling millions of DEM in value that were donated by the GPHF members, this co-ordinating function for acute humanitarian emergencies and natural disasters is now being institutionalised. In future, pharmaceutical companies, ministries and international relief organisations requiring information and help can address the GPHF direct. The latter will co-ordinate demand and supply of drug donations in compliance with the World Health Organisation’s International Directives for Drug Donations. In addition, the GPHF has published a practical guide on drug donations for its members. On the occasion of the scheduled presentation, the drug donation representatives of the pharmaceutical companies will be provided with in-depth information on the legal aspects of drug donations. More detailed information on this presentation scheduled for January 24, 2001, in Bonn, are available from the GPHF office. This GPHF manual, specifically addressing its members’ staff dealing with drug donations, summarises all relevant information on the subject of the provision of drugs for emergencies / drug donations. It contains international directives and easy-to-process forms for handling inquiries for drug donations as well as a list of the contact persons of Ministries, relief organisations and pharmaceutical companies. The informational content is completed by two separate chapters on the issues of a) drug donations and pharmaceutical law, and b) drug donations and fiscal law. Those from the GPHF and VFA members interested in this manual should also contact the GPHF office.
Battle Against Counterfeited Drugs Being Intensified "Malaria: Dozens dead in Cambodia from counterfeit drugs", "Antibiotic imports may have killed 17", "Every day people die because of counterfeit drugs" – These are headlines of the international press of the past few months which unmistakeably make it clear that the battle against counterfeited or substandard drugs is more urgent than ever. This is also reflected in the more than 200 inquiries from all over the world the German Pharma Health Fund has since received for the GPHF-Minilab® it has developed. By means of this mobile compact laboratory, the quality of drugs can be reliably identified quickly, thus protecting people from a danger which can be lethal. 40 Minilabs Already in Operation More than 40 GPHF minilabs are currently being used world-wide in Africa, Asia and Central and South America. To the GPHF it is a major success that the test methods provided with the minilab have also been integrated into the Roll Back Malaria Programme of the World Health Organisation and are thus being used for verifying drug quality in Ghana, Gabon, Mali, Sudan, Mozambique, Zimbabwe, Tanzania und Kenya. Since early this year, two application series of this compact laboratory in Tanzania und Ghana have been closely monitored. Presentation at EXPO 2000 and to the World Bank The international significance which is now being attached to the battle against the increasing distribution and use of counterfeited drugs is also reflected in the multitude of occasions the minilab is presented to experts and the public. For instance, it is presented at EXPO 2000 both in the Health Futures Pavilion and at the exhibition of Gesellschaft für technische Zusammenarbeit (German Service Enterprise for Development Co-operation) as one of the world’s exemplary health-care projects. In Hanover, visitors from all over the world could see for themselves the suitability of the simple test methods for identifying counterfeited or substandard drugs. Further presentations have been given in the past few months to the World Bank in New York, the Annual Congresses of the Pharmaceutical Students Federation in El Salvador and to the Fedération Internationale Pharmaceutique (FIP) in Vienna as well as to numerous German organisations providing development aid. Recently, the World Health Organisation has once more highlighted the risks resulting from counterfeited drugs, and stressed that only genuine experts are capable of recognising counterfeits by their label or their packaging only. The GPHF anticipates further progress to be achieved in spreading the use of the minilab by the co-operation of the Geneva-based health-care organisation with the IFPMA International Association of Pharmaceutical Companies under the motto "Access to quality drugs" as well as by the efforts undertaken within the Philippine National Drug Policy Programme, the main objective of which is the fight against counterfeited drugs which are widespread in the archipelago. Genuine or Fake? - Video Showing the Minilab in Operation To further heighten awareness of the danger resulting from counterfeited drugs, the GPHF now has produced a video film and two posters. The video film of 14 minutes in length, available in German, English, French and Spanish and in various TV standards, describes the problems caused by faked drugs by giving examples from Kenya, and presents the benefits of the minilab as a practical and reliable tool for improving drug quality. The two posters address their viewers both with objective and emotional arguments: one of them shows the open minilab cases and explains the four-stage test plan, while the second one shows an outstretched hand with two pills under the provoking headline: "Genuine or Fake?". Integration of Additional Agents Scheduled Currently, the test methods of the GPHF minilab covers 20 medical agents that are used all over the world. The integration of additional agents into the test methods is planned for 2001 so as to enhance their scope of application. Detailed information on the GPHF-Minilab® in German, French and English as well as the video films and the posters are available from the GPHF office. Stiftung Warentest Also Warns Against Counterfeits In its warning against the purchase of drugs in the Internet, Stiftung Warentest (a German consumer protection organisation) has recently reported that there is a real danger resulting from counterfeited pharmaceutical products in Germany, too. The Berlin-based organisation stresses that the web has evolved into the most important marketplace for drug counterfeiters. For this reason, a health risk induced by substandard or counterfeited drugs cannot be entirely excluded.
Additional Donations for the GPHF Project Work After AstraZeneca, Aventis Behring, Boehringer Ingelheim, Bristol-Myers Squibb, Chiron Behring, Grünenthal, Heumann, Knoll, Merck, Novartis, Schwarz Pharma and Schering as well as the Verband der forschenden Arzneimittelhersteller e.V. (Association of Research-Based Pharmaceutical Companies) have already supported this year’s project work of the GPHF by making sizeable donations, Bayer, Jannsen-Cilag and Sanavita have now also made their donation for the current year. The GPHF would like to thank all donors for their generous support.
Sponsoring Health? On the occasion of a symposium held in Berlin by the Stiftung Immunität und Umwelt (Immunity and Environment Foundation) this summer, experts discussed the perspectives of health sponsoring for developing countries. Representatives from the World Health Organisation, various development aid organisations and international companies unanimously highlighted the enormous potential provided by this new funding scheme for improving the health-care services in the developing countries. They collectively emphasized that in view of the current and future challenges the human right of adequate health-care should by no means be left exclusively to governmental and public institutions. More detailed information on the symposium titled "Health Sponsoring – A Financing Concept with Promising Perspectives?" can be obtained from the Stiftung Immunität und Umwelt, St. Johannes 5, D-59368 Werne, Germany, phone/fax: +49 - 23 89- 9 89 41-0/-11.
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