PRESCRIPTIONS FOR DEATH: The Drugging of the Third World by Milton; Philip R. Lee & Mia Lydecker Silverman
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PRESCRIPTIONS FOR DEATH: The Drugging of the Third World

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KIRKUS REVIEW

With assiduous documentation and straightforward reporting, Silverman, Lee, and Lydecker make it plain that the international drug industry has a blatant double-standard of drug promotion--one for industrialized countries, and another for the developing countries of the Third World. The authors' aim is to demonstrate the differences in claims for drug efficacy. In industrialized nations, those claims are limited to what ""can be supported by convincing scientific evidence, and hazards are openly disclosed."" In the Third World, however, claims of product efficacy ""are exaggerated to an almost ludicrous degree, and hazards--some of them life threatening--are minimized or not even mentioned."" First, the setting: almost three quarters of the world's population lives in the Third World, and medical treatment is always affected by poor sanitation, poor transportation, poor storage facilities, illiteracy, malnutrition, and often a grossly uneven distribution of wealth. Then, for six classes of commonly-used drugs (antibiotics, drugs against diarrhea, pain and fever fighters, anabolic hormones, ""tonics,"" and the Pill), the authors show how indications for use and warnings of hazards vary drastically from country to country--and especially from developing to industrialized nations. Oral contraceptives, for example, are recommended in the US for contraception only, and carry warnings that thromboembolic phenomena, hormone-dependent tumors, impaired liver function, and other problems may occur. In developing countries, other uses are suggested--regularizing of menstral cycles, relief of premenstrual tension and menstrual pain--and sometimes no warnings at all are given. Beyond this simple and damning disclosure, the authors discuss compounding factors in depth: the way physicians and pharmacists operate in the Third World (some dedicated, but hopelessly overworked; others looking for quick profit); the US drug industry itself, and its omnipresent drug-detail men with their gifts and free samples; and the prevalence of bribery in Third World pharmaceutical operations. Silverman, Lee, and Lydecker offer some possible solutions, including those currently being put forth by WHO; but they readily admit they have no answers. Instead, as Silverman and Lee did in previous works (Pills, Profits and Politics, The Drugging of the Americas, Pills and the Public Purse), they take the first, vital step of bringing the problem to public attention--where, soundly and roundly substantiated, it cannot be ignored.

Pub Date: July 1st, 1982
Publisher: Univ. of California Press