Rich Bee / International Health Partners
Millions of unused doses of life-saving medicines. Millions of people suffering for lack of access to safe and effective treatments. Surely the answer is to bridge the gap and donate these unused drugs to those in need? However, as we know, the true picture is somewhat more complicated: anyone who has worked in the developing world will have been offered a pack of kindly donated, but long-expired drugs at some stage in their career.
International Health Partners is a UK charity trying to bridge this donation gap safely and responsibly. They mainly work on long-term projects, but also equip travelling medics like us with supplies. We asked IHP’s Rich Bee about medicine donation, the charity and their amazing Doctors’ Travel Packs.
Why is medicine donation controversial?
The subject of medicine donation raises strong opinions across the spectrum of healthcare and humanitarian organisations, and for good reasons. The history of humanitarian aid is littered with examples of donations done badly. From well-intentioned but poorly-considered shipments of inappropriate products to large-scale dumping of expired pharmaceuticals into countries with health systems unable to cope with the consequences.
The picture is further complicated by the presence of large volumes of counterfeit medicines in countries across the developing world. As a consequence of under-resourced quality control processes, there are many documented cases of patients who die from relatively minor conditions, despite receiving treatment that is usually efficacious. The doctors in these situations freely admit that they cannot always trust the medicines their patients receive.
Some say it encourages a culture of dependency?
A few weeks ago, I visited a hospital that we support in The Gambia, West Africa. I met a group of four young mothers, dressed in the bright colours of their national dress, each with an infant riding on their hip. Ranging from four to nine months, the children had all been diagnosed with respiratory tract infections. When I spoke to them, they were waiting for the prescribed amoxicillin to be dispensed by the hospital pharmacy. So far so ordinary. Children all over the world are treated thus every single day. What they did not know, however, was that until a shipment of donated medicines arrived three days earlier, there was no amoxicillin to be had anywhere in the hospital, nor had there been for several weeks.
There will always be those who say that the end does not justify the means. That donations breed a culture of dependency on aid that is too hard to break and that the only valid approach is to build the capacity of local health systems to support their own populations. We say that there is a generation of young mothers with infants who would disagree with the sentiment that they have to wait a decade for the health system to improve so they can receive medicines for their children. We say that, regrettably, donations are necessary, and to be encouraged where the quality of product can be assured, the need is present and immediate and the local economy is not harmed in the process.
We also believe that we are all of equal value. People should not have to depend on expired or counterfeit medicines because they were born in the wrong place.
Who are International Health Partners?
International Health Partners (IHP) is a UK charity working to improve health outcomes across the developing world by improving the quantity and quality of donated medical products. We’re the intermediary, the broker if you will, between the pharmaceutical industry and humanitarian aid agencies. Philosophical differences often make direct contact between both sides difficult, so we work with both parties.
Our contact is directly with the manufacturers, operating inside the regulated supply chain (to the point of being regulated ourselves by the UK’s Medicines and Healthcare products Regulatory Agency, or MHRA). We respond to disasters, support long-term healthcare projects and equip travelling UK medics with essential supplies, verifying that any and all donations meet an existing need before we accept them.
How do you equip individual medics?
Most of our donations are used for disaster response or global health programmes. However, for over ten years, IHP has also been equipping medics volunteering in the developing world with boxes of essential medicines, ensuring that they can provide reliable treatment without further burdening the health system in their destination country. We call them Doctors’ Travel Packs, or DTPs, and they have been carried to some of the most remote regions on earth.
What’s in a Doctors’ Travel Pack?
A pack consists of two boxes, each about 40cm x 40cm x 40cm and weighing around 13kg. Many airlines have agreed to waive excess baggage fees. Between the two boxes, they contain enough treatments for about 800 people. The medicines include a range of antibiotics, analgesics, NSAIDs, antiemetics, inhalers and treatments for hypertension and diabetes. The exact makeup of the pack does change slightly due to shifting donation patterns, but the range of conditions the formulary can treat remains unchanged. Please email us for a detailed sample list.
Are the medicines of good quality?
The contents have all been donated directly by the manufacturers from UK/European stocks, have at least a year remaining before expiry and are kept within the regulated UK supply chain until they are dispatched to the travelling medic. We ensure that the medicines that we send around the world are as stringently monitored as anything that we might see on the shelves of our local pharmacy in the developed world. We even apply the same track-and-trace capability to our donated products as the manufacturers apply to their European stock, ensuring that medicines can still be recalled after they have been shipped.
Are packs available to elective students and other health professionals?
To ensure the integrity of the programme, DTPs are only released to GMC-Registered UK doctors with a License to Practice, although medical students on elective may also take them as long as a licensed doctor signs on their behalf.
How much do Doctors’ Travel Packs cost?
We ask for a contribution of 450 pounds towards each pack. This covers the cost of sourcing the medicines, assembling the boxes and courier delivery to the doctor’s nearest licensed premises (usually your local pharmacy or GP surgery).
How do we apply for a pack?
To ask more questions or to apply, please contact Patrick Keys on +44 (0) 20 7014 2859 or email travelpacks@ihpuk.org
