6. International Policy on Medicine Donations

“As soon as any disaster reaches our television screens, many drugs, the great majority sent with the best of intentions, are dispatched to the scene of the emergency. However, there also have been problems with some drug donations. They fail to meet the most urgent real health needs and, once in the country, they clog up already overloaded distribution systems and become difficult to dispose of.”
 -- Dr. Jonathan Quick, Director of the World Health Organization’s Department of Essential Drugs and Other Medicines (cited in a WHO press release on September 3, 1999)

The donation of improper medications to humanitarian relief efforts has proven to be a major problem for aid organizations. In some cases, the donated drugs have passed their expiration dates before they reach their destination and cannot be safely administered to patients. In other cases, donors send medicines that are not relevant to the recipients’ situation under the mistaken assumption that anything is better than nothing. And because drug formulations vary between countries, some donated drugs may be unfamiliar to health care relief workers. Such unknown or mistakenly identified medicine donations have had harmful effects on patients and are not safe for distribution.

The aid organization is then left with the burden of sorting and disposing of large quantities of medicines. Since the donations frequently go to situations of crisis, environmental safeguards for hazardous waste disposal may not be available. Read about some of the problems caused by unusable donations at www.drugdonations.org/eng/richtlijnen/cases.html.

Therefore, although a charitable donation may initially sound like a good use for leftover medicines, it is inadvisable in most cases. The items received at a community collection event are not eligible for donation. Pharmaceuticals that have been kept under the care of a medical professional, such as undispensed drugs from pharmacies or hospitals or unsold drugs from manufacturers, will be usable in some cases. It is always vital to consult with the intended recipients on what types of medications are needed. Further guidance is available from the Partnership for Quality Medical Donations (http://pqmd.org/guidelines.html) and from the World Health Organization’s “Guidelines for Drug Donations,” online at www.euro.who.int/document/EHA/PAR_Donate_Guidelines.pdf.

For related information on guidelines for international medicine donations, see www.who.int/water_sanitation_health/medicalwaste/unwantpharm.pdf and www.drugdonations.org/eng/richtlijnen/to_make_a_donation_.html.

An article by Hans Hogerzeil in the British Medical Journal discusses inappropriate medical donations and guidelines for ensuring that donations are of high quality and are suitable for the situation. See http://www.bmj.com/cgi/content/full/314/7082/737#top.

Also, the World Bank has published a study on drug donations, exploring where and why inappropriate donations occur and examining the influence of the WHO guidelines. That report is available online at http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/Nassery-DrugDonation-whole.pdf.

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