Should there be drug advertising?
The African experiance
Editor - We read the debate on drug advertising by Rhona MacDonald and Richard
Smith in the studentBMJ last month with
interest.1 2
In west Africa our choice has been made
for us by the drug companies, most of whom
will not support the BMJ's west Africa
edition either by advertising or sponsoring
meetings, including workshops on medical
writing for doctors and other health professionals. These workshops were started in
Nigeria in May 2001 followed by a rerun this
year in Ghana with the aim of rekindling the
art of writing among our colleagues so that
we can increase the local content of the local
edition of the BMJ.
When we launched the BMJ 's west
Africa edition in July 1996 the drug companies were very supportive with advertisements without which we could not have
published beyond the first issue because one
government in west Africa which encouraged us to print 10 000 copies - it took
5000 - has still not paid for these copies.
About a year later, the same government
decided to bulk purchase drugs from the
drug companies who formed themselves
into a consortium to share the booty.
from then on most of the drug companies have stopped advertising. We have had
to drastically cut our rates for the minority
who still place advertisements. It is interesting that since the policy of bulk purchasing
of drugs stopped there are signs that the
drug companies might be coming back to
advertise with us.
In west Africa there are no laws (or if
there are they are not enforced) to restrict
prescription only drugs or even controlled
drugs with the effect that drug companies do
not see the need to educate people through
doctors and health professionals. Their
drugs can be bought in open markets, minor
medicine shops, and on street corners.
It is difficult to get doctors to subscribe
even though the cost of the local BMJ is
subsidised and in local currency. Our
colleagues want their journals free of
charge.
We envy your position where you can
decide whether to carry drug advertisements or not. We do not have such options
yet we are striving to keep our local edition
going. We look forward to the day when
we can have the luxury to call the drug
companies' bluff.
joseph Ana, managing editor, BMj west Africa edition
gazeen.gazeen@virgin.net
- Smith R. Should there be drug advertising? studentBMj
2001;9:206. (june.)
- MacDonald R. Should there be drug advertising?
studentBMj 2001;9:207. (june.)
Balance needed between the haves and have nots
Editor - I found it rather amusing to
discover that two BMJ editors are at odds
with each other regarding drug advertisements in a medical student journal.1 2 I think
that readers need to know the form and
content of the advertisement before reaching any conclusions.
Nevertheless, the issue highlighted
clearly reflects the editors' experiences
between the "haves" and the "have nots,"
between free economy and fair trading. Dr
Smith implied that with today's globalisation, drug advertising in medical publications is no longer an option, and any
opposition will eventually be futile. Dr MacDonald, however, defended the need to
distance profiteering drug companies from
one of the last independent medical
publications which promotes medical student issues. however, she did not offer any
realistic options in tackling the increasing
financial burden in sustaining the publication of studentBMJ.
Assuming that the advertisement will
take the form of conventional drug publicity
(promoting a particular drug) as in other
journals,
I think this is probably inappropriate for a medical student journal. firstly, it
would be irrelevant because the majority of
readers - medical students - have no authority to prescribe drugs. Secondly, it may also
be unethical to inculcate brand consciousness for a particular drug among students at
such an early stage of medical training. This
will contradict one of the aims of medical
education which promotes critical appraisal
and evidence based medicine. Taken further,
this may compromise the care of patients
delivered by future doctors, who rely on
the studentBMJ as one of their sources of
education.
Dr Smith implied that financial gains
made from drug advertisements would
allow some editorial independence. however, this is not true. for example, in South
Africa major drug companies relaxed their
patent rights which resulted in cheaper
drugs for treating HIV and AIDS.3 If these
companies had pressed ahead it is hard to
envisage a journal as vocal as the BMJ
criticising them in the same issue as their
advertisements appeared.
Dr MacDonald's concerns about the
immoral practices and exploitation by drug
companies are understandable. Nevertheless, we cannot fault these companies for
their immense investment and contribution
towards disease treatment and eradication.
We must not forget that the eventual aim of
all businesses is to make a profit. Therefore,
drug company advertising is justifiable if it is
not promoting a particular drug. If the publicity is represented by, for example,
educational articles on clinical pharmacology with an acknowledgment of the drug
company, this is perhaps more palatable.
This would be more educational and
relevant. We should never deny these
companies the opportunity to be charitable
if the conditions are right.
kay Seong Ngoo, fourth year medical student, university of Aberdeen
Email: ksngoo@doctorsworld.com
studentBMJ 2001;09:217-260 July ISSN 0966-6494
- Smith R. Should there be drug advertising? studentBMJ
2001;9:206. (june.)
- MacDonald R. Should there be drug advertising?
studentBMJ 2001;9:207. (june.)
- Sidley p. Drug companies withdraw lawsuit against South Africa. BMJ 2001;322:1011.
