When disaster strikes it's natural to want to help in any way possible, and one of the ways that seems make sense is to donate medicine - either medicine from your own house, or expired medicine that can no longer be sold. However, before jumping into action there are some things you must understand first. The World Health Organization has developed Guidelines for Drug Donations, and it's important to ensure you follow these guidelines so that the medicine you send is helpful rather than harmful.
Be sure you understand and follow WHO's Guidelines for Drug Donations
How can a donation of medicine be harmful? Let's look at a couple of the points in the guidelines and why they came about:
1. All drug donations should be based on an expressed need and be relevant to the disease pattern in the recipient country. Drugs should not be sent without prior consent by the recipient.
This guideline is based on the problem caused when crates of random drugs arrive in country. An acquaintance of mine working on the Hurricane Mitch recovery efforts told me about helping medical teams work late into the night sorting through random drugs, pulling out half used tubes of Preparation H and opened bottles of Prozac. Huge percentages of donated drugs are unusable and not only take critical time from medical personnel to sort but also cause a medical waste disposal problem. What do you do with hundreds of pounds of unusable drugs? Do you throw them out and risk garbage sorters taking them out and selling them on the street to kids? Do you flush them down the toilet, which is probably a leach septic system, and risk them making their way into the ground water?
5. No drugs should be donated that have been issued to patients and then returned to a pharmacy or elsewhere, or were given to health professionals as free samples
Again this relates to the problems mentioned above.
6. After arrival in the recipient country all donated drugs should have a remaining shelf-life of at least one year. An exception may be made for direct donations to specific health facilities, provided that: the responsible professional at the receiving end acknowledges that (s)he is aware of the shelf-life; and that the quantity and remaining shelf-life allow for proper administration prior to expiration. In all cases it is important that the date of arrival and expiry dates of the drugs be communicated to the recipient well in advance.
Many companies see donating expired drugs as a great way to help out, generate some positive publicity, and take a tax write-off by donating goods they would not be able to sell. However, although that may be great for the company, it is not great for the health professionals that receive crates of expired drugs that they cannot use but must store or dispose of. This rule allows for expired drugs to be sent only if the health facility is well aware of the status and still believe that the donated drugs will be more beneficial than harmful given their current circumstance.
7. All drugs should be labeled in a language this is easily understood by health professionals in the recipient country; the label of each individual container should at least contain the international Nonproprietary Name (INN) or generic name, batch number, dosage form, strength, name of manufacturer, quantity in the container, storage conditions and expiry date.
Imagine if you worked in a rural health clinic in Kansas and received a shipment of medicine from Tajikistan with everything labeled in Farsi. How long would it take you to determine what medicine you'd received. Would you feel confident that you translated the labels correctly. Would you assume that you knew the correct dosage amount? Would you be willing to give that medicine to your patients? The same problem occurs when we donate medicine with the labels in English. While well intentioned, these donations could cause more harm than good if the wrong medicine or the wrong dosage is prescribed due to language barriers.
12. Cost of international and local transport, warehousing, port clearance and appropriate storage and handling should be paid by the donor agency, unless specifically agreed otherwise with the recipient in advance.
Drugs, like all other aid shipments, have to clear customs at whatever port they arrive at, and then be shipped to the actual aid site. Clearing customs can be both timely and expensive depending on national laws and tariffs. The cost of of clearing goods through customs, storing, and shipping them can add up to more than it would cost to purchase the goods locally. Therefore your donation may actually cost the organization more then it helps them. If you are going to ship goods overseas you need to be very clear as to how all the associated costs will be covered.
The average person should not donate medicine after a disasterBecause of the cost and organizational demands needed to meet all of the guidelines created by WHO, donating medicine should only be done by organizations with the budget and capacity to do it properly.
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