Bitter Fight on Number of Products on Sale : Groups Seek Restrictions on Legal Drugs

International drug companies and consumer groups are embroiled in a bitter fight over attempts to restrict the vast number of pharmaceutical products on sale, particularly in the Third World.

Plans to introduce a list of about 250 essential drugs for use in developing countries were intensely debated at a conference here of the World Health Organization. The organization says it is prepared to publish model lists of essential drugs as a contribution to solving the problems of Third World countries whose health needs far exceed their resources.

Developing countries spend $15 billion to $20 billion a year on drugs out of a global bill of around $100 billion, according to the organization, and activists say many products are ineffective or dangerous.

Spending could be cut significantly and health care improved if imports were restricted to a short list of drugs that could be used to treat most diseases prevalent in poor countries, the activists say.

But drug manufacturers say a wide variety of products is essential to ensure high standards of care.

“We believe any drug which is safe, effective and of good quality should be permitted on the market. There should be no other criteria,” said Jay Kingham, senior vice president of the U.S. Pharmaceutical Manufacturers Assn. “The practical effect of a limited list would be to doom a place like this (Kenya) to third-rate medical care.”

He condemned statements by activists that the vast numbers of different brands available create confusion more than real choice.

Individuals vary greatly in their response to slight differences in medication, and for some diseases such as hypertension it is often necessary to switch to another medicine of the same class to avoid diminishing response or side effects, Kingham said.

However, Andrew Chetley, a spokesman for the Dutch-based activist group Health Action International, cited Norway as an example of a country that has successfully implemented a limited drugs list for about 50 years. He said the standard of health care in Norway is among the highest in the world even though--or perhaps because--only about 1,950 different drugs, including dosage varieties, are registered there, compared to 10 times that number in some other European countries.