Drug Companies Should Be Held More Accountable for Their Human Rights Responsibilities

  • Published: September 28, 2010
  • DOI: 10.1371/journal.pmed.1000344
  • Published in PLOS Medicine

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Editorial excludes important areas

Posted by lexchin on 02 Oct 2010 at 22:35 GMT

There is little evidence that pharmaceutical companies or the organizations representing them, such as the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), have embraced corporate social responsibilty when it comes to either the rationality of medicines that they supply to developing countries or in the way that they promote their products.

Since 1977, the World Health Organization (WHO) has been producing its model essential medicines list (EML), defined as those medicines that “satisfy the priority health care needs of the population … [and] are selected with due regard to public health relevance, evidence on efficacy and safety, and comparative cost-effectiveness.”1 The EML clearly represents a statement that irrational medicines have no place in the markets of developing countries’ markets. From the beginning the pharmaceutical industry has consistently opposed the concept of an EML. In 1987, the IFPMA claimed that the medical and economic arguments for an EML were fallacious and that adopting it “could result in sub-optimal medical care and might reduce health standards.” Although the industry now accepts the EML for the public sector in developing countries it remains opposed to implementing it in their private sectors.1

The IFPMA maintains that “the industry has an obligation and responsibility to provide accurate information about its products to health care providers … Promotional activities (marketing practices) must be consistent with high ethical standards and … [t]he same high standards of ethical behaviour should apply to the marketing of pharmaceutical products in all countries, regardless of the level of development of their economic and health care systems.”2 Within the European Union (EU), according to Consumers International (CI), companies “have embraced the concept of corporate social responsibility … as an appropriate response to the mounting pressures to live up to their social and ethical responsibilities. Many companies proudly flaunt their CSR objectives in their annual reports, on their websites and their public relations activities.”3

An investigation by CI of the actual promotional practices by 20 large multinationals operating in the EU found that CSR was honoured more in the breach than in the practice. Out of 20 large multinational pharmaceutical companies operating in the EU only two, GlaxoSmithKline and Novartis, report the number of confirmed marketing code breaches and resulting sanctions. Consumers International (CI) could not find any information about the European marketing policies for 8 companies. According to CI “[t]he absence of clear marketing policies for these companies is remarkable, given that irresponsible marketing practices form a serious, persistent and widespread problem among the entire pharmaceutical industry… A particularly worrying trend shown by our
research is that the difference between policies and practices is often striking.”3

If CSR in promotion is absent in the EU how likely is it to be found in developing countries?


1. Laing R, Waning B, Gray A, Ford N, ‘t Hoen E. 25 years of the WHO essential medicines lists: progress and challenges. Lancet 2003;361:1723-9.
2. International Federation of Pharmaceutical Manufacturers and Associations. Ethical promotion and self-regulation. 2009. (Accessed October 2, 2010, at
3. Consumers International. Branding the cure" a consumer perspective on corporate social responsibility, drug promotion and the pharmaceutical industry in Europe. London; 2006.

Competing interests declared: In 2007 I provided advice to Apotex Inc on the relationship between promotion and sales. From 2007-2008 I was a consultant to the Canadian federal government in its defence of a lawsuit challenging the Canadian ban on direct-to-consumer advertising of prescription drugs.