Bulletin of the World Health Organization

Making medicines and health technologies safe and accessible

The Bulletin interview with Vladimir Lepakhin.

Q: What challenges do we face with health technologies?

A: Health technologies cover a diverse area: blood transfusion and safety, medical equip¬ment, diagnostics, surgery, anaesthesia, organ transplantation and so on. WHO has much experience in blood safety, but started working on transplantation recently. Here we advise governments on the technical aspects as well as the ethical concerns relating to organ donation, transplantation and trafficking.

Q: What is WHO doing to stop the sale of counterfeit medicines?

A: The quality of products on the market in each country is the responsibility of national drug regulatory bodies. We assist and support countries to strengthen their pharmaceutical legislation, drug standards and requirements, national drug regulatory performance at all stages: from production, distribution and sales to their use. Quality assurance should be built into the entire process. We have prepared guidelines for countries on distribution and laboratory services. We give workshops in Africa and Asia and have produced 20 training modules on CD-Rom in English, Chinese, Japanese and Spanish.

Q: Are generic medicines less safe or efficient than patented medicines?

A: Many generic medicines meet all requirements, which means they’re equivalent to the patented originals, but others do not. The generics industry is highly developed in both industrialized and in some developing countries.

Q: What are the common misconceptions about your work at WHO?

A: Some people think WHO is a supranational organization that creates and imposes norms and standards. WHO is an international organization, not a regulatory authority. Our role is to combine knowledge, skills and expertise to create international norms and standards and to assist countries in their implementation by providing information, training and capacity building.

Q: What is WHO’s view of traditional and alternative medicines?

A: Traditional medicines have been used in all countries, some for centuries. Self-medication with herbal medicines is popular both in developed and developing countries. In some countries, traditional medicine comprises up to 80% of primary health care. Sometimes traditional medicines are the only ones people can afford. Unlike modern medicines, these were often not studied in accordance with today’s scientific requirements. But without good study and information this can be dangerous, for example, when they interact with other medicines that people may be taking. That’s why it is WHO’s responsibility to evaluate these products and limit any damage by providing reliable information and expertise.

Q: WHO has been accused of giving conflicting drug recommendations?

A: Indeed, some time ago, there were different medicines on our list of essential drugs to those included in treatment guidelines of other departments. We have done a lot to harmonize these through collaboration. Now we are speaking more and more with one voice.

“About half of all drug-related problems are due to irrational use. This can start at any stage from prescription by the doctor or advice from a pharmacist to use by patients.”