The Partnership for Quality Medical Donations (PQMD) has become the first umbrella organization, representing a number of US-based pharmaceutical companies and non-governmental organisations, to underwrite the World Health Organization's (WHO) Interagency Guidelines for Drug Donations. This represents a significant step forward in WHO's efforts to ensure that only those drugs which are needed by recipients (e.g., the authorities in disaster-struck countries) are donated.

"We welcome PQMD's endorsement of the Guidelines. The commitment of organizations like PQMD is essential if we are to ensure that only good drug donations are made. As more companies and organizations underwrite the Guidelines, there should be fewer and fewer examples of inappropriate drug donations," said Dr Jonathan Quick, Director of WHO's Essential Drug Programme.

PQMD's adherence to the Guidelines is a big step in a needed direction, said Dr Quick. PQMD is comprised of six PVOs and ten pharmaceutical companies: AmeriCares, Catholic Medical Mission Board, Interchurch Medical Assistance, International AID, MAP International, Project Hope, Abbott Laboratories, Becton-Dickinson, Bristol-Myers Squibb Company, Johnson & Johnson, Eli Lilly and Company, Merck & Co., Inc, Pfizer Inc, Pharmacia & Upjohn, SmithKline Beecham and Wyeth-Ayerst Laboratories.

To improve the quality and appropriateness of donations, the revised Guidelines are being circulated to as wide an audience as possible and additional efforts will be directed at donors sending unhelpful donations. Donations that are perceived as unsatisfactory should be reported with details to dapmail@who.int. A standard reporting form will be made available. Only in the case of repeated shipments of unhelpful donations will names be published.

The Guidelines for Drug Donations continue to be urgently needed. In Turkey after the recent earthquake, and in recent crises in Bosnia and Herzegovina, Croatia, Kosovo and elsewhere, 15%, 30% and, in some cases, up to 60% of drug donations were inappropriate because the drugs had expired, they were inadequately labelled, or simply unknown to local health providers. The result has been hundreds of tons of unusable drugs which now constitute an environmental hazard.

When the Guidelines are followed, however, donations do inestimable good. For example, in the recent crisis in the Southern Balkans, the humanitarian response from governments, NGOs and the private sector meant that standard kits of carefully selected essential drugs sufficient to meet the needs of 1.5 million people for three months were sent to Albania.

Good donations also fill other needs: making long-term disease elimination programmes possible and contributing to health system development, for example. Examples of long-term donation programmes include Merck & Co, Inc's Mectizan donations for the fights to eliminate river blindness and lymphatic filariasis; and SmithKline Beecham's donation of albendazole for lymphatic filariasis.

Drug donations as part of long-term development may be part of bilateral aid programmes between governments, from major aid agencies such DANIDA (the Danish International Development Agency), the Catholic Medical Mission Board (USA) and other non-governmental organizations which provide individual health care units. These agencies provide large quantities of helpful and appropriate donations and are usually in close contact with the recipients. National guidelines have been issued or endorsed by the governments of 6 developed (donor) countries - Australia, Canada, Italy, Netherlands, New Zealand and Norway – while in 14 recipient countries, the Government issued or endorsed national guidelines for drug donations: Armenia, Bolivia, Estonia, Indonesia, Jamaica, Kenya, Madagascar, Mali, Mongolia, Namibia, Niger, Peru, Sri Lanka, Tanzania and Zimbabwe.

Intermediary organizations which distribute drugs they receive from pharmaceutical companies can also help, provided they select or solicit drugs which meet recipient needs. In comparison with agencies which buy drugs or with "produce-to-donate" programmes, these organizations obviously have less flexibility in the choice of drugs donated. They need to communicate with the recipient well in advance and must also be prepared to reject offers of unwanted and inappropriate drugs.

For further information, journalists can contact Gregory Hartl, Office of Press and Public Relations, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41 22) 791 48 58. E-Mail: hartlg@who.int