In the 2000s, observing the wealth of non-used medicines in economically developed countries, France implemented a strictly organized and supervised process to collect and destroy such products. The goal was to avoid domestic accidents and misusage, to reduce environmental pollution due to residual medical waste … and to limit the traffic of unused medication in developing countries.
Unused medication benefits from its status as “medicine from rich countries” and possesses high market value, making it a target for trafficking. Without irreproachable management on their arrival in developing countries, such medication is rerouted and recuperated by unscrupulous individuals who then resell them illegally in the streets or in outdoor markets. They are handled and prescribed by unqualified vendors.
They also feed parallel, unsafe circuits. Such practices entice patients away from legal distribution channels and reduce their chances for proper treatment.
Local foundations regularly receive donations of unused medicine, which they then redistribute. However, such institutions can fall prey to criminal organizations or to corrupt medical companies, who repackage and reintroduce the medication into legal distribution channels or resell them on other markets.
As of 2006, during the General Assembly of the Conférence Internationale des Ordres de Pharmaciens Francophones (CIOPF), the president of the Inter-Ordre des Pharmaciens d’Afrique (IOPA) called for “the end of shipments of unused medication from France, to stop creating an illusion of solidarity, which comes at the detriment of healthcare and the correct use of medicines.”
To avoid encouraging the traffic of falsified medicines, donations of drugs and unused medication must be strictly regulated, supervised, and adapted to the needs of the different populations, whether it be for medical emergencies (wars, natural catastrophes…) or as part of developmental aid.
The World Health Organisation (WHO) wrote up guidelines for drug donations in 1999. They are not international regulations but guidelines to help establish national and institutional norms.