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Healthy Skepticism Library item: 20477

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: news

Haslam A
Doctor on warpath
New Sunday Times 1986 May 4


In Bangladesh, Dr Peter Mansfield first became aware of an abundance of misleading drug advertisements in the Third World countries. So he began to campaign for the setting up of a watchdog organisation to check the inappropriate use and promotion of drugs.

Full text:

As a medical student doing his training in Bangladesh, Dr Peter Mansfield came across children who were given the wrong medicine. This motivated him to campaign for the setting up of a watchdog body to check the inappropriate use and promotion of drugs.

Back in Australia, Dr Mansfield’s idea gained the support and acceptance of senior doctors which eventually led to the launching of the Medical Lobby for Appropriate Marketing (MLAM).

The world’s first such medical lobby, MLAM today has established an international reputation with over 300 members, lay and medical, from 33 countries, which keeps a watch over drug and chemical promotions especially in the Third World. It is controlled by medical professionals and is entirely dependant on subscriptions and donations.

Dr Mansfield, on a stopover in Malaysia on his way to the WHO assembly in Geneva, spoke to doctors, pharmacists and nursing staff in Ipoh recently on the inappropriate marketing problem and the MLAM’s pursuit of better pharmaceutical advertising.

Dr Mansfield said that while in Bangladesh, he became aware of an abundance of misleading drug advertisements in Third World countries. MLAM’s prime target was against this inaccurate and inappropriate advertising.

MLAM receives requests from member doctors and pharmacists with regard to suspect advertisements and which they are concerned about. A search on the worldwide literature on the drug reveals any discrepancies between the advertisement and scientific data, which are then noted in a letter and sent to members for signing and then forwarded to the respective company.

As a safeguard, the letters are checked by an editorial panel consisting of senior doctors and academics. MLAM sends out one such letter a month.

Dr Mansfield, who is MLAM’s secretary, hoped a branch could be set up in Malaysia and was pleased with the positive response to the idea from local doctors. According to him, the doctors felt it was important to have access to unbiased information.

Dr Mansfield also spoke of the existence of double standards where products were promoted differently in different countries with little official surveillance of advertisement claims.

He supported the Malaysian Medical Association’s admission that while developed countries may have two reasons for using a drug, the Third World would have 20.

On the other hand, developed countries would have 10 reasons not to use a drug while the Third World would have only one or two.

The approach of the medical lobby is gentle and according to Dr Mansfield it is not their intention to alienate the pharmaceutical industry but get them to do the right thing.

He said the drug companies have not been able to refute the lobby’s claims and have refute the lobby’s claim and have responded with changes in their policy, although they have met with resistance at times.

Besides the drug companies are also concerned about their image in the major markets, and the need to be seen as responsive.

The medical lobby counts as one of their successes the fact that Bayer had undertaken to modify its advertisement for a penicillin called binotal. It had been inaccurately described in advertisements to Indonesian doctors as effective against a wide variety of bacteria. Yet gonorrhoea, for example, one of the recommended uses had a 30 to 50 percent resistance rate to this drug.

The medical lobby was also one of the groups to express concern about differences in the promotion of two drugs phenylbutazone and oxyphenbutazone, between Europe and Asia.

These are dangerous drugs, according to Dr Mansfield, to be used for severe diseases like rheumatoid arthritis but were being suggested for use for common illnesses such as headache and virus infections.

With other safer, equally effective drugs available, Britain decided to ban oxyphenbutazone and strictly limit the uses for phenylbutazone. In 1984, the manufacturer, Ciba-Geigy, informed Holland and Australia of precautions that should be taken with these drugs.

Yet in Indonesia, Malaysia and Thailand, the drugs were promoted with no mention of the precautions and were even recommended for long-term treatment and for quite inappropriate uses.

Ciba-Geigy has since announced a worldwide withdrawal of oxyphenbutazone, and strict limitations on the use of phenylbutazone. Dr Mansfield said this showed the drug companies would do the right thing with a little encouragement.

Dr Mansfield said MLAM’s aims were to encourage the drug companies to provide adequate information about indications, effectiveness and adverse effects of the drug.


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Email a Friend influence multinational corporations effectively, the efforts of governments will have to be complemented by others, notably the many voluntary organisations that have shown they can effectively represent society’s public-health interests…
A small group known as Healthy Skepticism; formerly the Medical Lobby for Appropriate Marketing) has consistently and insistently drawn the attention of producers to promotional malpractice, calling for (and often securing) correction. These organisations [Healthy Skepticism, Médecins Sans Frontières and Health Action International] are small, but they are capable; they bear malice towards no one, and they are inscrutably honest. If industry is indeed persuaded to face up to its social responsibilities in the coming years it may well be because of these associations and others like them.
- Dukes MN. Accountability of the pharmaceutical industry. Lancet. 2002 Nov 23; 360(9346)1682-4.