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The Knowledge Network on Innovation and Access to Medicines is a project of the Global Health Centre at the Graduate Institute, Geneva. The project seeks to maximize the contributions of research and analysis to producing public health needs-driven innovation and globally-equitable access to medicines.

Research Synthesis: Donations

 

v1.0 researched and written by Elise Erickson, edited by Suerie Moon, last updated June 2018

Introduction​

 

The literature on drug donations is thin*, especially with regards to non-emergency contexts and sustainability. Additional research seems to appear around revisions of the WHO’s ‘Guidelines for Drug Donations’ (revisions published in 1999 and 2010), but has been scarce since 2011/2012.

Search terms 

 

Pharmaceutical/medicine/drug and donations​

Synthesis of the literature

 

The WHO Guidelines for Medicine Donations (revised in 2010) is a key document (World Health Organization (WHO) 2011).

There are a handful papers that examine the extent to which donations comply with these WHO guidelines (Benaragam and Fernandopulle 2010; Bero et al. 2010; Dijk, Dinant, and Jacobs 2011; Reich et al. 1999), and others that document inappropriate donations pre-WHO guidelines (Berckmans et al. 1997). There is evidence that despite guidelines, many donations continue to be inappropriate (e.g. expired, unannounced, unsorted, or not registered in the recipient country). Cañigueral-Vila et al. (2015) propose both content and format modifications for the next edition of the guidelines.

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​There are a few studies that describe specific donation programs (Shretta et al. 2000, 2001; Thylefors, Alleman, and Twum-Danso 2008). Descriptions of Merck’s Mectizan donation program received a fair amount of attention as it has been running since 1987 (Thylefors, Alleman, and Twum-Danso 2008; Thylefors 2008; Samsky 2012; Collins 2004).

​There appear to be more studies on drug donations in post-emergency settings (Berckmans et al. 1997) rather than non-emergency settings. Only a few papers examine questions of sustainability (including access or price) associated with donations in a non-emergency context (Guilloux and Moon 2000; Pérez-Casas, Herranz, and Ford 2001; Rustomjee and Zumla 2015). Access concerns are also sometimes found in commentary pieces  (Smith 2017). Others argue that donations should be scaled-up, and that they are an appropriate answer to access issues such as medicine shortages and concerns with the impact of intellectual property rules (Tzeneva 2014).

Research gaps

  • Impact of drug donations on medicines access, prices and on generics industry

  • Sustainability of donation programs, especially in non-emergency settings and for diseases with long-term treatment periods (e.g. HIV/AIDS, TB, etc.)

  • Tracking of product donation history of different pharmaceutical companies over time (in emergency and non-emergency contexts)

  • Better understanding of tax benefits for pharmaceutical companies that make donations

* For the purposes of this review, we have established three categories to describe the state of the literature: thin, considerable, and rich. 

-   Thin: There are relatively few papers and/or there are not many recent papers and/or there are clear gaps

-   Considerable: There are several papers and/or there are a handful of recent papers and/or there are some clear gaps

-   Rich: There is a wealth of papers on the topic and/or papers continue to be published that address this issue area and/or there are less obvious gaps

 

Scope: While many of these issues can touch a variety of sectors, this review focuses on medicines. The term medicines is used to cover the category of health technologies, including drugs, biologics (including vaccines), and diagnostic devices.

Disclaimer: The research syntheses aim to provide a concise, comprehensive overview of the current state of research on a specific topic. They seek to cover the main studies in the academic and grey literature, but are not systematic reviews capturing all published studies on a topic. As with any research synthesis, they also reflect the judgments of the researchers. The length and detail vary by topic. Each synthesis will undergo open peer review, and be updated periodically based on feedback received on important missing studies and/or new research. Selected topics focus on national and international-level policies, while recognizing that other determinants of access operate at sub-national level. Work is ongoing on additional topics. We welcome suggestions on the current syntheses and/or on new topics to cover.