The Govt must ensure that Malaysia does not become a dumping ground for hazardous medical products

by Chan Chee Khoon

Haemophilia patients were infected through transfusions, mostly with imported blood products.

On May 22, 2003, the New York Times carried an article in which Malaysia was mentioned (along with Taiwan, Hong Kong, Japan, Singapore, Indonesia, and Argentina) as one of the countries where Cutter Biological - a Berkeley-based division of the German pharmaceutical giant Bayer - knowingly continued to sell Factor VIII (a blood clotting medicine for haemophiliacs) which was quite possibly HIV-contaminated. This went on for at least a year after a safer, heat-treated alternative was available, as the company tried to clear its inventory of old stocks.

Worse, the New York Times article reported that �even after it began selling the new product, the company kept making the old medicine for several months more. A telex from Cutter to a distributor suggests one reason behind that decision: the company had several fixed-price contracts and believed that the old product would be cheaper to produce�. Hong Kong and Taiwan between them have recorded about 100 cases of HIV infections among haemophiliacs. According to the South China Morning Post (May 23, 2003), �the government later confirmed that 61 of Hong Kong�s more than 200 haemophiliacs had been infected with HIV, the virus that causes AIDS�.

In Japan, haemophiliacs accounted for the majority of the 4,000 HIV/AIDS cases reported as of the mid-1990s. In Latin America, at least 700 cases of HIV/AIDS similarly arose from the use of contaminated blood products by haemophiliacs.

Citizens� Health Initiative (CHI) has tried to ascertain the number of Malaysian haemophiliacs who were diagnosed as HIV seropositives and/or AIDS cases from 1985 onwards.

Based on a global prevalence of 1:10000, the Haemophilia Society of Malaysia estimates that there may be about 2,000 people with haemophilia in Malaysia, of whom 1,213 were registered with the society as of December 2001. The society is aware of 12 haemophilia patients who were infected with HIV through transfusions in Malaysia, mostly with imported blood products. A New Straits Times cutting from late 1996 reported Health Ministry figures of 32 HIV/AIDS cases (cumulatively, 1985 - June 30, 1996) arising from blood transfusion or contaminated Factor VIII. Unfortunately, there was no detailed breakdown of these figures.

CHI wrote to Dr Ahamad Jusoh, Section of AIDS/STD, and we are still awaiting a reply from the Health Ministry for an updated and more detailed breakdown. The Penang Health Department indicates that between (1988 - April 2003), five HIV/AIDS cases (or thirteen, ambiguous because of possible double-counting) were reported among haemophiliacs in the state. Be that as it may, what is clear is that if the New York Times article gave an accurate portrayal of what transpired in 1984 with Factor VIII, Bayer (Cutter�s) actions were criminally culpable. Some HIV/AIDS advocacy groups feel that this is not a priority issue given that haemophiliac cases account for less than 1% among HIV-infected persons in Malaysia, and in any case, safer Factor VIII and IX are now available.

CHI thinks that there is a bigger issue at stake here: if no action is taken against the companies, it sends a wrong signal that they can get away with dumping hazardous products in Malaysia. What is needed instead is a very strong deterrent against any future temptations to repeat such criminal actions, with other products that they market (or plan to market) in this country. Otherwise, we might end up as a dumping ground of choice for products that are considered too hazardous in countries with stricter rules and penalties against such corporate malfeasance.

We urge the Health Ministry to initiate some appropriate actions, and if necessary, move to amend the laws so as to deter such practices with appropriately punitive sentences.

With the ongoing negotiations in the World Trade Organisation (WTO) for trade liberalisation, it is essential that we retain a high degree of national discretion and adherence to the precautionary principle in order to ensure the safety of imported products, and to protect our environmental health.

This article is based on an open letter that was sent to the Health Minister on June 6, 2003. Chan Chee Khoon is Co-ordinator, Citizens� Health Initiative

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