With regional offices in Africa (Nairobi), Asia Pacific (Colombo), Europe (Amsterdam) and Latin America (Lima) and a Global coordinating office in Amsterdam, HAI is a non-profit, independent, worldwide network of over 200 members including consumer groups, public interest NGOs, health care providers, academics, media and individuals in more than 70 countries.

HAI works towards a world in which all people, especially the poor and marginalised, are able to exercise their human right to health. HAI’s contribution is through advocating for increased access to essential medicines and improved rational use of medicines (RUM). This is achieved through research excellence and the engagement of civil society in advocacy in the medicines policy debate.

Together with its partner organisations, HAI recognises that poverty and social injustice are the greatest barriers to health and sustainable development. Partners are working for just societies where people can participate equitably in all decision making that affects their health and well being, including the allocation of resources. Partners work together to respond rapidly to priority issues by sharing information and expertise. Collaboration creates a broad base of support and ensures that the concerns of diverse communities are communicated at local, regional and international levels.

16 June 2009- A large alliance of European health stakeholders welcome Health Ministers’ critical conclusions on the proposed Directive “Information to the general public on medicinal products subject to medical prescription”. Read more

12 June 2009 - The TransAtlantic Consumer Dialogue (TACD), Health Action International (HAI) and Knowledge Ecology International (KEI) hosted a public meeting on the issue of intellectual property rights enforcement in Brussels on Wednesday, June 10th.
Click here for joint press release

Medicines are a vital part of improving and maintaining health and healthcare professionals, such as doctors and pharmacists, play a key role in ensuring that medicines are prescribed and used rationally. However, numerous concerns have been raised about the relationship between healthcare professionals and the pharmaceutical industry - particularly the industry’s influence on prescribing and dispensing decisions. This influence can lead to less than optimal treatment choices and can even be detrimental to patient health.

Research shows that while in training, many healthcare professionals receive little or no instruction on how to assess pharmaceutical promotion and how to understand its often subtle influence on their behaviour. In response, WHO and HAI have developed a new publication: Understanding and Responding to Pharmaceutical Promotion – A Practical Guide. This draft manual can assist educators and healthcare professionals in teaching medical and pharmacy students about pharmaceutical promotion.

On Wednesday, 20 May, Health Action International (HAI) held a Technical Briefing at the 62nd World Health Assembly, From Education to Regulation: Innovative Tools for the Rational Use of Medicines to present new initiatives aimed at improving public health by addressing the consequences of unethical pharmaceutical promotion. The meeting attracted a range of country delegations, health professionals, civil society organisations, medical and pharmacy students, academics and representatives from the pharmaceutical industry.

To learn more about the manual and related work on pharmaceutical promotion, please review the event materials from the briefing session.
Download the invitation, programme, and the event memo. Download the presentations below:

Carlos Fidel Berríos Cruz, MD, MPH, Director of Projects, Farmacéuticos Mundi, Managua, Nicaragua and member, AIS-Nicaragua (HAI-Nicaragua)

Barbara Mintzes, PhD, (Manual editor), HAI Global, Amsterdam, The Netherlands and Assistant Professor, Department of Anesthesiology, Pharmacology & Therapeutics, Therapeutics Initiative, University of British Columbia, Vancouver, Canada

Dee Mangin, (Manual editor), MB, ChB, DPH, Associate Professor and Director, Primary Care Research Unit, Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand

Carole Piriou, HAI-Africa, Nairobi, Kenya

Lilia Ziganshina, MD, PhD, Doctor of Sciences, Professor, Kazan State Medical Academy, Russia and HAI Global, Amsterdam, The Netherlands

Please click here to download Sample Chapter 3, Analysing pharmaceutical advertisements in medical journals, by Joel Lexchin

2 March 2009- Health Action International Europe (HAI Europe) welcomes the EMEA’s decision to hold a consultation on the draft Eudra Vigilance Access Policy for medicines for human use. Giving stakeholders access to Adverse Drug Reaction (ADR) data is an important step. However, ‘access’ is not the end of the story and it is vital that the process of retrieval and format of information is suitable for those who wish to use the data. As it stands, there is no evidence that the EMEA or any other part of the EU has asked stakeholders, in particular health professionals, patients and consumers how they wish to use this information. Read more

27 February 2009- Health Action International Europe (HAI Europe) welcomes the EMEA’s decision to hold a consultation on the draft EMEA Policy on the Practical Operation of Access to EMEA documents. Public accountability of regulatory decisions is only possible if the public has access to the evidence on which those decisions are based, and is provided with the decision making rationale. Read more

17 February 2009- In cooperation with the EU Coherence Programme (www.eucoherence.org), Health Action International, Europe hosted an expert meeting on Medicines, Access, Trade and Health, with a particular focus on the bilateral negotiations on trade agreements between the European Union and the Andean community (CAN) countries: Bolivia, Colombia, Ecuador, Peru. We are in the process of posting the meeting materials. We currently have the final programme, speaker presentation summaries , concept note and event memo available..

10 February 2009- Oxfam Novib and Health Action International call on the Dutch Government to launch an immediate inquiry on the interception of a shipment of generic medicines by the Dutch customs authorities. The seizure of this shipment, in transit from India to Brazil, undermines the free trade of goods and contradicts international public health policies, which have been strongly endorsed by the Dutch government. Read more. Also available in Dutch.

9 February 2009- On behalf of a wide constituency of non-governmental organisations representing European and Latin American civil society organisations, we would like to express our grave concern with respect to agreements under negotiation between the EU and Andean Community countries (CAN), especially as these agreements will impact access to medicines in the Andean region through the inclusion of strict Intellectual Property Rights provisions. Read more.

6 February 2009- Health Action International and Oxfam Novib are calling on the Dutch government to launch an immediate inquiry into the seizure of a shipment of generic blood pressure medicine en route from India to Brazil. The seizure in Rotterdam represents the latest case of European enforcement of intellectual property (IP) rights trumping access to medicines. The worrying trend of intercepting legitimate trade between generics manufacturers and developing country consumers could severely impact the affordability and availability of medicines in developing countries. Read more. Also available in Dutch.

11 December 2008- As DG Enterprise’s pharmaceuticals package came up for discussion at the college of Commissioners, all eyes were on the contentious proposal on ‘information to patients’ that is undoubtedly a relaxation on regulations for direct-to-consumer advertising (DTCA) of prescription-only medicines in Europe.
Read more

The presentation of facts gathered from the ten month investigation confirmed the fears of many civil society organisations that more affordable generic medicines were being stopped from reaching patients and consumers in Europe. Commissioner Neelie Kroes opened the proceedings with a speech presenting some of the most shocking findings from the inquiry such as evidence that some members of the pharmaceutical industry in Europe “have designed and implemented strategies aimed at blocking or delaying generic entry”. The day continued with a presentation of the findings followed by questions from participants, inputs from several other DGs and substantial participation from industry representatives. However, the overall structure of the programme demonstrated a distinct asymmetry between the commercial and public health perspectives, with significantly less time accorded to discussing the public health consequences of the inquiry's findings.
Read more

With the European Commission's consultation on 'patient information' – or advertising by any other name – nearing its conclusion, and the possibility of a legislative proposal to introduce DTCA looming, what is happening elsewhere?
In Canada, a major media company, CanWest MediaWorks is suing the federal government, claiming that the law prohibiting DTCA infringes on its freedom of expression. Read more about it here

Amsterdam, January 18 - HAI Europe welcomes the investigation launched into the pharmaceuticals sector by the DG Competition of the European Commission. On the 16th of January antitrust regulators raided several of the largest pharmaceutical companies in Europe.

This investigation is a response of the Commission to indications that competition in the European pharmaceuticals market is not working well: lack of innovative medicines being brought into the market, and delays in the registration and commercialization of generics. The inquiry will investigate the factors contributing to the current situation.

The commission suspects that the companies in question, either by misusing patent rights or recurring to vexatious litigation and other means, have made it extremely difficult for other generic manufacturers to enter the European market.

HAI Europe welcomes the move taken by the Commission in defending consumer and patient rights and hopes that the results of the enquiry will lead towards ensuring equitable access to essential medicines within the European Region.

On 18 May 2007, the 60th WHA approved the Resolution on Rational Use of Medicines. This resolution calls for an integrated health-systems approach to the rational use of medicines and urges Member States to set a national body aimed at monitoring and promoting the rational use of medicines.

In addition, it advocates for a multidisciplinary approach among interested parties, as well as the engagement of civil society. Most notably, it urges Member States to enact and enforce legislation to ban unethical drug promotion, as well as calling for governments to work on the provision of independent information.

HAI has been involved in the writing up of this resolution since its inception. We have also lobbied actively for its approval, as we recognize that there is a lot to be done in what concerns the rational use of medicines. The foundation has now been laid for future work in this field and we shall be looking forward to the rolling out and implementation of the resolution.

As a preparatory activity, HAI organized, jointly with WHO, EPN and ReAct a briefing on 15 May entitled Saving lives, Saving money, achieving the rational use of medicines. The event was well attended and highlighted the importance of the resolution being proposed and its potential impact on health outcomes.

The presentations from that briefing are now available here.

For the resolution, click here

For the report on the Progress in the rational use of medicines, click here

HAI Europe thanks all those who helped to celebrate its 25th Anniversary by attending the special jubilee conference ‘Pills, Politics and Practice’ in Amsterdam on 26-27th October 2006 (For programme click here).
The report on the conference proceedings can now be downloaded by clicking here.

These proceedings give further links to the speakers’ biographies. For an overview of those who registered participation at the conference please click here.

If you would like to obtain a copy of the special conference publication ‘Pills, Politics and Practice’ which was distributed to all participants during the conference and which featured some of the people who have made HAI a leading NGO worldwide on pharmaceutical policy issues, then please contact the HAI Europe secretary, Rose de Groot, on rose@haiweb.org.

Educating medical and pharmacy students about drug promotion

An editorial in the November 2006 issue of the open-access journal PloS Medicine highlights the need to educate health professionals about drug and device medicine and provides key recommendations for how this education should be carried out. Four groups are involved in this call to action: the American Medical Students’ Association, Healthy Skepticism, No Free Lunch and PharmAware. See full article

HAI-Europe and WHO are jointly collaborating on a project, together with an international team of educators, to develop and field test an educational manual for medical and pharmacy students on drug promotion. A global survey of educational initiatives carried out as part of this project describes the work of 228 educators from 64 countries. There are many individual initiatives to educate students about the influence of drug promotion on professional practice, but they remain marginal in most cases to core curricula, with students in most cases devoting one half day or less to this topic during their professional training. See full survey report

EMEA implementation of transparency regulations called into question

11th October 2006 – A broad definition of commercial confidentiality is the key barrier to public access to information on the safety and effectiveness of medicines, leaving European citizens at greater risk for otherwise preventable harm.

For more information, please read the press release

HAI Europe responds to EU Pharmaceutical Forum initiative: is this advertising disguised as health information?

Health Action International Europe (HAI-E), the International Society of Drug Bulletins (ISDB), the Association Internationale de la Mutualité (AIM), the Bureau Européen des Unions de Consommateurs (BEUC), and the Medicines in Europe Forum (MiEF) have endorsed a joint declaration on the provision of relevant health information to citizens, to be presented on the occasion of the meeting of the European’s Commission Pharmaceutical Forum.

Considering that health information is a fundamental and necessary part of healthcare, the organisations call for a clear distinction between information and advertising disguised as “information”. They warn of the inherent conflicts of interest of pharmaceutical companies which are unable to provide unbiased comparative information on available drug and non-drug treatment alternatives.

For more information, please read the press release or download the declaration.

HIV/AIDS Universal Access by 2010 ten challenges on the way

If universal access to antiretroviral therapy (ART) by 2010 is to be achieved, all those engaged in implementation - at every level - must address challenges. HAI has developed a policy brief which highlights 10 challenges on the way to achieving universal access to ART by 2010. Healthworkers, policy makers and ART users from 14 countries identified these challenges during rapid appraisal assessments conducted by HAI, the International Treatment Preparedness Coalition (ITPC) and the University of Amsterdam. Read the brief.

Now in Spanish: Acceso Universal para el 2010 10 retos en el camino

Report from the HAI Seminar on Risk communication with patients

This seminar was a by-product of HAI Europe’s participation in the Working Group with Patients’ and Consumers’ Groups in the European Medicines Agency (EMEA).One area of work of this Working Group is Pharmacovigilance, information and communication about safety issues, Adverse Drug Reactions (ADR) of medicines and reporting systems for ADR.

The issue of communication with the public and patients about the positive and negative effects of medicines involves both patients’ and consumers’ groups and so HAI Europe arranged an additional seminar in London for the members of this Working Group who came together for the EMEA meeting.
Read more ....

A small HAI team stayed on after the WHA to lobby members of the Executive Board in support of the WHO secretariat's proposed resolution on the Rational Use of Medicines (RUM) last week. HAI welcomes the decision of the EB to revisit the resolution next year before it goes forward to the World Health Assembly. However, whilst the resolution passed by the EB re-establishes the Rational Use of Medicines as a core agenda item, the resolution could go much further.
Read the press release and HAI's intervention to the Executive Board here

Health Action International (HAI) applauds the decision of the World Health Assembly (WHA) to pass a resolution which calls on governments to act to boost innovative research and development (R&D) of medicines. The passing of this resolution indicates that governments recognize the crisis in R&D and the failure of current systems to effectively address health needs in developing countries. The resolution builds on the findings of the Commission on Intellectual Property Rights, Innovation and Public Health (CIPIH)) report and acknowledges the need for immediate action.
For full text of Press Release

Recent high-profile drug withdrawals, such as Vioxx and Lipobay, have rightly proved to sharpened public interest in the European system of pharmacovigilance. Moreover, the tendency towards the direct promotion of medicines to consumers (especially via the internet), the limited amount of clinical trial data available to the general public, shorter approval times and the switching of prescription only medicines to over-the-counter, all add up to the need for robust post-marketing surveillance. It is therefore timely and appropriate that HAI is pleased to engage with the European Commission’s (DG Enterprise) consultation on pharmacovigilance in the EU, which we argue is flawed, and certainly cannot offer the robust and responsive system that European citizens might expect, need and vote for. Read our full response here

HAI is encouraged by the clear assertion in the report of the need for people oriented approaches to health policy, and that application of intellectual property rules should take account of the circumstances in which they were being used. 'Real people and not realpolitik should be the central emphasis' stated Dr. Kumuriah Balasubramaniam, Regional Coordinator of the Asia-Pacific Office. Read more

Education of medical and pharmacy students plays a crucial role in preparing future practitioners to respond appropriately to drug promotion. But a survey of medical and pharmacy schools, conducted by HAI and WHO in 2005, found that while most respondents included education on promotion in the required curriculum, a half a day or less was devoted to this important issue during the students’ professional training. In nearly one-third of cases, medical schools devoted only 1-2 hours often within a broader course on pharmacology, clinical pharmacology or therapeutics. Few students are taught how to respond to patient requests for advertised drugs despite direct-to-consumer advertising of prescription drugs and other promotional techniques targeting the public becoming more prevalent. These are some of the key findings in the survey report Educational initiatives for medical and pharmacy students about drug promotion: an international cross-sectional survey by Barbara Mintzes.