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WORLD HEAlth ORGANISATION STUDY GUIDE Raffles Model United Nations 2018 Sapere Aude – Dare to Know
WORLD HEAlth ORGANISATION
STUDY GUIDE
Raffles Model United Nations 2018 Sapere Aude – Dare to Know
TABLE OF CONTENTS
WELCOME LETTER FROM THE DAIS 2
CHAIR BIOGRAPHIES 4
THE COMMITTEE 6 Introduction to the Committee 6 Mandate of the Committee 8
TOPIC A: THE ISSUE OF COMBATING SUBSTANDARD AND FALSIFIED MEDICINES 10
Statement of Problem 10 Current Situation 13 Past International Action 17 Case Studies 19 Key Areas of Concern 21 Identification of Blocs 21 Proposed Solutions 23 Key Guiding Questions 25 Suggestions for Further Research 25 Bibliography 26
TOPIC B: THE ISSUE OF PESTICIDE USE IN FOOD PRODUCTION 29 Statement of Problem 29 Historical Background of the Problem 30 Current Situation 33 Past International Action 35 Case studies 37 Key Areas of Concern 38 Identification of Blocs 39 Proposed Solutions 40 Key Guiding Questions 41 Bibliography 41
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WELCOME LETTER FROM THE DAIS
Dear Delegates,
Welcome to the World Health Organisation (WHO) of RMUN 2018! It is my pleasure to be
chairing this council with my co-chairs, Haoyang and Jiating. During the conference, I hope you
will find like-minded delegates who are passionate about global health issues, vigorous in
reasoning and innovative with solutions to debate and collaborate with!
The Issues of Substandard and Falsified Medical Products and the Use of Pesticides in Food
Production are the top priorities on the WHO’s agenda this year.
Substandard and Falsified Medical Products continues to remain a murky issue. Only recently in
2013 did the WHO begun to build a database regarding these illegal products. Nevertheless, the
valuable information collected in the following years have managed to shed some light on the
magnitude of the problem. Much more can still be done at both the national and international
level to prevent this problem from occurring, and to better detect and strengthen response when
the problem does arise.
The Use of Pesticides in Food Production has been a long-standing, controversial issue. Its
benefits in increasing food yield is widely acknowledged, but the powerful influence of the
pesticide industry on regulatory agencies and on assessments of the risks of pesticides has and is
likely to continue leading to detrimental outcomes for public health. Solutions to stop this
influence and to establish a common framework for regulating pesticides moving forward is
greatly needed. Furthermore, recent suggestions of ecological farming as an alternative could be
explored, so that pesticide use and the harms they bring can be significantly reduced.
I look forward to seeing delegates who are well-prepared for the issues and well-versed in their
country stances engage in discussion. Empathy, sound reasoning, and originality are critical for
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developing effective solutions to these problems. On a final note, remember the journey is more
important than the destination―if anything, stay curious to learn and wanting to improve, and
most importantly, have fun in council! If you encounter any problems along the way, do contact
your chairs at [email protected].
Best regards,
Aaron Chua
Head Chair, World Health Organisation, RMUN 2018
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CHAIR BIOGRAPHIES
Head Chairperson: Aaron Chua Cher Jin
Aaron is a second year student in Raffles Institution who is taking the ubiquitous PCME subject
combination. His interest in global affairs led him to join the Historical and Strategic Affairs
Society. Since then, he has participated in 5 MUNs, obtaining a couple of VCs before going on
to clinch a Best Position Paper and an Outstanding Delegate award. He has a penchant for
in-depth understanding and novel ideas, both within and without MUNs. Among other things, his
main hobbies include bicycle touring, watching YouTube and reading. He hopes that delegates
will be able to expand their understanding of the world beyond the microcosm of the Singapore
education curriculum through RMUN, and hone their speaking, writing and collaboration skills
in the process.
Deputy Chairperson: Pang Haoyang
Haoyang is a pro at MUN-ing, in Chinese before moving to Singapore. While studying in
Singapore at the secondary level, he was unaware of the existence of Singapore MUNs. In Junior
College, he joined HSTA and restarted his MUN journey― this time in English. Although it was
difficult familiarizing himself with various complicated English terms, his efforts have paid off:
he attained a VC in his second MUN, a Honourable Mention in his third, and an Outstanding
Delegate award in his fourth. Unfortunately, his streak of improvement was broken when he
attained another Outstanding Delegate award at his fifth MUN. Though his record may not
outshine those of his council’s delegates, he is confident that his pace of improvement and
interest in foreign affairs makes up for it. Haoyang truly hopes that his delegates will not only
focus on competing for rewards, but to understand the issues and be encouraged to make changes
in the real world. Above all, he wishes that the council will have fun, and enjoy this experience.
Deputy Chair: Ling Jiating
Jiating is a Year 5 student taking the fairly orthodox PCME combination (despite hating
physics). When she is not attempting to remember pages of equations or being distressed over
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how economics works, she can usually be found jamming to K-Pop or trying to break her sleep
record of 25 hours. Having joined HSTA with zero experience at MUNs, Jiating has only
recently embarked on her MUN journey this year at SMC. Hence, she is well aware of the
uncertainties that fellow new MUNners may face, and is always ready to lend a listening ear. She
sincerely hopes that delegates will not only be able to take away new insights from RMUN, but
also truly enjoy and treasure their time in council!
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THE COMMITTEE
Introduction to the Committee
The World Health Organisation (WHO) is a specialised agency of the United Nations (UN) that
was formed on 7 April 1948. It acts as the “the directing and coordinating authority on
international health within the United Nations’ system” and takes the lead in addressing health
issues. The WHO is actively involved in the entire process, from monitoring health trends and
crafting the research agenda, to formulating policy options and providing technical assistance. 1
The WHO has had significant successes in dealing with global health issues.
In 2013, the WHO Substandard and Falsified Medical Products Group was able to quickly
respond to a case in Paraguay where the presence of a wrong ingredient in cough syrup caused
44 children to be hospitalized. The children suffered from difficulty breathing due to the
consumption of a dangerous drug, levomethorphan, instead of dextromethorphan. The WHO
used the precedent of a previous such incident in Pakistan to identify the cause of the outbreak,
and was able to successfully avert the crisis by quickly notifying local authorities to treat patients
with an antidote to levomethorphan. 2
In 2014, WHO was also able to successfully identify and counter a case of falsified medication
in the Ituri district of the Democratic Republic of Congo. Authorities found that the drug
haloperidol, which can cause muscle spasms and rigidity or even induce coma, was used in place
of diazepam, a medicine used to treat anxiety, causing 930 people to be hospitalized with
1 What we do. (2016, September 01). Retrieved from http://www.who.int/about/what-we-do/en/ 2 WHO Global Surveillance and Monitoring System for substandard and falsi ed medical products. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
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dystonia and 11 deaths by the time the problem was identified. WHO supported further
investigation into the case, determining that some falsified products bore names of manufacturers
who did not even produce diazepam. Upon confirmation of falsification, WHO issued an
international medical product alert to notify neighbouring countries on the case, and proposed an
antidote, successfully checking the distribution of this falsified product. 3
More recently in 2017, the International Code of Conduct for Pesticides Management developed
by the WHO and FAO (Food and Agricultural Organization of the United Nations) was
instrumental in guiding the efforts by 11 Caribbean countries in clearing 319 tonnes of obsolete
pesticides stocks and related wastes. Current Chairperson of the Coordinating Group of Pesticide
Control Boards of the Caribbean, Miriam Serrut, has also called for stakeholders, in particular
the pesticide industry, to heed its responsibilities outlined in the above mentioned Code of
Conduct in order to launch and implement a pesticide stock management system preventing the
future accumulation of obsolete pesticides stocks. 4
However, the successes of the WHO are limited by several factors. The Paraguay example
highlights the urgent need of a global system that can quickly alert people worldwide to the
danger posed by substandard and falsified medical products by global supply chains. This is also
an area lacking in the Ituri case where poor international collaboration mechanisms led to missed
detection opportunities of levomethorphan disguised as diazepam. International collaboration is
especially important today in light of globalisation in the 21st century. Without an efficient
system to disseminate relevant information and take actions, the influence of WHO’s
recommendations would be greatly restricted.
Other factors driving production and distribution of falsified medications illustrated by the Ituri
case that the WHO has yet to address include: poor infrastructure limiting access to quality
3 ibid. 4 Ninvalle, P. (2017, November 15). Saint Lucia joins in removal of obsolete pesticides and hazardous wastes.
Retrieved from https://stluciatimes.com/2017/11/15/saint-lucia-joins-in-removal-of-obsolete-pesticides-and-hazardous-wastes/
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medicines, irrational use of medicines creating market for substandard or falsified products,
weak regulatory capacity of countries, lack of field detection technologies and laboratory
capacity impeding detection and increasing detection time, as well as disproportionate actions or
responses by the local government potentially exacerbating situations. These factors could be
considered for both the issues covered below in this study guide, and international healthcare as a
whole.
Mandate of the Committee
The role and responsibility of the WHO includes providing leadership for matters relevant to
global public health concerns and facilitating cooperation between government, NGOs and
relevant professional bodies especially with respect to research and knowledge sharing. It also
extends to issuing policy recommendations based on scientific evidence and bioethics, thereby
helping to establish norms and standards in emerging health issues. Furthermore, it aids in the
practical implementation of health policies in member countries through providing technical
support and building up stable institutions, as well as through ongoing assessment of healthcare
trends.
The WHO mainly functions as an advisory board, and therefore delegates should note that while
they are able to provide suggestions or recommendations to the international community, they
cannot force states to adopt specific policies or measures. Delegates are also unable to
purposefully allocate funding or resources from specific states in order to achieve their goals.
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TOPIC A: THE ISSUE OF COMBATING
SUBSTANDARD AND FALSIFIED MEDICINES
Statement of Problem
Introduction
Cures to illnesses have been peddled since ancient times, but medical products have
exponentially grown in importance in the twentieth century with the discovery and development
of radical methods of protecting health. For example, though vaccinations were used as early as
the seventeenth century in China and discovered in the late eighteenth century in Europe, it was
only in the twentieth century when the development of many of today’s most important vaccines
took off. Similarly, antibiotics was discovered only in the previous century, yet their use is 5
ubiquitous today. Medical products have become an essential part of modern life, enabling
societies and individuals to stay healthy and function effectively― smallpox, killed an estimated
400 000 people annually in Europe alone during the eighteenth century, but has since been
eradicated. 6
It is no surprise then that the market for medical products is large and growing― In 2014, total
pharmaceutical revenues worldwide had exceeded one trillion U.S. dollars for the first time. 7
And in the globalized, free-market economy of the twenty-first century, where there is demand
for medical products, there will be supply.
Unfortunately, supply does not always keep pace with demand in the markets of many medical
products. Consumers, both individuals and healthcare institutions, are compelled to turn to less
trusted sources of medical products, providing unscrupulous manufacturers the opportunity to cut
5A brief history of vaccination. (2017, April 04). Retrieved from http://www.immune.org.nz/vaccines/vaccine-development/brief-history-vaccination 6B. (n.d.). Retrieved from https://web.archive.org/web/20090601172056/http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=vacc.chapter.3 7Laporte, J. (n.d.). Topic: Global Pharmaceutical Industry. Retrieved from https://www.statista.com/topics/1764/global-pharmaceutical-industry/
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costs and increase profits by supplying Substandard and Falsified (SF) medical products.
Moreover, since verifying the authenticity of medical products typically requires sophisticated
technologies, most buyers do not even realise they have been deceived. Verifying that a medical
product is SF requires a lengthy process of laboratory tests, and this process typically begins only
after trained staff along the supply chain report something suspicious about the product, such as
its repeated failures to work.
SF medical products were previously labelled Substandard, Spurious, Falsely-labelled, Falsified
and Counterfeit (SSFFC). However, this was abridged to SF medical products to exclude certain
issues, such as the breaching of intellectual property rights, which the WHO believed was
beyond its mandate. 8
Definitions
Substandard medical products are medical products that do not meet the quality standards of the
government drug regulator. It is distinct from falsified medical products as there is no intent to
fool or defraud the consumer.
Falsified medical products also fall short of quality standards but are characterised by their
deliberately misrepresentation of their identity, composition and/or source . Common problems 9
arising from falsified medicines are the lack of key ingredients, incorrect degree of potency,
presence of wrong active ingredients and dangerous contaminants, production in unsanitary or
unsterile conditions and improper labels.
A closely related issue but one that is beyond the scope of council is unlicensed medical
products. These are products that have not undergone evaluation and/or approval by the National
8Definitions of Substandard and Falsified (SF) Medical Products. (2017, June 19). Retrieved from http://www.who.int/medicines/regulation/ssffc/definitions/en/ 9 In the technical terms of the WHO, “identity” refers to the name, labelling or packaging or to documents that support the authenticity of an authorized medical product, “composition” refers to any ingredient or component of the medical product, “source” refers to the identification of the marketing authorization holder, manufacturer, importer, exporter, distributor or retailer. “Deliberate misrepresentation” refers to any substitution, adulteration, or reproduction of an authorised medical product, or the production of an unauthorised product.
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or Regional Regulatory Authority (NRRA) for the market in which they are marketed,
distributed or used.
Consequences
The most obvious consequence is that SF medical products prolong the illness and corollary
suffering of the individual consumer. Furthermore, since the consumer is unable to work and
require a second treatment, personal finances are strained. In the worst cases, consumers die
from the untreated disease or the SF medical product itself.
Healthcare systems are also hindered by SF medical products from operating efficiently. Health
workers waste time attempting alternative treatments when a quality version of the same
treatment would have sufficed. Public and private healthcare institutions alike―including
healthcare NGOs, national health systems, and insurance companies―deplete their funds, while
the general public may lose confidence in medical products. Legitimate pharmaceutical
manufacturers bear the cost of product recalls, and lose out when public confidence is
undermine. These lead to a greater degree of suffering, illnesses and deaths that could have
otherwise been easily prevented or cured.
The global population is also affected, as SF medical products promote antimicrobial resistance.
Antimicrobial medicines are manufactured and prescribed at precise doses to destroy pathogens.
SF medical products contain only a fraction of the correct dose or are designed incorrectly such
that the active ingredients are not properly released. They only destroy some of the pathogens,
leaving behind those that have mutated enough to survive low doses of the medicine. With the
more susceptible pathogens killed by the weak medicines, the more resistant ones have room to
multiply and spread to other people, rendering even authentic antimicrobial medicines ineffective
on those infected. Those who profit from SF medical products are typically criminals, some of
whom were found to use the profits for other illegal activities.
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Thus it is of paramount importance for WHO to resolve this issue to end the direct and indirect
harm that SF medical products bring to public health. 10
Current Situation
Prevalence and Range
The prevalence and full range of SF medical products is not known till date, but the WHO is able
to get a glimpse of the severity of the problem based on the database collectively constructed by
the multitude of National Medicines Regulatory Authorities (NMRAs) involved in the WHO’s
Global Surveillance and Monitoring System (GSMS).
In just four years of operation of the GSMS, one thousand five hundred reports of SF medical
products have been made, from the countries shaded in blue in Figure 1. However, the
prevalence of the problem is likely to be even more severe. The reports only include those from a
limited number of focal points of NMRAs, by staff who have been trained to identify and report
SF medical products. In fact, the WHO has found an unsettling direct correlation between the
number of focal points it has trained over the years and the number of suspect products reported,
which suggests that many SF medical products exist but go unreported only because of the lack
of trained staff to do so.
10 Further readings on the consequences of SF medical products can be found at the bottom of the study guide
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Figure 1: Countries in which SF medical products have been
discovered and reported to the GSMS from 2013–2017 (Source: WHO)
The range of SF medical products is very broad. Table 1 shows some of the common types of
products that have been reported. Barriers to reporting pervade the entire medical supply chain.
The authentic packaging of most SF medical products makes identification by distributors and
individual consumers near impossible. Though better equipped at identification, licensed
manufacturers risk damage to their product’s or brand’s reputation, while healthcare
professionals may face a poor reporting system, or fear reprisals from managers or the SF
medical product manufacturers when they report.
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Figure 2: Examples of SF medical products reported
to the GSMS from 2013–2017 (Source: WHO)
The process from production to consumption is highly sophisticated. Though people have been
falsifying medical products ever since they existed, some producers of SF medical products
today are able to operate much like other transnational corporations, employing technology and
global connectivity to reduce the cost of production. According to the WHO, “[p]roduction is
carried out on an industrial scale at one location or it may be on a smaller and less sophisticated
scale. Often the packaging and the medicines are manufactured and printed in different countries
and all of the components are shipped to a final destination where they are assembled and
distributed.” To bypass regulations, “products are sometimes concealed or smuggled and
declared on the accompanying paperwork as something other than medicines…[s]ometimes,
offshore companies have been used to facilitate the sale of the falsified medicines”. Furthermore,
some manufacturers are able to quickly adapt to the latest authentication devices, such as
holograms, and have been using the Internet as a means of distribution as well.
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SF medical products are frequently found in unlicensed outlets, such as street markets, hawkers
and illegal internet pharmacies. However, they are also reported from legal and regulated outlets
such as hospitals, clinics, pharmacies and drug stores, places where patients should have the
highest degree of confidence in receiving quality medical products.
Causes
An analysis of the 2013-2017 GSMS database revealed patterns among areas where producers
and sellers of SF medical products were able to thrive. Three key factors contributed to the
likelihood of the emergence of SF medical products. The first two relate to falsified medical
products, while the third is relate to substandard ones.
The first factor is constrained access to affordable, safe and quality medical products. Price is an
important consideration for patients and their families, and where a quality product from a
known supplier is too costly, people may turn to cheaper products from unlicensed suppliers.
Attempts by insurance companies and national health systems to cut costs may also undermine
the quality of the medical products obtained. Regions with shortages―whether due to poor
planning of stocks, mishaps in the supply chain, natural disasters or wars―can also induce
wholesalers to turn to less reliable manufacturers to supply medical products.
The second factor is the lack of good governance. In regions where there are no clear
delineations of how each party in the supply chain is responsible for verifying the authenticity of
the intermediate good, the buyer (since he/she will bear the cost if the good turns out to be SF) is
expected to exercise due diligence even though this may not the most appropriate method to
ridding SF medical products. For example, importing countries are typically expected to inspect
their imported medical products, which does make intuitive sense as it indeed the government's
responsibility to safeguard the health of citizens. However, quantities of unique medical product
formulations can reach into the tens of thousands, from hundreds of different manufacturers.
With limited inspection capacity, some importing countries may assume that the medical
products are authentic if they come from well-regulated countries, thus allowing SF medical
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products by conniving, overseas licensed manufacturers to slip through this loophole. This
arrangement whereby the onus of verification is on the importing nation is not just problematic,
but also inefficient: neighbouring countries who are importing similar medical products often
duplicate regulatory structures, where a common one could work. Additionally, the cross-border
nature of SF medical products requires collaborative investigation by many parties to track down
the culprit, so regions where investigation is frequently hampered by governance structures, lack
of expertise in pharmaceutical crime among the police, language barriers, and regional conflict
are where SF medical products are most likely to continue proliferating. Furthermore, the failure
of governance structures to establish transparent accountability mechanisms that encourage
reporting and protect those who voice their suspicions enables SF medical products to continue
spreading under the radar. Finally, regions where institutions have not implemented robust legal
frameworks for countering SF medical products encourages the production of SF medical
products, as criminals are lured by prospects of high profits with little risk of detection,
successful prosecution or harsh penalties.
The third factor is weak technical capacity and tools. Unambiguous standards of
procedures are needed in both production and distribution, so that the quality of medical products
are consistently high and they do not degrade during storage and transport. Detection tools,
trained personnel, and sufficient budgets are also equally important in enforcing these protocols.
Unfortunately, many regions lack one or more of these elements, resulting in a weakened ability
to prevent the emergence of SF medical products.
Past International Action
Member State Mechanism
In 2012, WHO established the Member State Mechanism (MSM), a global platform where
countries can convene and coordinate actions to address substandard and falsified medical
products. Its purpose is to protect public health and promote access to affordable, safe,
efficacious and quality medical products, through effective collaboration between Member States
and WHO to prevent and control substandard and falsified medicine and associated activities.
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For the past 6 years the MSM is developing and promoting training material and guidance
documents to strengthen the capacity of regional regulatory authorities for the prevention and
detection of and response to substandard and falsified medical products. There are other actions
in progression to improve the awareness of countries about the SF drugs and enhance their
capability to detect and track these drugs.
Global Surveillance and Monitoring System
In 2013, WHO also launched the Global Surveillance and Monitoring System to encourage
countries to report incidents of substandard and falsified medical products in a structured and
systematic format, to help develop a more accurate and validated assessment of the problem.
This resulted in the publication of the WHO Global Surveillance and Monitoring System for
Substandard and Falsified Medical Products in November 2017. The system provides technical
support in emergencies, links incidents between countries and regions, and issues WHO medical
product alerts. It also gathers a validated body of evidence to more accurately demonstrate the
scope, scale and harm caused by substandard and falsified medical products and identify the
vulnerabilities, weaknesses and trends.
WHO has also trained a global network of over 550 regulatory staff in 141 Member States to
report substandard and falsified medical products to the WHO GSMS. However, due to limited
amount of personels deployed and dynamic environment of the SF production, the information
collection process is not as effective as expected. Without accurate data collected, it is very hard
to carry out regulation procedures.
Interpol Operations
Interpol has carried out multiple operations in different parts of the world to protect the public
from SF drugs. On-the-ground operations are run on national and regional levels in order to
disrupt transnational criminal networks involved in pharmaceutical crimes. Directed at both
physical outlets and Internet suppliers, these are multi-agency efforts supported by key scientific
partners. Flagship operations – Storm (Southeast Asia), Mamba (Eastern Africa) and Pangea
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(which targets the Internet) – continue to go from strength to strength. Successive raids on licit
and illicit markets have shown improved results in terms of seizures, arrests, convictions and the
closure of illicit websites. The most recent action is the Operation Pangea VII, which aims to
combat the sale of illicit drugs online and raise the awareness of the danger of purchasing drugs
online. This operation has garnered abundant international support, with the participation of 115
countries and 236 agencies. Also, it has achieved fruitful results with the seizure of a record 11
20.7 million fake and illicit medicines, worth an estimated USD 81 million. More than 2,410
websites have been taken offline – two websites linked to the sale of the potentially lethal and
illicit diet drug DNP shut down.
However, even though there were actions and yield plentiful results to seize the control the sale
of SF drugs, more must be done to crack down on syndicates involved in the manufacture of SF
drugs.
Case Studies
Corrupt Governance in Developing Countries
Bribes paid to government officials to prevent or avoid regulations lead to high-priced and
inferior medicines for consumers. In Latin America, corruption was found to be one of the key
causes of health problems. According to a World Bank scholar, in Latin America, an estimated 12
$28 billion are stolen or diverted from health systems per year. A high profile incident involved 13
the vice-president of Honduras, who was prosecuted for having links to a company that sold poor
11Operations. (n.d.). Retrieved from https://www.interpol.int/Crime-areas/Pharmaceutical-crime/Operations/Operation-Pangea 12Bate, R., & Mathur, A. (2018, April 24). Corruption and Medicine Quality in Latin America: A Pilot Study. Retrieved from https://www.degruyter.com/view/j/bejeap.ahead-of-print/bejeap-2017-0076/bejeap-2017-0076.xml 13W. (2007, January). Transparency and Corruption in the Health Sector: A Conceptual Framework and Ideas for Action in Latin American and the Caribbean. Retrieved from https://www.researchgate.net/publication/254309932_Transparency_and_Corruption_in_the_Health_Sector_A_Conceptual_Framework_and_Ideas_for_Action_in_Latin_American_and_the_Caribbean
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quality medicines to the state at inflated prices. However, there are likely to be many other 14
more relatively low-profile corruption cases that have not been uncovered, or surfaced on news
headlines.
On the other hand, governments may become overzealous in eliminating SF medical products
and may thus create other social ills. President Duterte of the Philippines has opened up a new
front on his war on drugs, by targeting falsified medical products as well. However, the war on 15
drugs has attracted much criticism for its lack of a transparent judicial process.
Loopholes in Regulations in Developed Countries
Regulatory responses with proper enforcement are needed to counter the rise of novel
distribution methods. In the United Kingdom (UK), antibiotics are illegally available through
45% of pharmaceutical websites. These websites were easily accessible―they were the top few 16
results when the search term ‘Buy antibiotics online’ was entered into Google and Yahoo.
Despite the law stipulating that online medicine vendors selling products to UK consumers must
register with the UK’s regulatory authority, only 25% of websites displayed appropriate evidence
of registration and showed evidence of operating from within Great Britain. Half of websites did
not even require a prescription prior to purchase.
Countries that have a highly fragmented market may require stronger governance structures. In
the United States, the drug wholesale market is made up of three major national wholesalers, a
few regional wholesalers, and thousands of secondary wholesalers. Wholesalers trade 17
according to market demand, often repackaging products. In wholesale repackaging, illegitimate
products can gain authentic packaging.. Furthermore individual state agencies that license
14Honduras charges congress' vice president with fraud in widening health corruption scandal. (n.d.). Retrieved from http://www.foxnews.com/world/2015/06/18/honduras-charges-congress-vice-president-with-fraud-in-widening-health.html 15 Philippines Duterte moves to target fake drugs. (2018, March 28). Retrieved from https://www.channelnewsasia.com/news/health/philippines-duterte-moves-to-target-fake-drugs-10083740 16 Torjesen, I. (2017, February 17). No prescription needed to obtain antibiotics from almost half of online sites, study shows. Retrieved from https://www.pharmaceutical-journal.com/20202356.article 17 The 2017 List of Top Pharmaceuticals Distributors. (n.d.). Retrieved from https://www.mdm.com/2017-top-pharmaceuticals-distributors
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wholesalers have licensing requirements that vary widely, enabling unscrupulous wholesalers to
enter states with lenient requirements and move elsewhere when charged.
Weak technical capacity and tools
Weak technical capacity manifests itself not just in the poor quality of medical products
produced, but also the inability of governments to respond adequately to the proliferation SF
medical products in their countries. In the Ituri district of Democratic Republic of Congo, an
outbreak of dystonia occurred among the population in 2014. Local healthcare workers could not
identify the problem, and although it was eventually hypothesised that the cause was due to a
toxic drug, there was no well-equipped laboratory in the country to analyse urine samples or the
suspected drugs to confirm their suspicions. These had to be transported to France to conduct
further tests. By the time the source of the problem was identified, 930 people had been
hospitalized with dystonia, and eleven had died. While reflecting the potential consequences
resulting from the lack of capacity, this case also demonstrates what can be achieved when
stakeholders cooperate to resolve an issue.
Key Areas of Concern
Any resolution to tackle the issue of SF medical products must consider how the proliferation of
SF medical products can be prevented, and how to effectively respond when SF medical
products proliferate in the medical market. This means tackling the three causes identified by
improving access to affordable and quality vaccines, promoting good governance, and
strengthening technical capacity. Delegates could also consider how existing international
actions can be enhanced, and how to promote regional and international cooperation given the
transnational nature of many medical products.
Identification of Blocs
Consumers of SF Drugs
Latin America
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Drug counterfeiting has increased significantly in Latin America in recent years, where more
than 30 percent of the drugs sold in South America are counterfeit . This increases pressure on 18
the healthcare industry, as the adverse health impact of counterfeit drugs lead to illnesses, and
consequently, a high mortality rate. With the help of Interpol, Latin American countries have
been combating the infiltration of counterfeit medical products from exporting countries, such as
China and India. Moreover, they also seek to implement more stringent checks on the imports of
medicines, and fight pharmaceutical crime.
Africa
Unfortunately, the severity of the problem is greater in Africa than Latin America. It is estimated
that substandard and counterfeit antimalarial drugs contribute to an additional 72,000 to 267,000
deaths in sub-Saharan Africa annually. Zimbabwe, for example, have implemented the 19
necessary legislation to prohibit the sale and manufacture of SF drugs, but the smugglers are hard
to detect and prosecute due to the porous borders between African countries.
Manufacturers of SF Drugs
China
Widespread regulatory failure and unscrupulous business practices have created a market
flooded with falsified drugs in China. China is a major exporter of medical products, and is an 20
increasingly significant supplier of health aid to African countries in recent years, such as its
promotion of plans to open at least 30 malaria treatment centres across Africa. However, there 21
has been a concerted effort to combat the proliferation of falsified medicine in the country. In
18 Paillé, J. (2016, July 07). Le marché de la lutte contre la contrefaçon des médicaments, un nouvel eldorado ? Retrieved from http://www.latribune.fr/entreprises-finance/industrie/chimie-pharmacie/le-marche-de-la-lutte-contre-la-contrefacon-des-medicaments-un-nouvel-eldorado-584771.html 19 Deutsche Welle. (n.d.). Fighting the spread of fake drugs in Africa | DW | 10.01.2018. Retrieved from http://www.dw.com/en/fighting-the-spread-of-fake-drugs-in-africa/a-42100713 20 McLaughlin, K. (2013, June 11). Fake Fake Drugs From China: What's Stopping a Cure for Malaria in Africa? Retrieved from https://www.theatlantic.com/china/archive/2013/06/fake-fake-drugs-from-china-whats-stopping-a-cure-for-malaria-in-africa/276750/ 21 Ibid.
21
2012, the government launched a nation-wide operation and seized products $1.16 billion yuan,
arresting 1,900 people in the process. However, there is little effort at preventing the distribution
of SF drugs outside the country. The country must bridge this gap if they wish to mend their
tarnished reputation in the biomedical industry.
India
India is also a major exporter of falsified drugs due to poor regulations and low standard of
manufacturing. Prior studies suggest that 0.4% of drugs produced in India are fake, and one in
seven are of substandard quality. The country exports around 35,000 crore ($5.2bn) worth of
drugs per year. The Narcotics Control Bureau, the chief law enforcement and intelligence 22
agency of India, was created on 17 March 1986 to enable the full implementation of the Narcotic
Drugs and Psychotropic Substances Act (1985) and fight its violation through the Prevention of
Illicit Trafficking in Narcotic Drugs and Psychotropic Substances Act (1988).
Proposed Solutions
Overview
To tackle the issue of SF medical products, a ‘Prevent, Detect, Respond’ framework has been
proposed by the WHO. This refers to preventing the manufacture, sale and consumption of SF
medical products from occurring, the implementing of systems to detect any SF products already
in the supply chain; and responding quickly and proportionately to any incidents that are
detected, in ways that safeguard patients and the supply chain, and take appropriate action
against those responsible whilst not causing unnecessary shortages. Beyond that, delegates could
consider how cooperation among member states could be further enhanced.
Prevent
22 India pharma firms caught for exporting counterfeit drugs. (2016, October 12). Retrieved from https://www.securingindustry.com/pharmaceuticals/india-pharma-firms-caught-for-exporting-counterfeit-drugs/s40/a2976/#.WuHSLIhubSQ
22
Education and raising awareness of the existence of SF medical products among stakeholders
enables them to be more cautious about where they source their product, and exercise more
vigilance during purchases. This would reduce the market for SF medical products, and improve
efforts in identifying existing ones. Access to affordable medical products from trusted sources is
also important in ensuring that people do not turn to unlicensed sources. Medical products must
also be used rationally, as using them wrongly could lead to antimicrobial resistance which
require more potent and hence more expensive drugs to cure. Quality manufacturing and
distribution standards should be set and enforced. A possible solution is to expand the
prequalification process by WHO, where manufacturers are subjected to a stringent certification
process before organizations are willing to buy from them.
Detect
Encouraging greater cooperation and usage of the WHO GSMS by parties throughout the
medical supply chain can improve detection, as information on SF medical products becomes
easily accessible and alerts can be raised at one central node. Further information-sharing and
improvements in detection technologies both in the field and in the laboratory will also enabled
better detection.
Respond
Strong legislation and criminal justice systems is needed to handle cases of SF medical products.
At the local level, is it necessary for regulators to monitor quality problems, identify the problem
suppliers and shut them down. There should be collaboration with police and other law
enforcement to prevent bribery of regulators and public officials, since this affects procurement
processes for drugs and allow dubious producers to supply low quality drugs. A possible solution
would be to empower governmental authorities with powers to confiscate assets and recover the
proceeds of criminal activity, especially if laws allow for a proportion of the seized assets to be
reinvested in purchasing detection devices and laboratory equipment or finance awareness
campaigns and training events. Furthermore, each incident should be reviewed to identify
weaknesses in the regulatory system, so that similar incidents do not recur.
23
Cooperation
Many investigations concerning SF medical products are international in nature. This makes
gathering evidence complex. For successful prosecution, countries could consider mutual legal
assistance agreements to permit gathering of evidence from other jurisdictions. Countries could
also consider how they could coordinate their regulatory agencies to reduce the duplication of
roles.
Key Guiding Questions
1. How can countries deter the production of SF medical products in the first place?
2. What can countries do to further strengthen their health systems in terms of better
governance and technical capacity?
3. How should countries respond to crises of SF medical products?
4. How can WHO facilitate access to quality and affordable medical products for all the
regions around the world?
5. How can WHO further promote regional and international cooperation in tackling the
issues of SF medical products?
Suggestions for Further Research Causes & Solutions to Substandard and Falsified Medical Products
“WHO Global Surveillance and Monitoring System for substandard and falsified medical
products” by WHO (relevant reading: Part Four, Five and Six)
(http://www.who.int/medicines/regulation/ssffc/publications/gsms-report-sf/en/)
Consequences of Substandard and Falsified Medical Products
“A study on the public health and socioeconomic impact of substandard and falsified medical
products” by WHO (relevant reading: Part Three and Conclusion)
(http://www.who.int/medicines/regulation/ssffc/publications/se-study-sf/en/)
24
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?rid=vacc.chapter.3
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A Pilot Study. Retrieved from
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076.xml
Definitions of Substandard and Falsified (SF) Medical Products. (2017, June 19). Retrieved
from http://www.who.int/medicines/regulation/ssffc/definitions/en/
Deutsche Welle. (n.d.). Fighting the spread of fake drugs in Africa | DW | 10.01.2018.
Retrieved from
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Drew, A. (2017). Insecticides and Pesticides: Techniques for Crop
Protection
Dobrow, J. (2014). Natural prophets: From health foods to whole foods
Honduras charges congress' vice president with fraud in widening health corruption scandal.
(n.d.). Retrieved from
25
http://www.foxnews.com/world/2015/06/18/honduras-charges-congress-vice-president-wit
h-fraud-in-widening-health.html
India pharma firms caught for exporting counterfeit drugs. (2016, October 12). Retrieved
from
https://www.securingindustry.com/pharmaceuticals/india-pharma-firms-caught-for-exporti
ng-counterfeit-drugs/s40/a2976/#.WuHSLIhubSQ
Laporte, J. (n.d.). Topic: Global Pharmaceutical Industry. Retrieved from
https://www.statista.com/topics/1764/global-pharmaceutical-industry/
McLaughlin, K. (2013, June 11). Fake Fake Drugs From China: What's Stopping a Cure for
Malaria in Africa? Retrieved from
https://www.theatlantic.com/china/archive/2013/06/fake-fake-drugs-from-china-whats-sto
pping-a-cure-for-malaria-in-africa/276750/
Operations. (n.d.). Retrieved from
https://www.interpol.int/Crime-areas/Pharmaceutical-crime/Operations/Operation-Pangea
Paillé, J. (2016, July 07). Le marché de la lutte contre la contrefaçon des médicaments, un
nouvel eldorado ? Retrieved from
http://www.latribune.fr/entreprises-finance/industrie/chimie-pharmacie/le-marche-de-la-lut
te-contre-la-contrefacon-des-medicaments-un-nouvel-eldorado-584771.html
Philippines Duterte moves to target fake drugs. (2018, March 28). Retrieved from
https://www.channelnewsasia.com/news/health/philippines-duterte-moves-to-target-fake-d
rugs-10083740
The 2017 List of Top Pharmaceuticals Distributors. (n.d.). Retrieved from
https://www.mdm.com/2017-top-pharmaceuticals-distributors
26
Torjesen, I. (2017, February 17). No prescription needed to obtain antibiotics from almost
half of online sites, study shows. Retrieved from
https://www.pharmaceutical-journal.com/20202356.article
W. (2007, January). Transparency and Corruption in the Health Sector: A Conceptual
Framework and Ideas for Action in Latin American and the Caribbean. Retrieved from
https://www.researchgate.net/publication/254309932_Transparency_and_Corruption_in_t
he_Health_Sector_A_Conceptual_Framework_and_Ideas_for_Action_in_Latin_American
_and_the_Caribbean
WHO Global Surveillance and Monitoring System for substandard and falsified medical
products. (2017, November 28). Retrieved from
http://www.who.int/medicines/regulation/ssffc/publications/gsms-report-sf/en/
27
TOPIC B: THE ISSUE OF PESTICIDE USE IN FOOD
PRODUCTION
Statement of Problem
Introduction
The term “pesticide” covers a wide range of compounds including insecticides, fungicides,
herbicides, rodenticides, molluscicides, nematicides and plant growth regulators. Despite their 23
importance in increasing crop yield, it remains questionable as to whether their use is ethical.
Ideally a pesticide should effectively deter the target pests from close contact with the plants,
while leaving non-targeted species unaffected. However, this is difficult to achieve, so the use of
many pesticides often hinges on the extent of harm it causes, rather than whether or not it causes
harm. For example, organochlorine insecticides―used successfully in controlling a number of
diseases including malaria and typhus―were banned or restricted after the 1960s in most
technologically-advanced countries when it was linked with serious health issues like central
nervous system excitation, depression and many other symptoms.
Almost everyone is exposed to certain types of pesticides through food, water, air, or direct
contact with such pesticides or residues. However, since most diseases are multi-causal and
individuals tend to be exposed to a complex mixture of chemicals in their daily lives, a direct
causal link between exposure to pesticides and their health problems is difficult to establish. This
can be a challenge for accountability, and for victims seeking access to an effective remedy.
Even so, the persistent use of pesticides, in particular agrochemicals used in industrial farming,
have been connected to a range of adverse health impacts, both at high and low exposure levels.
23 Aktar, M. W., Sengupta, D., & Chowdhury, A. (2009, March). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984095/
28
Regulation of the pesticide industry has been fraught with difficulties, due to the lobbying power
that the pesticide and agricultural industries wield. Countries grapple with the maintenance of the
neutrality of public health agencies, and the lack of regulatory oversight of the importation or
development of pesticides. It is also publicly known that pesticides empowered the green
revolution and it is potent in increasing the yield of agriculture production. On the contrary,
some researchers believe that it is possible to produce highly-nutrient food without much use of
chemicals. In any case, any attempt by countries to phase out dangerous pesticides and 24
transition towards sustainable agricultural practices must consider if an adequate food supply can
be maintained.
Despite grave human health risks having been well established for numerous pesticides, many of
them still remain in use. Despite banning or restricting the use of pesticides in certain regions,
people are still contaminated by pesticides through the residue in the soil or the leftover which
seeps into the underground water. In many cases, the health problems incurred from pesticide
exposure have not been extensively studied before pesticides are placed on the market. This is
particularly true for “inactive” ingredients that are added to enhance the effectiveness of the
pesticide active ingredients, as these ingredients may not be tested and are seldom disclosed on
product labels. However, these inactive gradients are usually decomposition-resistive remain in
the ecosystem for a prolonged period of time. Moreover, inadequate studies have been done on
the aggregate impact on human when exposed to pesticides in water, soil, food and many other
medium. Hence, it obstructs the progress in seeking effective counter actions.
Historical Background of the Problem
A Study of DDT
Date Event Details
24 The Top 5 Sources of Toxins You Need to Know About (And What You Can Do to Protect Your Health). (2013, February 21). Retrieved from https://bodyecology.com/articles/top-5-sources-of-toxins.php
29
1939 Discovery of
uses of
dichlorodiphenylt
richloroethane
(DDT)
The most potent broad-based insecticide ever seen at that time,
effective even on pests that had developed a resistance to the traditional
alternative, arsenic.
1939 -
1945
Military uses
DDT to control
disease.
The U.S. military and the War Production Board used DDT to control
the spread of "louse-borne typhus" in Europe and malaria in the Pacific,
thus proving its efficiency. 25
1946 DDT released for
public
commercial
usage.
DDT was supplied to the market for farm and household use right after
the war, and quickly became the standard for insecticides. Exhaustive
scientific tests have shown that, when properly used, DDT kills a host
of destructive insect pests, and maximise crops’ yield. In order to
maximize the food production in the 1950s, farmers adopted various
form of irrigation systems to water the plants or to maintain the
moisture level of the soil. However, this yielded a severe setback: the
breeding of mosquitoes and the spreading of insect-borne diseases.
Apart from the efficacy of protecting the crops, DDT was effective in
killing mosquitoes in the drainage and those pond formed, which
reduced the spread of malaria. In India alone, the number of people
infected with malaria from 100 million to 60,000 cases per year. DDT 26
therefore, in the 1950s became the sole pesticide, with very few
substitutes in the markets all round the world.
25 Dobrow, J. (2014). Natural prophets: From health foods to whole foods: How the pioneers of the industry changed the way we eat and reshaped American business. Emmaus, PA: Rodale. 26 Offit, P. A. (2017, February 04). How Rachel Carson Cost Millions of People Their Lives. Retrieved from https://www.thedailybeast.com/how-rachel-carson-cost-millions-of-people-their-lives
30
1962 Increasing public
awareness of the
side effects of
DDT
Most of these new agricultural chemicals were known to be highly
toxic, although the specific risks—such as bio-accumulation in humans,
development of birth defects, creation of algal blooms in the oceans,
and destruction of the stratospheric ozone layer—would not be
discovered for many years. Mounting evidence revealed its toxic 27
impact on the environment and human health. The publication in 1962
of Rachel Carson's Silent Spring evoked widespread public concern
over the dangers of improper pesticide use and stressed the need for
stricter pesticide controls.
1972 First ban issued
on the DDT by
the United States
of America
The fear accumulated in the general public, and was being manipulated
by politicians to win their campaigns. Richard Nixon promised the
public to eliminate the usage of DDT not only in the US, but
worldwide, therefore establishing the Environmental Protection
Agency. In 1972, EPA issued a cancellation order for DDT due to the 28
adverse health risks posed to humans and animals up the food chain.
Researchers later hypothesised a positive correlation between DDT
exposure and the deterioration of human health, as some animals
developed liver tumors after being exposed to DDT. As a result, DDT
is currently classified as a probable human carcinogen by U.S. and
international authorities. 29
1980 Subsequent bans Nixon’s plan and actions were followed closely by many other
27When Did We Start Using So Many Pesticides? The Important Backstory... (2015, July 01). Retrieved from https://www.rodalewellness.com/food/when-did-we-start-using-pesticides
28 The Birth of EPA. (2016, September 06). Retrieved from https://archive.epa.gov/epa/aboutepa/birth-epa.html 29DDT - A Brief History and Status. (2017, August 11). Retrieved from https://www.epa.gov/ingredients-used-pesticide-products/ddt-brief-history-and-status
31
issued on the
DDT by other
member states
countries. Gradually most countries in the world banned the usage of
DDT due to its potential health effect on human and animals.
Current Situation
Definitions
Pesticides are defined as “chemical substances used to prevent, destroy, repel or mitigate any
pest ranging from insects (i.e., insecticides), rodents (i.e., rodenticides) and weeds (herbicides) to
microorganisms (i.e., algicides, fungicides or bactericides)”. Although pesticide exposure
through home and garden use, termite control, spray drifts, residues in household dust, and in
food and water are common, the focus is on the manufacturing, sale and use of pesticides in the
agricultural industry.
Prevalence of Pesticide Use
On a global scale, it is estimated that approximately 1.8 billion people contribute to the
agricultural industry and most use pesticides to protect the food and commercial products that
they produce. Approximately 5.6 billion pounds of pesticides are used worldwide. In many 30 31
developing countries, programmes to control pesticide exposure are limited in scope or rarely
enforced. Consequently, it has been estimated that as many as 25 million agricultural workers
worldwide experience unintentional pesticide poisonings each year. 32
Problems Afflicting Pesticide Use
Despite attempts to reduce pesticide use through organic agricultural practices and the use of
other technologies to control pests, pesticides still play an important role in the agricultural
30Alavanja, M. C. (2009). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946087/ 31Pesticides. (2018, April 25). Retrieved from https://www.epa.gov/pesticides 32Jeyaratnam, J. (n.d.). Acute pesticide poisoning: A major global health problem. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/2238694
32
industry. However, the challenges in assessing the health effects and enforcing the regulation of
pesticides make it a serious cause of concern for the WHO.
Firstly, at the national level, there are often loopholes in the national registration processes of
pesticides products. Toxicity studies are frequently unable to identify or analyse the chronic
health effects of pesticides submitted for registration, hindering the assessment efforts of
regulators. The level of consumer protection found at the national level is also poor. Reviews 33
can be too seldom, and regulatory authorities can be influenced so that bans are not imposed.
Without standardized and stringent regulations, communities in countries that have weak
regulatory and enforcement systems remain vulnerable.
Second, at the international level, there is a lack of a common framework to regulate pesticides,
allowing hazardous pesticides banned in industrialized countries to be exported to developing
countries where they are cheaper substitutes to safer pesticides.
Thirdly, the influence of the pesticide industry on public agencies hinders effective regulation of
the pesticide industry. As there are only three corporations―Monsanto and Bayer, Dow and
Dupont, and Syngenta and ChemChina―that control more than 65 percent of global pesticide
sales and almost 61 per cent of commercial seed sales, conflicts of interest easily arise.
Companies often dispute scientific evidence relating to the harm caused by their pesticide
products, thus delaying the bans on their pesticides. Companies can also be patrons of
educational institutions which conduct pesticide research, which, due to a declining amount of
public funding, can become dependent on such companies and thereby cause conflicts of interest.
In view of the many difficult challenges that exist and inadequacies of current measures, a
possible option is to turn to safer alternatives and develop them further.
The Report of the Special Rapporteur on the right to food published in January 2017, argued that
33Report of the Special Rapporteur on the right to food (A/HRC/34/48). (n.d.). Retrieved from https://reliefweb.int/report/world/report-special-rapporteur-right-food-ahrc3448
33
pesticides are not necessary to achieve food security, claiming instead that inequitable
production and distribution systems hinder those in need from accessing food. Ecological
farming was proposed. It involves environment-friendly practices, such as protecting crops from
pests by developing habitats around farms conducive to the natural enemies of the pests and
other beneficial wildlife. Crop rotation and cover crops can also protect the soil from various
pathogens, suppress weeds and increase organic content, while more resistant crop varieties can
help prevent plant disease.
In conclusion, international and national legislation have failed to protect humans and the
environment from hazardous pesticides. Existing measures are unable to address the international
nature of the pesticide market, as can be seen from how exporting banned highly hazardous
pesticides to third-world countries is still legal. Though regulating the pesticide industry is
extremely important, a long-term method to resolving the issue of pesticide use might be to shift
to ecological farming.
Past International Action
Regulation ― Treaties
In response to concerns about the harm that pesticides pose, international environmental treaties
have been signed to reduce the use of hazardous pesticides, such as the Stockholm Convention of
Persistent Organic Pollutants and the International Code of Conduct on Pesticide Management.
The Stockholm Convention on Persistent Organic Pollutants
The Stockholm Convention on Persistent Organic Pollutants was signed in 2001, which stipulate
global prohibitions and restrictions for a certain set of hazardous pesticides. Over the years, the
treaty has expanded from the restriction of the use of initially 12 largely obsolete industrial
chemicals and pesticides. However, it is still unable to cover many extremely hazardous
pesticides within its scope. Given that toxic pesticides are only regulated if they meet the narrow
criteria established by the Stockholm Convention, and the vast majority of hazardous pesticides
34
do not check these boxes, many pesticides are remain unregulated. Hence, it is imperative for the
international community to conceive a comprehensive regulatory mechanism which cover a
variety of hazardous pesticides.
The International Code of Conduct on Pesticide Management
The International Code of Conduct on Pesticide Management, established by WHO and Food
and Agricultural Organization (FAO), is a ‘voluntary framework that guides governments, the
private sector, civil society and other stakeholders on best practices in managing pesticides
throughout their life cycle, particularly where there is inadequate or no national legislation to
regulate pesticide management’.
While several major pesticide companies are members of Croplife International, an industry
trade associate that pledges to “champion the role of agricultural innovations in crop protection
and plant biotechnology to support sustainable agriculture”, civil society groups have made
grave allegations regarding breaches of the Code. For example, a monitoring report submitted 34
by several non-governmental organizations to the FAO Panel of Experts on Pesticide
Management alleges that Bayer CropScience and Syngenta are involved in the manufacturing,
distribution and sale of highly hazardous pesticides in violation of the Code. According to the
report, in 2014, Punjab, India, the farmers did not receive sufficient information about the
dangers of their pesticides or the precautionary measures from companies. While this initiative
has had some impact, its non-binding nature limits its effectiveness.
Non-Governmental Organizations
Meanwhile, some non-governmental organizations have significantly influenced recent policies.
Pesticide Action Network International, for example, has developed its own list of highly
hazardous pesticides, which has been used to support various policy making process.
34About. (n.d.). Retrieved from https://croplife.org/about/
35
While these efforts are helpful in raising awareness about the problem and developing legislation
in the future, they cannot provide remedy to victims who are suffering from the harmful effects
of hazardous pesticides.
Case studies Novartis: Suppressing disputes regarding pesticide safety
Novartis is a Swiss multinational pharmaceutical company―one of the largest pharmaceuticals
in the market―producing pesticides like atrazine. When a study showed that atrazine resulted in
adverse health and environmental impact, Novartis engaged in a campaign to discredit the
scientists involved in that study. However, additional research largely supported the original
findings. This highlights the danger facing scientists who reveal health and environmental risks
of pesticides to the detriment of corporate interests, like being harassed or having their reputation
damaged.
Monsanto
Monsanto is a multinational agrochemical and agricultural biotechnology corporation that
illustrates how conflicts of interest arise and how governmental agencies that should act in the
interests of public health, are manipulated to do otherwise.
Monsanto seeds are engineered to be resistant to Monsanto pesticides. Farmers only have to
spray the pesticide to remove weeds, rendering expensive and laborious tillage obsolete.
Large-scale agriculture is built on similar models, and it is estimated that nearly half a pound of
every acre of cropland worldwide is sprayed with the herbicide glyphosate, which Monsanto’s
Roundup pesticide also contains. As the crops Monsanto sells have been genetically engineered
to be resistant to the lethal compounds of Monsanto’s pesticides, Monsanto is incentivised to
defend the safety of its current pesticides so as to maintain its profitable business model of
selling both seeds and pesticides, rather than complying with regulations to produce safer
pesticides.
Paraquat―sale of harmful pesticides by developed countries to developing countries
36
Paraquat, a highly toxic weed killer outlawed by EU states in 2007, was found to be being
exported to developing countries with weaker regulation and controls from a UK factory in 2017
by Swiss pesticide manufacturer Syngenta. Syngenta is responsible for 95% of Europe’s 35
exports of paraquat, which it sells under the brand name Gramoxone. The substance can be
absorbed through the skin and has been linked with Parkinson’s disease. Despite this, Syngenta
has argued that paraquat is among the world’s most effective and environmentally beneficial
herbicides, helping millions of farmers stay productive and competitive. The corporation also
argues that since the herbicide is authorised for use in countries with some of the most stringent
regulatory systems, including the US, Australia and Japan, it should similarly be permitted
elsewhere. Developing countries like Brazil, Mexico, Indonesia, Guatemala, Venezuela and
India purchase almost two-thirds of these exports. About one-third is exported to the US, where
paraquat can only be applied by licensed users.
European Food Safety Authority
In 2015, a renewal assessment report published on glyphosate, which had been linked to cancer,
was used by the European Food Safety Authority to make a recommendation that glyphosate was
safe for public use. However, many pages of the report were found to be identical to those of an
application submitted by Monsanto.
The pages contained important sections that analysed peer-reviewed studies of the links between
glyphosate and various health problems. If regulators rely entirely on the assessments of the
industry, then it is effectively the pesticide industry which decides what pesticides are safe for
public health.
Key Areas of Concern
35 Ross, A. (2017, August 22). UK condemned over 'shocking' export of deadly weedkiller to poorer countries. Retrieved from https://www.theguardian.com/global-development/2017/aug/22/uk-condemned-shocking-export-deadly-weedkiller-poorer-countries-paraquat
37
Resolutions to address the issue of pesticide use in food production should focus on the
regulation of development and use of pesticides, as well as the adoption of safer alternatives to
pesticides. In order to effectively regulate development and use of pesticides, delegates should
keep in mind the harmful effects of pesticides to human life and the influence of the pesticide
and agricultural industry in preventing regulation and reform of pesticides. Delegates should also
consider improving on the monitoring of pesticides during stages of transportation and
consumption strengthening regulations in developing countries to stop imports of harmful
pesticides and ensuring neutrality of public agencies evaluating these pesticides. As for the
adoption of safer alternatives, delegates could contemplate how the gradual phaseout of
pesticides can be achieved, and what member states can do to invest in safer alternatives.
Identification of Blocs
Industrialized countries
Most developed countries have instituted bans on harmful pesticides, such as DDT. Their robust
healthcare infrastructure insures them from the risk brought about by pesticide usage.
The United State Environmental Protection Agency administered the Federal Insecticide,
Fungicide, Rodenticide Act to regulate the sale and usage of pesticides. With the banned of
certain types of pesticides included in the act, the US is currently pushing for the elimination of
illegal import of the pesticides and also monitoring strictly on the usage of the banned pesticides
under the exempted conditions. Meanwhile, with her own perception of DDT, the US has chosen
to stop its export of DDT to many countries, like Sri Lanka and many African states.
China has declared to ban the “production, sale, use, import and export of chlordane, mirex, and
DDT” on 18th of May 2009, in order to be in line with the Stockholm Convention. This act has
cut short the supply of POP pesticides (persistent organic pollutant) and possibly left India as the
sole producer of DDT. 36
36China phases out pesticide POPs. (n.d.). Retrieved from http://www.chinadaily.com.cn/bizchina/2009-05/18/content_7788342.htm#
38
Agricultural Countries
Countries, mainly in developing world, are still heavily reliant on pesticides exported from more
developed countries for agricultural uses, so as to prevent the insect-borne diseases and increase
their crop yield. These countries, due to the low health care standard and poor education on more
efficient ways of farming, have to balance the pros and cons of using pesticides. In many
agricultural countries, they have to continue their use of DDT in agricultural production to
maintain the yield as DDT is one of the most effective pesticides that come at an affordable
price, about a quarter of the next cheapest insecticides. Also, the usage of DDT effectively 37
prevents the breeding of mosquitoes in the farmland, which subsequently deters the spread of
many insect-borne diseases. However, the usage of pesticides in food production leads to the
building up of resistance in the target pests, eventually limiting the impact of such pesticides.
Proposed Solutions
Creating a comprehensive treaty to regulate hazardous pesticides throughout their life
cycle―production, usage and disposal―is of paramount importance. The measure should
prevent the exportation of pesticides to countries with weak regulations and phase out hazardous
pesticides.
Neutral, independent assessment and registration processes should also be established, whether
at the national or regional level. Non-chemical alternatives could be considered first, allowing
only chemicals to be registered where need can be demonstrated. Unbiased scientific studies on
the potential health effects of pesticides should also be funded, and measures taken against
companies that doctor scientific evidence or disseminate misinformation on the health and
environmental impacts of their pesticides.
37 Rosenberg, T. (2004, April 11). What the World Needs Now Is DDT. Retrieved from https://www.nytimes.com/2004/04/11/magazine/what-the-world-needs-now-is-ddt.html
39
At the national level, incentives to support alternatives to hazardous pesticides could be
introduced, with targets set to gradually reduce pesticide use. Regulators need to sufficiently
monitor pesticide use and storage, for example, by ensuring that only licensed individuals use
pesticides, and that they comply with standards of handling pesticides. Education programmes
could raise awareness of the harm caused by hazardous pesticides and of alternative farming
methods.
Beyond reducing the health risks of pesticides, delegates can consider encouraging farmers to
adopt ecological practices suited to local conditions through the use of subsidies or financial and
technical assistance. Delegates could also consider how to encourage the pesticide industry to
develop alternative pest management approaches, such as by eliminating pesticide subsidies, and
initiating pesticide taxes, import tariffs and pesticide-use fees instead. Lastly, methods of
engaging civil society in reforms and informing the general public about the harmful impact of
pesticides on health would be helpful to reducing pesticide use in food production.
Key Guiding Questions 1. How can the World Health Organization ensure that public regulation agencies act in the
best interests of the public and fulfil their role of objectively assessing the safety of pesticides?
2. How can governments reform their pesticide and agricultural industries?
3. What can developing countries do to stop the importation of harmful pesticides?
4. How can the gradual elimination of pesticides be achieved?
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