Afghan Poppy for Medicine pilot projects could help meet the need for affordable and reliable pain-relieving medicines in emerging countries. The establishment of a second-tier supply system through special trade agreements would allow medicines to reach patients that would otherwise not have access to morphine. This second-tier supply system however, would also need to be tested at the consumer end. Linked to the Pilot Poppy for Medicine projects, Pilot Projects should be implemented in selected locations in emerging countries to ensure that the production of affordable Afghan-made morphine does actually result in increased access to morphine where such access is most needed.

Brazil: a Pilot Project to provide pain relief Pilot Projects for the use of Afghan-made morphine medicines in Brazilian hospitals could target local populations lacking access to pain-relieving medicines. Finished medicines imported from Afghanistan could be bought by the Brazilian Ministry of Health, who would be able to provide target communities with inexpensive medicines. Afghan morphine would need to be adequately presented and priced so as to bring about sufficient willingness to use it. Prescription could be fostered by the WHO, while the Brazilian Red Cross could contribute to the appropriate pricing and review the final use of the medicines.

Poppy flower

Afghan-made morphine consumer-end Pilot Projects could be integrated with WHO efforts to increase the use of poppy-based medicines in emerging countries. As such they could benefit from the WHO’s expertise and usefully contribute to the WHO’s stated objectives. Indeed, fair trade Afghan morphine should help address the price issues that limit the prescription and thus use of these essential medicines around the world.

A Pilot Project would enable an assessment to be made of the extent to which Afghanmade medicines can be made available to populations otherwise lacking appropriate treatment of their pain. A Pilot Project would also examine whether Afghan-made morphine is reliable and affordable enough to respond to some of the currently un-met need for pain-relieving medicines.

Supplying morphine to UN agencies and international NGOs Whether working with developing countries’ national health authorities, or organising the medical response to natural or human disasters in crisis-ridden countries, UN agencies and international NGOs such the International Red Cross play an important role in the procurement of essential drugs such as morphine. International aid agencies and organisations represent a stable potential market for Afghan-made morphine. The UN Inter-Agency Procurement Service (IAPSO) is the self-funding procurement agent for a range of UN agencies, NGOs and international financial institutions. In 2006, USD 8.5 million of medical supplies were bought through the IAPSO, and in 2005, 43.1% of goods were procured from emerging countries. Equally, tenders for contracts can be made directly to a specific UN agency. The UN Global Marketplace also provides a shortlist of potential suppliers available to UN agencies. The WHO and the UN are equally involved in the construction of national procurement agencies in less economically developed countries; national governments can either utilise their own procurement agencies or call upon the services of a public or private agency. These agencies purchase the medicines on behalf of the Ministries of Health for their respective countries, who then authorise the import of the drug. Eighty percent of anti–retroviral (ARVs) used by Médecins sans Frontières are purchased in India. These figures are similar to the percentage of ARVs purchased by UNICEF, IDA and the Global Fund. Affordable Afghan-made morphine, produced through a Pilot Poppy for Medicine Project could provide a competitive solution for international aid agencies involved in the procurement of both large and smaller orders of pain relieving drugs.