HAI News reports on the developments in the international campaign for more rational and fairer health and drug policies worldwide. The communication tool of Health Action international, an informal network of non-governmental organisations and individuals committed to striving for "health for all now", this newsletter also carries material supportive of the participants' work.

Cover story: Public health first: Revised Drug Strategy addresses trade and health

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by Kiran Sagoo and Lisa Hayes

The 52^nd World Health Assembly (WHA) marked a step forward in the long walk towards achieving Health for All. On the 22^nd of May, delegates unanimously adopted the resolution on the Revised Drug Strategy (RDS) with overwhelming support. It was the first time that an Assembly resolution substantially addressed trade-related issues. In fact, the resolution urges countries 'to ensure that public health interests are paramount in pharmaceutical and health policies.' The resolution strengthens WHO's mandate to study the effects of international trade agreements on health and to assist countries implementing trade agreements while addressing public health needs and priorities. For example, countries that would like to use compulsory licensing (granting a license without permission of the patent holder for the greater public good) for certain essential drugs under patent can call upon the WHO for assistance.

The RDS was formulated in 1985 at the WHO conference on 'the rational use of drugs', and adopted by the WHA in 1986. Since 1986, there has been regular discussion of the resolution during the WHA. In 1996, the WHA adopted a resolution on the RDS, which requested the Director General " to report on the impact of the work of the World Trade Organization (WTO) with respect to national drug policies and essential drugs and make recommendations for collaboration between WTO and WHO." The January 1998 Executive Board formulated a draft resolution on RDS for the WHA in May 1998. Unfortunately, no consensus was reached and the resolution was referred to the WHO Executive Board for redrafting. In October 1998, after intense debate, the text of the resolution was finalised by an ad hoc Executive Board working group. A total of 59 countries participated in the meeting. When the resolution was tabled at this year's Assembly, many delegates broke into spontaneous applause, something that rarely happens. After the resolution's adoption, a number of countries and organisations, including Consumers International made statements in support of the resolution. Germany, speaking on behalf of the EU position on the RDS stated that, ' A high level of health protection is a fundamental objective of the EU… The EU fully supports the resolution', while the United States expressed that, 'This is a good development for WHO and for all of us.'

Various countries expressed their concern on the negative effect of trade agreements on the health of their population. As said by the representative from Thailand's delegation, "…We believe that TRIPs has a negative impact on public health in terms of access to necessary drugs, especially in developing countries and least developed countries…Thailand strongly supports the resolution." The representative from Columbia, speaking also on behalf of Bolivia, Ecuador, Peru, Venezuela and Chile stated, "…We insist on the fundamental aspects of public health, which are described in the constitution of the WHO. We must reduce the gulf which separates our countries from the developed countries."

Though the trade issues drew the most attention, the resolution addresses other issues of importance to ensure access and rational drug use. For example, the resolution also points out that drug promotion is a problem in both developing and developed countries, and also emphasises specific aspects of national drug policies, quality assurance, drug donations and independent drug information.

Already countries have shown that they see the resolution as placing health above trade. As stated by the representative from the Philippines, "…the Philippines takes this particular item to mean that in the formulation and implementation of pharma-ceutical policies, public health concerns take precedence over commercial, trade or other economic interests." And said Bas van der Heide, coordinator of HAI Europe,

"From now on, the public health consequences of trade agreements will no longer be left only to trade lawyers."

HAI's Role at the WHA

The adoption of the resolution in May was the culmination of a year-long lobbying effort by HAI to which many national groups contributed. HAI took part in the sessions of the ad hoc working group set up by the WHO's Executive Board last year which drafted the text tabled at the Assembly. Members of HAI also contacted their national delegates before the Assembly to discuss the text of the resolution with them and ask them to support it. During the week of the Assembly, HAI contacts worked to promote support of the resolution. The HAI team met with most of the 191 national delegations attending the Assembly to discuss the issues brought up in the resolution and show how they would affect such areas as drug pricing, drug promotion and overall access to essential quality drugs. They also referred to the WHO publication Globalization and Access to Drugs: Perspectives on the WTO/TRIPs Agreement as a resource offering guidance on how to interpret the requirements.

Technical Briefing: Access to Medicines

As part of the week's official programme, HAI organised, in collaboration with Médecins Sans Frontières (MSF) and Consumer Project on Technology (CPT), a special meeting for Assembly delegates on "Access to Essential Drugs: International Trade Agreements and Public Health". During the meeting attended by more than 64 representatives of national delegations, NGOs, industry and press, James Love of the US-based, Ralph Nader group, CPT described the various options that countries have in implementing trade agreements involving intellectual property rights while improving access to essential medicines.

In her introductory statement at the meeting, chairwoman Ellen 't Hoen said "Countries that are presently incorporating the TRIPs provisions into national legislation are looking for ways to do so in a meaningful way. They need support in reviewing the options they have and the provisions for protecting and possibly even enhancing public health while implementing TRIPs rules. Some such options include parallel importing and compulsory licensing, both perfectly legal options under the TRIPs agreement. Good patent laws protect both the patent holder and those that need access to the patented products". She added, "After all, what is the use of having new effective drugs if the majority of the world population has no access to them."

Love urged country delegates to support national legislation that would increase access to new essential medical technologies. He pointed out that the concept of compulsory licensing is already common practice in both developed and developing countries in a number of fields. He mentioned a US example where compulsory licenses are given to ensure that people can continue to watch their favourite TV show.

Love emphasised that the multinational pharmaceutical industry has strongly opposed compulsory licensing of medicines, and has lobbied developed countries including the United States, England, Italy, and the European Union, to particularly oppose compulsory licensing of medicines in poor countries. This has already resulted in trade pressures against the practice of compulsory licensing of drugs for HIV/AIDS and other essential medicines, and it may result in a future dispute before the WTO. "In the companies' view", he said, "poor countries will abuse the compulsory licensing system. This will lower returns from research and development (R&D) or undermine their ability to charge high prices in the more developed countries. Their concerns about R&D incentives are legitimate concerns for those concerned about the public health, because we are concerned both about access to medicines and the mechanisms to fund the R&D that creates new and better medicine." he stressed. "The best public policies about compulsory licensing of essential medical technologies are those that will best serve public health goals, and which explicitly address the obvious ethical dilemmas. Restrictions on access must be reasonable, and they must not create situations where entire populations are denied access to known therapies."
Raising awareness of key issues: Sponsorship

The meeting also provided an opportunity for HAI contacts to raise concerns about other priority issues including WHO's increasing close collaboration with the pharmaceutical industry. Shortly before the Assembly began, HAI discovered that an employee of the pharmaceutical firm Merck, Sharp and Dohme (MSD) had been seconded to the staff of WHO's Tobacco-Free Initiative. HAI raised objections about this situation's potential conflict of interest and the Organization's lack of guidelines on industry collaboration in a letter sent to WHO's Director General. The letter was released to members of the press with a short statement explaining HAI's concerns. The statement quickly gained support from other NGOs attending the Assembly. Since the Assembly, the statement and letter have been circulated in various fora and the number of groups supporting the statement has increased to 27. HAI is now waiting for a reply from the Director General. During the Assembly, a number of countries also raised questions about WHO's close relationships with the commercial sector and were promised that guidelines would be published within one month. [Editor's note: Since this article was published, the WHO Director General has replied to HAI's letter. See the website's news page for the latest developments.]

(Copies of letter sent to Dr. Brundtland and statement in support can be obtained from the HAI website or the HAI Europe office. For background information about the RDS resolution and other issues raised at the 52nd WHA, visit HAI's news page on the websitehttp://www.haiweb.org/news/news.html. Official WHO documents can also be downloaded from the WHO website in all of the organisation's official languages (http://www.who.ch).
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Kiran Sagoo is Project Officer at Consumers International Regional Office for Asia and the Pacific. Lisa Hayes is Publications & Information Officer at the HAI Europe office.

 Sri Lanka

Following up on the workshop on Quality of Healthcare (see leading article in HAI News December 1998), ARDA Sri Lankan partners met with the Honourable Mr Nimal Siripala de Silva, Minister of Health and Ministry of Health Officials for further discussions on the Health Policy. Input was made in the areas of: the tasks of the private sector, National Health Commission and Patient's Rights. With more than 50 percent of the population seeking treatment at private institutions, it is important that these institutions be regulated by the state for the ultimate benefit of the patient. With regard to the composition of the National Health Commission, the commission should include officials from the Ministry of Finance, Financial Commission, Private Sector Medical Institutions and consumer representatives. The composition should not change with politics. The Health Policy document is at present in the draft stage.

Indonesia

YLKI and the Ford Foundation surveyed the impact of the economic crisis on access to medicines at the grassroot level. The survey focused on Amoksilin, Simetidin, Kloramfenikol, Tiamfenikol and Kotrimoksazol. It found that many drugstores substituted generic drugs for branded ones. Depending on the location, the generic drug Tiafenikol was substituted with either Thiambiotic or Biothicol.

The survey also found that many drugstores were not obeying the mandated pricing policy. Instead of reducing the price for generic drugs, most drugstores increased their prices.

Drugs are essential in maintaining the health of the general community. Placing drugs effectively out of reach of communities at risk, results in life being sacrificed. The irony of things were that drugstores that increased their prices were located in the capital, closer to central authority.

Dr Peter Mansfield from MaLAM, had a successful trip to New Zealand. The visit, aimed at educating health professionals on drug marketing, was featured as news articles in daily newspapers and as a full-page feature in the New Zealand Doctor. Dr Mansfield also gave a seven-minute interview on the National Radio Morning Report and a three-minute interview for Prime Television News.

MaLAM's first Healthy Scepticism newsletter which provides a second opinion on drug advertisement (featured in Network News, April 99) has received positive feedback from GPs in New Zealand.

 Europe

Correspondence on E-Drug highlights the problem of inappropriate drug donations for Kosovo refugees. Tons of drugs and medical supplies are pouring into Albania, the Former Yugoslav Republic of Macedonia and the Federal Republic of Yugoslavia (Serbia and Montenegro).

The governments of these countries report that some relief cargoes have been sent without prior notice or the required clearance, on arrival they are forwarded directly to camps which are not equipped to manage, store or distribute them. Large loads of hospital and surgical equipment have also been sent to camps, which do not currently need them. The fear is that this will lead to a repetition of what happened in Bosnia and Herzegovina and Rwanda: the stockpiling of unused drugs which will expire and deprive patients of their benefit. The present priority is for medicines to treat chronic and non-communicable diseases among women, children, elderly refugees and internally displaced persons.

Donors are requested to pay close attention to the internationally accepted guidelines for drug donations.

The Dutch Medicines Evaluation Agency (CBG) has started posting on its website all of its evaluation reports on drugs newly registered in The Netherlands (http://www.cbg-meb.nl). These reports summarise scientific data on the medicine's method of working, safety and pharmaceutical quality that the agency receives from the drug's manufacturer.

HAI Europe has been invited to become an interested party at the European Agency for the Evaluation of Medicinal Products (EMEA). In a letter to HAI, the EMEA's Executive Director, Fernand Sauer, said the agency was "currently rethinking how to integrate interested parties in the work of the Agency and in particular how to do so for consumer and patient representative organisations." HAI plans to use its new role at the agency to promote consumer participation and to advocate for greater transparency in EMEA decision-making.

Anne Rochon Ford has developed the booklet A Different Prescription: Considerations for Women's Health Groups Contemplating Funding from the Pharmaceutical Industry. The booklet is based upon discussions raised at an earlier seminar in Toronto on ethical issues related to drug industry sponsorship. The text explores why industry is often so keen to fund women's health groups and it provides practical advice on considering many arguments raised about sponsorship. While the book focuses on some specific concerns related to NGOs promoting the women's health, its ideas are useful for all NGOs confronted with this funding choice. Copies of the booklet can be ordered from: National Network on Environments and Women's Health, 214 York Lanes, York university, 4700 Keele St., Toronto, ON, M3J 1P3 Canada, email: nnewh@yorku.ca

Several HAI Africa volunteer subregional coordinators have been busy making new contacts, helping to link up interested individuals and groups and explaining the HAI Africa network. These activities are essential aspects of building a sustainable and effective HAI network in the region.

In Angola, Dr. Alexandre Saúl, of the Church Action in Angola Health Working Group, recently accepted an invitation from the Ministry of Health to address a meeting of health professionals about rational drug use (RDU), essential drugs policies (EDPs), drug donations and the HAI Africa network. Dr. Saúl was successful in raising awareness and interest in these issues and in promoting communication and links among participants.

In Uganda, Rosette Mutambi, member of the Uganda Media Women's Association (UMWA), has been busy making new contacts and promoting the RDU message in various ways. In UMWA's rural outreach project, of which she is part, each of the six radio producers produce a rational drug use message at least once a month. Ms. Mutambi and members of the Participatory Development for Women Initiative (PADWI) recently made contact with the Ugandan Youth Development Link (UYDEL) to assist them in improving their ability to create awareness and education messages that will be successful in reaching youth who live on the street. Through this new contact, UYDEL is now interested in creating RDU messages for their youth constituency. Ms. Mutambi and PAWDI members have teamed with a pharmacist and nurse to give monthly RDU presentations to a community women's group located in a semi-urban area that has many drug shops. In Mbarara District, Ms. Mutambi helped link up educators at the university and high school with Youth Educational Network (YEN) in Nairobi, Kenya. YEN demonstrated the use of drama to spread RDU messages among high school students during the HAI Eastern Africa training workshop held in March 1997, which Ms. Mutambi attended.

In Malawi, Sister Nympha Qué, of the Christian Health Association of Malawi (CHAM), and John Capito, chair of the Consumer Association of Malawi, have agreed to form a committee to steer a program of activities on medicines and health for consumers. This new relationship should facilitate the integration of RDU information and advocacy in consumer campaigning in the country. Sister Nympha discussed essential drugs policies with administrators and accountants of hospitals and health centres as part of a session titled, "Drug Management, Drug Financing and Sustainability," that was held during three CHAM-organised workshops. She was also involved in a retraining exercise for clinical officers, medical assistants and nurses in rational prescribing.

In Nigeria, Godwin Nwadibia Aja, Health Action Centre of Babcock University, Ilishan-Remo, used knowledge gained during his participation in the HAI Southern Africa workshop in June 1998 to revise the curriculum of a course he teaches on substance abuse education so that it includes a section on RDU, the Nigerian national drug policy and problem drugs. It is also an opportunity to discuss the HAI Africa network. Mr. Aja reports that students, who come from Nigeria and other countries in Africa, finish the course quite determined to take home and apply RDU knowledge and to remain connected to the HAI Africa network.

Mr. Aja used a public campaign, "Walk around the World 2000" to increase awareness of RDU. More than 600 people, including school children, government officials and community leaders took part in the 10-km walk. The campaign was so successful that walks may be organised in other cities.

He also attended the April meeting of the Nigerian Network of NGOs for Drug Demand Reduction. He met with individual NGOs and stressed the relevance of integrating RDU information into their programs.

In March, the Adventist Seminary of West Africa organised a community education program to raise awareness about the dangers of anti-diarrhoeal medicines. Approximately 140 men, women and youths also learned how to prepare an oral rehydration solution.

Mr. Jacques Akerekoro, ARAMBE-KAFU in Bénin, has been working to expand the HAI Africa network into Togo. In April, he met with three organisations in Lomé. Preliminary agreement has been reached with the Association Togolaise pour la Défense du Consommateur (ASTODEC) for it to become a voluntary HAI Africa country focal point.

HAI Africa organising in Niger, which was reported in HAI News number 106, has been delayed because of political upheavals in that country.

With the support of WHO, WTO, WIPO and NGOs, conference delegates plan to return to their countries and demand that their national governments use existing legal means to increase the supply of affordable essential drugs. If price is a criteria for/campaign/campaigns.htmlOlle Hansson Award

Dr Dzulkifli Abdul Razak is the recipient of the Olle Hansson Award for 1999.

Dr Dzulkifli is a Professor at the National Science University, Malaysia, and founding Director of the National Poison Centre. Dr Dzul has been mainly responsible for developing undergraduate courses in neuro and psychopharmacology, and also developing the Social and Administrative Pharmacy Programme. One such course of critical importance is "Drugs in Developing Countries".

Dr Dzul's main research contribution has been in the area of 'Computerization in Health-Care." He pioneered this interest in Malaysia and through his efforts, a nationwide health information service with emphasis on drug and poison information was introduced in 1989.

Currently, Dr. Dzul has the responsibility of developing expertise relating to toxicology and informatics at the National Poison Centre. Under his leadership, "Create Health" has been adopted has the motto for the National Poison Centre. This has lead to activities and service that promote health and better quality of life through health awareness and injury prevention programme.

In view of the National Poison Centre's achievements, it was designated in 1998 as the WHO Collaborating Centre for Drug Information, with Dr Dzul appointed as the founding Head of the Centre.

The Award is named in memory of Olle Hansson, a leading Swedish paediatric neurologist who became renowned as an advocate for patients injured by the anti-diarrhoeal drug clioquinol. He is also known as a powerful campaigner against the reckless marketing practices of drug multinationals. Dr Hansson was primarily responsible for the drug giant Ciba-Geigy's withdrawal of all their oral hydroxyquinoline drugs which were being prescribed as anti-diarrhoeals, and Tanderil (oxyphenbutazone) as an analgesic. Dr Hansson died from cancer on 23 May 1985 at the age of 49. May 23, is commemorated as Olle Hansson Day in many countries of the world. He is remembered for courageously and tirelessly speaking up against malpractices and injustices in the pharmaceutical and medical world.

The International Alliance of Patients Organizations (IAPO), a cross-disease and multinational organisation will be formally operational in January 1999. IAPO comprises more than 50 patient organisations mainly from Europe and the US but also from South America and Africa.

Mr Enrique Silver of IAPO declared, "IAPO has a very strong partnership with the pharmaceutical industry and is looking forward to the establishment of a partnership with the World Health Organization. IAPO will advocate in favour of the TRIPs Agreement." (Email received from James Love, US, 8 Apr 99)

Editor's note: Mr James Love of Consumer Project on Technology comments that in the United States and Europe, the pharmaceutical industry has already co-oped many patient groups, turning them into low paid PR and lobbying arms of the industry trade associations on many important policy issues. Please see lead article on Drug Industry Sponsorship in HAI News, April 99.

A team of Swiss and Azerbaijani researchers assessing the use of directly observed treatment, short course (DOTS) against tuberculosis in a prison setting in Baku, Azerbaijan, concluded that the programme did not meet the 85 percent effectiveness target set by the World Health Organization. Of 467 sputum-positive patients, only 54 percent had successful treatment.

Treatment failure was found to be independently associated with resistance to two or more antibiotics, a positive sputum test at the end of initial treatment, cavitary disease, and poor compliance. The researchers concluded that treatment with first-line anti-medications may not be sufficient in settings with high rates of drug resistance. (Tim France, tfran@hivnet.ch)

More than 10,000 Americans are inadvertently killed each year by prescription drugs. A study published in the Journal of the American Medical Association in 1998 concluded that adverse drug reactions are among the top six causes of death in the United States. A majority of these deaths are preventable, the results of mistakes or confusion about dosage, dangerous drug interactions from mixing medications or known allergic reactions.

Alarmed by such drug induced fatalities, the Food and Drug Administration (FDA), the drug regulatory authority in the US, is talking with a leading drug companies, the American Medical Association and consumer groups seeking ways to further protect consumers.

Another factor that propelled consumer protection to the top of FDA's agenda is the pressure from patients and politicians for faster access to promising medications; in recent years FDA has moved drugs more rapidly through the regulatory pipeline. Such speed raises the risk once a drug is in widespread use. Over the last two years the FDA has recalled five drugs and moved to re-evaluate several others including the diabetes drug Rezulin. (Los Angeles Times, US, 10 May 99)

Active Aging Makes the Differences

'Older people' constitute a very diverse group. Many older people lead active and healthy lives, while some much younger 'older people' have a poorer quality of life. People age in unique ways depending on their gender, ethnic and cultural background, geographical location and many other such factors. The differences are further increased by disease experiences throughout life, which may accelerate the aging process.

Poverty is clearly linked to a shorter life span and poorer health in older age. Less well off people tend to live in more harmful environments where they are more likely to be exposed to higher levels of indoor air pollution and to the risk of diseases such as diarrhoea and respiratory infections. Social isolation, because of widowhood or divorce for example, has adverse affects on health.

Although the individual may not have control over early life experiences and other factors such as poverty or low education, actions taken during the remaining life course greatly affect health in later life. Information about healthy life styles needs to be promoted. Policy decisions to encourage healthy, active aging must include the creation of supportive social and environmental conditions throughout life. Playing a part in family life, and being a member of a community or religious organisation have beneficial effects on health, improve a person's self-worth and enable older people to make a greater contribution to society. Equity, provision of efficient basic services and participation by all in society are essential concepts if the opportunities and potential of a rapidly aging world are to be realised.

 Source: Aging: Exploding the myths, Aging and Health Programme, World Health Organisation.

• The World Bank's Experience with Post-Conflict Reconstruction

by Alcira Kreimer, John Eriksson, Robert Muscat, Margaret Arnold and Colin Scott, published by the World Bank, Washington, D.C., 1998, 96 pp.

The explosion of civil conflicts has tested the ability of the entire international community to address unprecedented devastation of human and social capital. Since 1980, the volume of the World Bank's lending to post conflict countries has increased over 800 percent, to US$6.2 billion.

This report by the World Bank Operations Evaluation Department presents the findings of an assessment of the Bank's experience with post-conflict reconstruction. Case studies of nine diverse countries experience - Bosnia and Herzegovina, El Salvador, Uganda, Cambodia, Eritrea, Haiti, Lebanon, Rwanda and Sri Lanka, form the core of this assessment. The key issues addressed by the assessment are the timing and scope of the Bank's role; partnership and coordination with other donors, international organisations and NGOs; the World Bank's contribution to the damage and needs assessment and to reconstruction strategies; it role in rebuilding institutions; and implications for monitoring and evaluation.

The study aims to contribute to the dialogue on the Bank's ability to respond more effectively to the needs of societies rebuilding after conflict. The main recommendation emerging from the study is that the World Bank should develop a clear Operational Policy on post-conflict reconstruction assistance. Available from: The World Bank, 1818H Street, N.W., Washington, D.C. 20433, USA.

• The New Public Health: An Australian Perspective

by Fran Baum, published by Oxford University Press, Melbourne, 1998, 570 pp.

This publication provides the first comprehensive overview of contemporary public health practice. Divided into eight parts, this book starts off with a history of public health and a description of the rise of the New Public Health. The section is designed to provide an introduction to some of the key invisible factors, such as politics and civil society participation which drive public health policy and practice. This is followed by a discussion on the ideologies, political perspectives and ethics that shape public health responses. Patterns of health and inequities in health status is given due focus. Other topics include the environment and its impact on human life. The book concludes by assessing the crucial factors that will determine the future of public health.

This book is an excellent resource for students, public health and primary health care workers, health and environment planners, and anyone interested in creating communities that maximise the health of people and the environment.

Available from: Oxford University Press, 253 Normanby Road, South Melbourne, Australia.

• World Culture Report 1998

published by UNESCO, 1998, 488 pp.

The report breaks new ground by bringing together specialists from different fields to look at the interactions between culture and markets, inter-culturality, democracy, social urban phenomena, the environment and global ethics. Divided into seven major sections, the report starts with a discussion of the interrelationship between economic development and cultural diversity. This is followed by an outline of several major world trends. The conditions of indigenous cultures and populations, the diverse understanding of environmental issues, cultural heterogeneity and encounters in the face of the urban explosion, and the links between cultures and democracy is analysed. Considered also is the impact of global markets on culture, and the complex relationship between culture and ethics. The report contains a discussion of methodological issues that arise in devising cultural indicators. Statistical data available on culture and development are also presented with some discussion on ways of improving their collection and analysis.

In keeping with its mission of promoting understanding of intercultural exchanges, UNESCO will publish the World Culture Report every two years with an interdisciplinary, scientific and artistic analysis to inform policies on culture and development.

Available from: UNESCO, 7 place de Fontenoy, 75352 Paris 07 SP, France.

by Russell Mokhiber and Robert Weissman,

Wealth disparity, megamergers and the resulting consolidation of corporate power, commercialism run amok, rampant corporate crime, death without justice, pollution, cancer and an unrelenting attack on democracy. In a compilation of compelling snapshots from two of the leading reports on corporate power, Corporate Predators documents the price we pay for living in a corporate-dominated society.

Available at local bookstores or from http://www.corporatepredators.org or from Common Courage Press, 1-800-497-3207.

"The incisive and sharply focused snapshots presented here give a telling portrait of some of the most dangerous forces undermining what is decent and hopeful in American and global society. A warning that should be taken very seriously." - Noam Chomsky.

"Russell Mokhiber and Robert Weissman are veteran trackers of the corporate beasts that pillage the globe. In Corporate Predators, they are on the tail of GM, Exxon, Philip Morris and other snakes, showing how they prey on workers, the environment and consumers." - Jim Hightower

"Mokhiber and Weissman chronicle the immense power corporations have acquired for themselves and the effect they have on our health, economy, communities, environment and democracy. This book should serve as a call to action for us to reclaim our democracy from the corporate predators." - Lois Gibbs

" Go forward readers who wish to be leaders in the advancement of justice - what Daniel Webster once called ' the great work of men on Earth' - and savor the writings that will motivate more and more women and men to band together in organisations that build a more just democracy." - from the introduction by Ralph Nader.

HAI News is produced six times a year by the Regional Office for Asia and the Pacific of Consumers International (CI). For more information about the publication or to subscribe, contact HAI-Asia.

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