Last month I talked about my perceived wisdom being challenged by my first big project in Russia, where I found that problems, and their solutions, were rarely black and white. The same thing happened to an even greater extent when I worked in southern Africa ten or so years ago. I was working for the Commonwealth Secretariat on a project which took me to Seychelles, Mauritius, Kenya, Uganda, Mali, Swaziland, Zambia and Zimbabwe.
At the time, African governments were spending billions of dollars importing medicines for the populations, money they could ill afford. And as a result, the trade in counterfeit drugs was rife. Counterfeits might be cheap knock-offs that might have the correct active ingredients, but not necessarily in effective quantities; or they might contain deliberate substitutions of cheaper ingredients, which could be lethal.
And the worst thing about the whole situation was that the countries in question had lots of factories of their own. But because of differing regulations and standards, trading across the continent was minimal. The role of my project team was to work with companies and government bodies to provide a level playing field and thus strengthen the internal African industry.
Understandably, there was a high degree of scepticism from many people, well used to colonial experts coming and telling them what they should do to improve their lot. And then one day I was sitting in a meeting with a number of government officials and the current Health Minister. He listened to everything we had to say and then he looked me straight in the eye and said: “This is all well and good in principle. But I have the responsibility to provide medicines for millions of people in this country. And I have a very limited budget with which to do it. I can’t afford to worry about quality; I have to concentrate on quantity. And if that means a few people are affected by bad drugs, then so be it.”
At the time, I was outraged. But when I’d cooled down, I realised he was not wicked or heartless; he was just a man dealing with an intractable problem in the best way he could. Once again it was brought home to me that in this life things are rarely black or white.
