Pharmaceutical transnational corporations are not responsive to the real drug needs of individual countries. Importation of pharmaceuticals is one of the fastest growing drains on hard foreign currency for developing countries. Some health ministries are spending over 50% of their budgets on drugs alone. In addition to cost, there are dangers of uncontrolled availability of potentially dangerous drugs. In many countries the great majority of drugs are available over the counter, without prescription. At the other end of the scale, are products which respond to consumer and commercial pressure rather than genuine medical needs, such as expensive cosmetic treatments for skin pigmentation and hormone treatments for height and weight. Somewhere in the middle, and related to the social responsibility of corporate activity, is the question why it is more attractive to devote the best of pharmaceutical research expertise to cures for ailments rather than prevention, ie vaccines and other form of prophylactic medicines.
In the case of inappropriate use of drugs, recent studies have disclosed, for example, that a fifth or North Yemen's drug imports and a quarter of all drugs sold in India are tonics, vitamins or indigestion tablets. Part of the flood of inessential drugs is due to the marketing practices of the international pharmaceutical industry. The WHO says that promotion activities of the drug manufacturers have created a demand greater than the actual needs. In Colombia, for example, the money spent on drug advertising is equivalent to more than half of the country's health budget. In Nepal, Brazil and some Central American countries there is one sales representative for every three doctors; this leads to overprescribing on a massive scale.