Sterilization of workers from pesticide exposure: the causes and consequences of DBCP-induced damage in Costa Rica and beyond.

Public health hazards from the use of agricultural pesticides have received increasing attention in developing as well as industrial nations. This article examines a remarkable case of massive sterilization of approximately 1,500 workers in Costa Rica, due to exposure to a toxic nematicide called DBCP 1,2-dibromo-3-chloropropane), applied in large commercial banana plantations. Although the product was used during the 1970s, sterile victims have continued to be diagnosed through the 1980s. The effects include psychological trauma as well as permanent infertility. The case has international repercussions because several hundred workers have filed law suits against the U.S.-based transnational DBCP manufacturers, and because DBCP use was continued during the 1980s in other developing nations. The author analyzes the causes behind this serious impairment. It is argued that the contributing factors include not only biomedical processes and technical dimensions (i.e., how DBCP was used), but most importantly, political-economic factors that explain how and why DBCP was used despite the severe hazard. The crucial determinants pertain to the dominance of short-term profit motives, and the control over information and technology by the manufacturers (who concealed early toxicological research evidence of the reproductive hazards) and by the managers of the banana producer-companies. This case well illustrates problems and injustices from labor exploitation and resource extraction from transnational agro-industries. The article concludes with a brief summary of policy implications from the case.

Technology policy and planning in the Third World pharmaceutical sector: the Cuban and Caribbean community approaches.

There has been growing international concern over many aspects of the use and flow of medicines in developing countries. This article briefly reviews factors which have contributed to problems in this area including marketing and promotional practices of the pharmaceutical companies, rising drug import costs, and the unsuitability or poor quality of available drugs. This analysis is primarily concerned with policies that have emerged from efforts to alleviate such problems, to increase control over multinational drug companies, and to bring about changes in the technology transaction processes and in the pharmaceutical sector. It focuses on two cases: the regional cooperation scheme of the Caribbean countries (CARICOM) and the national-level policy of Cuba. It is shown that the CARICOM strategy has significant limitations, primarily due to its voluntary nature and lack of enforcement mechanisms for member countries. On the other hand, the Cuban approach has brought about positive effects and progressive changes, made through political commitment to achieve social benefits, and in conjunction with integrated broad reforms of the entire health system within a socialist framework. Thus, the problems and promises of such strategies are viewed in a context which emphasizes the prevailing forces of the global political economy. The lessons from this study, applicable to other developing countries, not only reveal important measures for the pharmaceutical sector, but also stress the ultimate need for strong commitment to enforce policies at the national level and for major structural changes, in order to adequately meet the health and medical needs of the people.