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1. Are Drugs Made in Emerging Markets Good Quality? A Preliminary Assessment of Product Consistency by Use of Raman Spectra

Author:
Roger Bate
Publication Date:
02-2011
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
Increasing competition generally decreases product prices. But in the case of pharmaceuticals, this is only beneficial if competitor products are therapeutically equivalent (bioequivalent). One measure of quality control is a consistently made product, examined in detail in this paper. A comprehensive study of drug samples in African and Asian countries--assessed for variability by spectrometer--suggests that registered products perform notably better than unregistered products. As all of the sampled drugs are used to treat potentially lethal infections, this product variability (particularly of unregistered drugs) could prove detrimental to public health. Future analysis will assess how significant these spectral differences are in terms of drug quality and hence how important changes in policy should be to limit quality variability.
Topic:
Emerging Markets, Health, Human Welfare, and International Trade and Finance
Political Geography:
Africa, China, and Asia

2. Drug Use in Nigeria

Author:
Roger Bate, Richard Tren, Thompson Ayodele, Kimberly Hess, and Olusegun Sotola
Publication Date:
08-2009
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
For decades, Nigeria has been plagued by counterfeit and poor-quality medicines, yet little information exists on the extent to which healthcare personnel are aw are of counterfeit and substandard medicines, and how this influences their behavior.
Topic:
Crime, War on Drugs, and Narcotics Trafficking
Political Geography:
Africa and Nigeria

3. Africa Malaria Day 2007 - Time for a Checkup

Author:
Roger Bate and Kathryn Boateng
Publication Date:
04-2007
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
Funding for malaria control has increased significantly over the past decade, but it is still unclear whether that funding is actually saving lives. Setting targets has emerged in recent years as a key fundraising tool for disease-control programs. However, available evidence shows that most health targets are immeasurable or not measured. Unless performance is measured in a meaningful way and successful policies followed thereafter, current and future malaria funding may not help to save lives and may even be counterproductive. It is time to stop setting meaningless targets.
Topic:
Development, Health, and Human Welfare
Political Geography:
Africa

4. WHO's Comprehensive HIV Treatment Failure - Will We Learn the Real Lessons from 3 by 5?

Author:
Roger Bate and Lorraine Mooney
Publication Date:
11-2006
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
It should be a cause for celebration that over 1.6 million people in the poorest parts of the world are now on antiretroviral treatment to halt the advance of HIV. But in a rush to improve access mistakes have been made. These mistakes, many of which were predictable, will be costly in terms of money and lives as drug resistance accelerates and more advanced (second-line) drugs may be unaffordable in poor countries.
Topic:
Development, Health, and Poverty

5. Poor Countries Need Relief from the World Bank's 'Help' on Malaria.

Author:
Roger Bate
Publication Date:
10-2006
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
The World Bank attempts to improve health in poor countries by providing advice in health financing and infrastructure development, as well as grants and loans to poor countries. This is a formidable mission given that the greatest difficulty poor countries have in carrying out public health programs is their lack of infrastructural, managerial and clinical capacity. Its efforts to this end have been diluted by irresponsible forays into disease control financing without a commensurate increase in institutional competence with only limited technical staff capacity. Instead of deferring to the World Health Organization for technical advice on malaria control, Bank staff members have promoted ineffectual malaria prevention and treatment, causing countries to move away from best practices in disease control. The Bank has been criticized in the Lancet medical journal, and its senior staff claim that changes have been made. This working paper reviews the most recent performance from the Bank, which demonstrates the continuing failure of its malaria work. The Bank should stick to its core mission of funding health systems and get out of the disease control business.
Topic:
International Relations, Debt, Economics, and Third World

6. Tariffs, Corruption and Other Impediments to Medicinal Access in Developing Countries

Author:
Roger Bate, Kathryn Boateng, Lorraine Mooney, and Richard Tren
Publication Date:
08-2006
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
There are many factors which hamper health care delivery in the developing world. These factors include tariffs, taxes, corruption, such as bribes and other local price inflators on medicines and medical products. Non-tariff barriers, such as lengthy registration periods for medicines and onerous requirements to clear customs, also restrict the availability of medication in the developing world. According to the World Health Organization, approximately one-third of the world's population lacks access to essential medicine and proper medical treatment. Drawing upon extensive evidence from surveys and accounts from the field, this paper examines the impact of tariffs, taxes and other markups on imported medicines and medical products provided to lesser developed countries by pharmaceutical companies, not-for-profit groups, for-profit corporations, multilateral and bilateral aid and health agencies. The paper discusses how these regulatory barriers affect access to medication. The authors conclude that although efforts to reform the current system of government revenue generation through tariffs collection may meet resistance in many developing countries, especially those featuring systemic corruption and those with domestic production, governments which take steps to eliminate tariffs could in fact expedite health care delivery and consequently improve the well-being of their people.
Topic:
Corruption, Economics, Health, and Third World

7. Zimbabwe's Impending Elections: What Other Countries Can Do, and Why

Author:
Roger Bate
Publication Date:
02-2005
Content Type:
Policy Brief
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
Without pressure from outside nations, upcoming elections in Zimbabwe are almost certain to hasten the country's slide into dictatorship under longtime leader Robert Mugabe. Pressure must be brought to bear on Zimbabwe's Southern African neighbors to enforce the agreed election protocols or they, and not just Zimbabwe, should face the withdrawal of aid, trade deals, and other U.S. largesse.
Topic:
International Relations and Government
Political Geography:
Africa and United States

8. South Africa's War against Malaria: Lessons for the Developing World

Author:
Roger Bate and Richard Tren
Publication Date:
03-2004
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
Malaria imposes enormous human suffering and economic costs on many poor countries. For South Africa, which has a relatively minor malaria problem for a developing country, from 2000 to 2002 the economic cost ranged between US$15 million and US$41 million, excluding estimates of the human suffering and estimates of lost investment in malarial areas..
Topic:
Economics, Environment, and Human Welfare
Political Geography:
Africa and United States

9. Beyond Kyoto: Real Solutions to Greenhouse Emissions from Developing Countries

Author:
Roger Bate and David Montgomery
Publication Date:
07-2004
Content Type:
Working Paper
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
Whether the Kyoto Protocol is ever ratified is fast becoming irrelevant. Many of the European nations that ratified the convention are failing to reach their targets, while developing countries, not required to comply with Kyoto, claim they will never participate in targets and timetables, as it would retard their economic growth. Given that developing countries are likely to emit well over half of future greenhouse gases (GHGs), a more promising strategy would be to devise an approach that limits emissions while helping development.
Topic:
Economics, Environment, Treaties and Agreements, and Third World
Political Geography:
Europe

10. China's Route to a Green and Prosperous Future

Author:
Roger Bate
Publication Date:
12-2004
Content Type:
Policy Brief
Institution:
American Enterprise Institute for Public Policy Research
Abstract:
By opening its economy to greater domestic and foreign investment in the technologies needed to reduce greenhouse gas emissions, China can dramatically improve its environmental record while becoming richer. The same promise holds for other developing countries as well.
Topic:
International Relations, Foreign Policy, Democratization, and Economics
Political Geography:
China