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141. Pandemic Influenza and the Globalization of Public Health

Author:
Karen Eggleston, Qiong Zhang, and Michele Barry
Publication Date:
11-2009
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Globalization means a threat to any of the world's peoples is a threat to all the world's peoples. As American journalist Laurie Garrett says in her famous book The Coming Plague: Newly Emerging Diseases in a World out of Balance, none of us can escape from a pandemic in our increasingly globalized world. Most of us are active members in prosperous communities, whose daily lives involve interactions with dozens of people of varied backgrounds; even if we were Robinson Crusoes safely living a life of autarky on an isolated island, a fly or bird could bring an avian or swine flu virus to puncture our well-protected balance.
Topic:
Globalization, Health, and Humanitarian Aid
Political Geography:
Global Focus

142. Closed to Reason: The International Narcotics Board and HIV/AIDS

Publication Date:
02-2007
Content Type:
Special Report
Institution:
Open Society Foundations
Abstract:
In this report on the International Narcotics Control Board—a secretive UN-funded body responsible for monitoring compliance with the UN drug conventions—Daniel Wolfe, OSI International Harm Reduction Development Deputy Director, and Joanne Csete, Executive Director of the Canadian HIV/AIDS Legal Network, detail the ways in which the Board rejects scientific evidence and expert legal analyses, praises governments that violate human rights, and stresses drug control at the expense of public health, blocking evidence-based efforts to address the epidemic of HIV among injecting drug users. Closed to Reason offers recommendations to increase the Board's accountability and transparency and to make it an effective part of the international response to HIV/AIDS.
Topic:
HIV/AIDS, Health, United Nations, Narcotics Trafficking, and Legal Sector
Political Geography:
Global Focus

143. Mother and Child: A Multi-Determinant Model for Maternal and Infant Health Outcomes in Urban, Low-Income Communities and the Effectiveness of Prenatal Care and Other Interventions

Author:
Matthew W. Wolfe
Publication Date:
05-2006
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
Research examining the outcomes of prenatal care has largely been restricted to medical interventions. Focusing on low-income women in urban communities, this paper fi rst describes a broadened set of expectations of prenatal care and other interventions. It proposes a more holistic framework for analyzing policy choices by examining the numerous determinants that affect maternal and child health outcomes. Then, it examines policy options through these determinants.
Topic:
Health, Children, Cities, Parenting, and Pregnancy
Political Geography:
Global Focus

144. Why is There No AIDS Vaccine?

Author:
Michael Kremer and Christopher M. Snyder
Publication Date:
10-2004
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
We argue that differences in timing of drug and vaccine consumption will lead firms to be biased against developing vaccines. Vaccines are sold before consumers are infected, when they still have private information regarding their infection risk, whereas drugs are sold after consumers are infected, when those with positive valuation have no private information on infection risk. Calibrations suggest that, for sexually transmitted diseases, for which infection risk is highly heterogeneous across consumers, producer surplus from drugs may exceed that from vaccines by a factor of four. Consistent with the model, empirical tests suggest vaccines are particularly unlikely to be developed for sexually transmitted diseases. Biases against vaccines are exacerbated by the durability of vaccines and by the interaction between the timing of vaccine and drug consumption and the temporary protection of intellectual property rights. We extend the analysis to allow for government procurement and for income heterogeneity among consumers. Given that antiretroviral drugs are difficult to deliver in the poor countries where most people infected with HIV/AIDS live, biases against developing a vaccine raise enormous public health concerns.
Topic:
HIV/AIDS, Health, Public Health, and Vaccine
Political Geography:
Global Focus

145. Micro-Economic Approaches to Evaluating the Burden of Malaria

Author:
Pia Malaney
Publication Date:
04-2003
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
The links between malaria and poverty are both obvious and subtle. While the correlation between the two is apparent, directions and mechanisms of causation are less so, and different methodological approaches to understanding the relationship provide widely divergent perspectives on the impact of the disease. Recent macroeconomic studies have suggested that in highly malarious countries the disease may be responsible for reducing economic growth by up to 1.3 percentage points a year. This methodology, however, functions independently of the chains of causation and cannot shed much light on underlying mechanisms. Micro-economic studies, which aggregate the cost per case to households, find a much smaller impact, generally less than one percent of per capita GDP. The traditional cost-of-illness methodology, which forms the basis of most of these studies, however, was designed to study illnesses that represent a far smaller disease burden. The pandemic nature of malaria presents economic costs that the traditional model is simply not able to capture. The paper explores the difference between the results of the different methodological approaches, examining some of the mechanisms through which malaria can affect long-term economic growth and development, and expands the cost-of-illness methodology to incorporate these effects.
Topic:
Economics, Health, Poverty, and Malaria
Political Geography:
Global Focus

146. Impact of Patents on Access to HIV/AIDS Drugs in Developing Countries

Author:
Joan-Ramon Borrell and Jayashree Watal
Publication Date:
05-2002
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
This paper uses sales data on HIV/AIDS drugs in a sample of 34 low and middle income countries between 1995 and 1999 to assess empirically the impact of patents on unsubsidized access to a new drug therapy. There can be two possible effects of patents on access to new drugs in developing countries. On the one hand, patents may constrain access to new drugs through less competition and higher prices. On the other hand, patents may promote access to new therapy by encouraging innovators to launch new drugs in low and middle-income countries soon after introducing them in high-income countries. The net effect is theoretically ambiguous and, therefore, it is an empirical matter to evaluate. Our main finding is that patent rights do have a negative effect on unsubsidized access to HIV/AIDS drugs. Between 1995 and 1999, switching all HIV/AIDS drugs from a patent regime to a no patent regime would have actually increased access to therapy at least by 30%. However, we also find that the negative impact of patents on access differs strongly over time, and across countries with different income levels. Patents hurt access most in the early period from the date the drug is launched in the US, and in the countries of our sample with the relatively higher per capita income levels.
Topic:
HIV/AIDS, Health, Developing World, Drugs, and Patents
Political Geography:
Global Focus and United States of America

147. Nutrition Knowledge Versus Schooling in the Demand for Child Micronutrient Status

Author:
Steven Block
Publication Date:
08-2002
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
This study extends the literature on the demand for child height to consider the demand for child micronutrient status. Micronutrient malnutrition is a pervasive and debilitating problem in many developing countries. A central focus concerns the distinct roles of maternal schooling versus maternal nutrition knowledge as determinants of micronutrient status. Applying both parametric and non-parametric techniques to Indonesian household data, the study finds that critical determinants include: child gender and age, the number of children in the household, household expenditure levels, access to water, and maternal nutrition knowledge. Maternal schooling contributes to child micronutrient status primarily through its effect on nutrition knowledge (for which schooling is not the primary source), and possibly through its effect on household expenditures.
Topic:
Education, Health, Human Resources, and Nutrition
Political Geography:
Global Focus