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11. Tackling the Triple Transition in Global Health Procurement

Author:
Rachel Silverman, Amanda Glassman, Kalipso Chalkidou, and Janeen Madan Keller
Publication Date:
06-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
There have been impressive gains in global health over the past 20 years, with millions of lives saved through expanded access to essential medicines and other health products. Major international initiatives backed by billions of dollars in development assistance have brought new drugs, diagnostics, and other innovations to the fight against HIV, malaria, tuberculosis, and other scourges. But behind these successes is an unacceptable reality: in many low- and middle-income countries, lifesaving health products are either unavailable or beyond the reach of the people who need them most. While each country’s context is unique, a reliable, affordable, and high-quality supply of health products is a vital necessity for any health system. In its absence, lasting health gains will remain elusive.
Topic:
Health, Public Health, Pandemic, Procurement, and Medicine
Political Geography:
Global Focus

12. Accelerating the Development of a Universal Influenza Vaccine

Author:
Aspen Institute
Publication Date:
07-2019
Content Type:
Working Paper
Institution:
Aspen Institute
Abstract:
The Sabin-Aspen Vaccine Science & Policy Group convened in 2018 to explore challenges and opportunities to develop a universal influenza vaccine. The group’s recommendations on how to overcome the scientific, financial and organizational barriers to developing a vaccine are synthesized in this report published in July 2019.
Topic:
Vaccine, Pandemic, Medicine, and Influenza
Political Geography:
Global Focus

13. Classification of Psychoactive Substances: When Science Was Left Behind

Author:
Global Commission On Drug Policy
Publication Date:
01-2019
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
In Classification of Drugs: when science was left behind, the Global Commission on Drug Policy explains how the biased historical classification of psychoactive substances has contributed to the "world drug problem". It is the first-ever comprehensive report providing a political reading of the current evaluation and classification, or "scheduling" of drugs according to their harms. Psychoactive substances should be classified with regard to their potential for dependence and other harms. This is not the case today, where some substances are legally available because they are considered beneficial (medicines) or culturally important (alcohol), while others are seen as destructive, and are strictly prohibited. The classification of drugs is at the core of the international drug control system. As such, governments must ensure that such a classification is pragmatic and based on science and evidence, makes clear the benefits and harms of drugs, and allows for responsible legal regulatory models to control drugs.
Topic:
Health, War on Drugs, Drugs, Alcohol, Public Health, and Medicine
Political Geography:
Global Focus

14. Global Issues and Business in International Relations: Intellectual Property Rights and Access to Medicines

Author:
Yoshiko Kojo
Publication Date:
01-2018
Content Type:
Journal Article
Journal:
International Relations of the Asia-Pacific
Institution:
Japan Association of International Relations
Abstract:
In international relations, globalization transfers the location of governance from nation-states laterally to such private actors as nongovernmental organizations (NGOs) and multinational firms, as well as vertically to local governments and supranational organizations. The purpose of this article is to clarify how the competitions among firms affect the problem of global issues by examining the case of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) and public health. This study shows why most of least developed countries implemented the TRIPS despite the warning of NGOs not to implement earlier for the sake of access to medicines. In order to understand the positive attitude of least developed countries toward the TRIPS, we have to examine how the distribution of pharmaceutical firms capacities in developing countries affect the implementation of the TRIPS Agreement. The existence and different capacities of generic pharmaceutical companies in developing companies are important elements of state policy toward the TRIPS.
Topic:
International Relations, Globalization, International Trade and Finance, Intellectual Property/Copyright, Business, and Medicine
Political Geography:
Global Focus

15. More Room for European Agencies in the EU Decision-Making Process?

Author:
Basile Ridard
Publication Date:
09-2018
Content Type:
Working Paper
Institution:
EGMONT - The Royal Institute for International Relations
Abstract:
The European institutions are not always able to address crises in a timely manner due to the cumbersome decision-making process. European agencies often provide the most appropriate response to the concerns of citizens and businesses that are experienced across the single market. They should be granted greater autonomy to bring to life EU policies while being made more responsible. At a time of growing uncertainties, the EU needs to further develop existing EU agencies and create new ones for addressing new cross-border challenges. A common legal framework should also be created for all EU agencies in order to harmonize their overall functioning.
Topic:
Regional Cooperation, European Union, Legal Theory, and Medicine
Political Geography:
Europe

16. Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan

Author:
Jui-fen Rachel Lu and Karen Eggleston
Publication Date:
04-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan’s National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer. Analyzing a unique dataset linking medical claims, cancer registry data and proxies for income between 2004 and 2015, we find that lower-income patients are more likely to be diagnosed with later stages of breast cancer, and this pattern renders NHI coverage of anti-HER2 therapy pro-poor even before full coverage of the diagnostic tests. Moreover, the expansion of NHI coverage—including the FISH diagnostic test and trastuzumab for early-stage breast cancer—strengthened the pro-poor distribution of genetic testing and target treatment, albeit only marginally. The extent of pharmaceutical company coverage of testing and its impact on patient access are topics of our ongoing research, contrasting breast cancer with colorectal cancer.
Topic:
Health, Health Care Policy, Economic Inequality, and Medicine
Political Geography:
Taiwan and Asia

17. How Individuals’ Birth Weight and Later Risk Factors Interact to Determine Their Risk of Cardiovascular Disease: A Longitudinal Study in the Philippines

Author:
Marjorie Pajaron
Publication Date:
12-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Cardiovascular diseases (CVDs), which are disorders of the heart and blood vessels, are the world’s leading cause of death (WHO, 2016). The transition from infectious diseases to non-communicable diseases (NCDs), primarily CVDs, as the primary cause of mortality and morbidity worldwide— combined with the economic burden associated with heart-related diseases—prompted the World Health Organization (WHO) and its regional offices to identify CVDs’ risk factors (WHO, 2016). This paper examines these risk factors with a focus on the fetal environment and its interaction with adult body mass index (BMI), using longitudinal data from the Cebu Longitudinal Health and Nutrition Survey (CLHNS). Using a Cox proportional hazards model to estimate hazard ratios adjusted for age and risk factors in adulthood, such as cigarette smoking, the results suggest that there is a positive association between birth weight and heart disease. In addition, when birth weight is interacted with BMI, raised blood pressure is found to be higher among those who were bigger infants at birth and grew to be lighter adults, suggesting centile crossing. Probit models are also used for sensitivity analysis, and the results are consistent with those of the hazards model. Other factors such as adult obesity and a smoking habit are also positively associated with hypertension and CVD.
Topic:
Health, Medicine, Risk Factors, and Birthing
Political Geography:
Global Focus

18. Biology’s Misuse Potential

Author:
Filippa Lentzos
Publication Date:
03-2016
Content Type:
Journal Article
Journal:
Connections
Institution:
Partnership for Peace Consortium of Defense Academies and Security Studies Institutes
Abstract:
The international community has laid down clear red lines about the use of biology to enhance national armaments. Advances in bioscience and biomedicine are, however, significantly eroding technological barriers to acquiring and using biological weapons. This article describes recent scientific trends and analyses their security implications. Three emerging fields of research that have particularly high potential for misuse are considered in more detail: potentially pandemic pathogens, synthetic biology and neurobiology. It is argued that continued efforts are required in multilateral, national and scientific spheres to strengthen the red lines and to foster responsible science.
Topic:
Science and Technology, Biological Weapons, Pandemic, Biology, and Medicine
Political Geography:
Global Focus

19. The Negative Impact of Drug Control on Public Health: the global crisis of avoidable pain

Author:
Global Commission On Drug Policy
Publication Date:
10-2015
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
Ninety-two percent of the world’s supply of morphine is consumed by just 17 percent of the global population, with consumption primarily concentrated in the global north and 75 percent of the world’s population does not have access to any pain relieving drugs. The reasons for this have little to do with issues of cost or scarcity of supplies- and everything to do with with the prohibition and repressive stand the world has taken on drugs. This Global Commission report explores the current crisis related to the lack of access to controlled medicines and makes concrete policy recommendations to Member States and UN agencies on ways to improve these conditions. This report is available in English, Spanish, Russian, French and Arabic.
Topic:
Health, War on Drugs, Drugs, Public Health, and Medicine
Political Geography:
Global Focus

20. Taking Control: Pathways to Drug Policies That Work

Author:
Global Commission On Drug Policy
Publication Date:
09-2014
Content Type:
Special Report
Institution:
Global Commission On Drug Policy
Abstract:
The Commission’s 2014 report broke ground by advancing and globalizing the debate over drug control measures and its alternatives. Anticipating the 2016 United Nations General Assembly Special Session on drugs (UNGASS), the report provides clear-cut pathways for Member States. The five recommendations for more effective drug policies include: putting health and community safety first; ensuring equitable access to controlled medicines; ending the criminalization of people who use or possess drugs; promoting alternatives to incarceration for low-level participants in illicit drug markets, including cultivators; and encouraging policy innovations such as legally regulated markets, beginning with, but not limited to cannabis, coca leaf and certain other psychoactive substances. Never had so many former world leaders spoken out in support of legal, regulation of currently illicit drugs.
Topic:
Crime, War on Drugs, Regulation, Drugs, Public Health, and Medicine
Political Geography:
Global Focus