Global Health Watch 1 in one file

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Health care systems | B2 decision only applies to review articles. The authors of scientific studies are often funded by private drug companies with a stake in the results. In other cases, papers are ghost-written by pharmaceutical company staff or contractors. Scientists at universities are often allowed to have stock options in companies benefiting from the research they are conducting. Researchers on industry payrolls may be persuaded to suppress unwanted results, and those who defy their corporate sponsors may lose their funding. Lastly, where university research was once oriented to producing independent and public knowledge, it is now increasingly locked up in patents. This type of corruption and bias also extends to prescribing doctors and medicine regulatory authorities (Angell 2004, Avorn 2004, Kassirer 2005). Big Pharma spends lavishly to influence doctors who write the prescriptions. It funds and thereby influences much of the continuing medical education doctors need to renew their licences, and subsidizes scientific meetings of medical societies where it hawks its wares and often sponsors its own programmes. Pharmaceutical companies have also been able to purchase influence in regulatory bodies: half the US Food and Drug Administration’s budget for evaluation of new drugs comes from pharmaceutical company user fees, making it dependent on the industry it regulates – an obvious conflict of interest. A significant number of staff in regulatory authorities also have long and close connections with the pharmaceutical companies. The executive head of the regulatory authority in the UK, for example, was an employee of SmithKlineBeecham for over 20 years. Even more alarming is the absence of effective laws and regulations to force drug companies to reveal all their clinical trial data. The FDA and its European counterparts have no right to demand to see any data that drug companies do not wish to reveal. This selective and biased release of scientific data, which should be made illegal, is potentially harmful to patients and also has a corrosive effect on the ethics and values of scientific inquiry. Regulatory bodies are also under political pressure to speed up the licensing of new medicines in order to minimize the loss of potential profits due to delays in marketing a new drug. Proposals for a new agenda TRIPS and international trade agreements Intellectual property rights related to essential medicines and other essential health technologies should not be governed by the WTO and trade agreements, but by public health considerations and public health institutions – elevating human rights and social considerations above the narrower considerations of commercial trade. In 112
8 Informal supply: lack of regulation of pharmaceutical markets is a key problem for many poor countries. the long term, civil society should work towards the annulment of the TRIPS agreement related to medicines and the creation of a more just framework. Similarly, civil society and health professional associations should campaign Medicines 113
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About this book Today’s global he
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Global Health Watch 2005-2006 An al
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Contents Boxes, figures and tables
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C2.1 The facts about disability 180
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Illustrations 1 Medicine cannot dea
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Acknowledgements The following indi
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London School of Hygiene and Tropic
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Victoria, Canada; Centre for Health
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Foreword New reports on different a
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Introduction Origins The Global Hea
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Child malnutrition, death and disab
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Human rights and responsibilities A
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impacting on health. The Watch hope
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part a | Health and globalization T
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Health and globalization | A1 and h
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Health and globalization | A1 in 20
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Health and globalization | A1 is gl
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Health and globalization | A1 peopl
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Health and globalization | A1 numbe
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Health and globalization | A1 and p
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Health and globalization | A1 econo
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Health and globalization | A1 Box A
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Health and globalization | A1 half
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Health and globalization | A1 appro
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table a1 Key health concerns with W
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Health and globalization | A1 Healt
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Health and globalization | A1 merci
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Health and globalization | A1 thems
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Health and globalization | A1 Even
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Health and globalization | A1 • A
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Health and globalization | A1 non-v
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Health and globalization | A1 27-28
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Health and globalization | A1 Jenki
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Health and globalization | A1 Satte
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Health and globalization | A1 WHO (
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and regulatory authorities mandated
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Health care systems | B1 4) selecti
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Health care systems | B1 • And si
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Health care systems | B1 • declin
Page 80 and 81: Health care systems | B1 user charg
Page 82 and 83: Health care systems | B1 focus on t
Page 84 and 85: Health care systems | B1 for health
Page 86 and 87: Health care systems | B1 their cont
Page 88 and 89: Health care systems | B1 health car
Page 90 and 91: Health care systems | B1 ing servic
Page 92 and 93: Health care systems | B1 Box B1.7 G
Page 94 and 95: Health care systems | B1 many of th
Page 96 and 97: Health care systems | B1 the lack o
Page 98 and 99: Macro-economic factors Impoverished
Page 100 and 101: Health care systems | B1 HALE 2000
Page 102 and 103: Health care systems | B1 But improv
Page 104 and 105: Health care systems | B1 high-incom
Page 106 and 107: Health care systems | B1 Structural
Page 108 and 109: Health care systems | B1 the high t
Page 110 and 111: Health care systems | B1 and histor
Page 112 and 113: Health care systems | B1 norms (Loe
Page 114 and 115: Health care systems | B1 Foster M,
Page 116 and 117: Health care systems | B1 Toole M et
Page 118 and 119: B2 | Medicines Introduction Essenti
Page 120 and 121: Health care systems | B2 of new med
Page 122 and 123: Health care systems | B2 chapter re
Page 124 and 125: Health care systems | B2 the fourth
Page 126 and 127: Health care systems | B2 agenda thr
Page 128 and 129: Health care systems | B2 nonetheles
Page 132 and 133: Health care systems | B2 for the an
Page 134 and 135: Health care systems | B2 expenditur
Page 136 and 137: Health care systems | B2 Medawar C
Page 138 and 139: Health care systems | B3 between he
Page 140 and 141: Severe shortage Low density Moderat
Page 142 and 143: Health care systems | B3 sector and
Page 144 and 145: Health care systems | B3 to the US,
Page 146 and 147: Health care systems | B3 500 400 30
Page 148 and 149: Health care systems | B3 have been
Page 150 and 151: Health care systems | B3 to underta
Page 152 and 153: B4 | Sexual and reproductive health
Page 154 and 155: Health care systems | B4 10 Policy-
Page 156 and 157: Health care systems | B4 women and
Page 158 and 159: Health care systems | B4 of funding
Page 160 and 161: Health care systems | B4 debate on
Page 162 and 163: Health care systems | B4 the sexual
Page 164 and 165: Health care systems | B4 perspectiv
Page 166 and 167: Health care systems | B5 genome res
Page 168 and 169: Health care systems | B5 drugs base
Page 170 and 171: Health care systems | B5 Complete f
Page 172 and 173: Health care systems | B5 when a tes
Page 174 and 175: Health care systems | B5 are allowi
Page 176 and 177: Health care systems | B5 of life sc
Page 179: part c | Health of vulnerable group
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Health of vulnerable groups | C1 me
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Health of vulnerable groups | C1 pr
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Health of vulnerable groups | C1 Th
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Health of vulnerable groups | C1 Ca
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Health of vulnerable groups | C1 Bo
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Health of vulnerable groups | C1 Pa
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Health of vulnerable groups | C2 DP
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Health of vulnerable groups | C2 di
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part d | The wider health context T
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D1 | Climate change Introduction En
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increasing quantities are now causi
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development, local availability foo
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14 Droughts threaten the food secur
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Protocol can meet their targets by
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15 Transport and travel are major d
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• Redesign trade rules. Governmen
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D2 | Water Access to enough clean w
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water consumption worldwide. Each p
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table d2.1 Top corporate players in
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16 Protesting against the privatiza
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Box D2.3 Regulating private water c
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The private sector overestimates th
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Box D2.7 US citizens told to boil t
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to water. Worse still, it does this
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References Barlow M, Clarke T (2002
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D3 | Food Undernutrition is by far
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Functional and Productive Capacity
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table d3.1 Corporate control of US
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keting and processing means that sm
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average Indian family of four reduc
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Bank’s US$ 93.5 million loan to C
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Avery N, Drake M, Lang T (1993). Cr
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D4 | Education Some 135 million chi
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ledge about health-care practices a
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2005, and on present trends about 4
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Box D4.3 Programmes that aim to emp
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• per capita public spending fall
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unable to recruit 9000 badly needed
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Gordon D et al. (2003). The distrib
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D5 | War War has an enormous and tr
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19 Chechnya destroyed. War has wide
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initiated a ‘war on terrorism’.
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an explosive force equivalent to ab
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the risk of their misuse and divers
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Box D5.3 An agenda for peace The Ha
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Machel G (1996). Impact of Armed Co
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part e | Holding to account: global
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E1 | World Health Organization The
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The sources consulted worldwide in
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Box E1.1 Milestones in WHO history
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aised by his attempts to revitalize
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• stronger internal focus on perf
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21 WHO - up in the clouds? Reaction
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in favour of so-called ‘vertical
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to speak openly, while bullying and
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velop a unified, purposeful health
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to medicines, and the mobilizing ro
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Recommendations WHO’s core purpos
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doctors, and more people with exper
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E2 | UNICEF In 2005, Carol Bellamy,
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In sum, for almost a decade, childr
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prompted a global debate on how to
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E3 | The World Bank and the Interna
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22 World Bank: the centre of world
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approach to conditionality is being
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tal policies should explicitly refe
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E4 | Big business This chapter deal
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23 The Marlboro Man was described b
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dedicated funding [Articles 5.6 and
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grass roots in building government
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24 A pack of Cerelac cereal food pu
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USAID has also funded work on breas
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(from whatever its source, and howe
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These trends in taxation are underp
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Norway Denmark Netherlands Luxembou
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Global aid trends - allocation Wher
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weapons, vehicles and military trai
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table e5.1 Value (in £) of new DFI
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OECD (2005). Development Co-operati
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25 Breaking the chains of debt: pro
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Box E6.1 Zambia: inflation or death
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have met the Fund’s conditions, a
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E7 | Essential health research Rese
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Developing national health research
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for African Medical Editors (Certai
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Neither the consultations leading u
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Box E7.4 Asking the social-politica
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• global architecture for health
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part f | Conclusions Global Health
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current debt relief mechanism - the
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agreement, and taking health and he
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ity of the now-developed countries
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tion and water are experiencing sim
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