Health Breaking News 322

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 322

 

Italy’s Draft WHO resolution: Improving the transparency of markets for drugs, vaccines and other health-related technologies 

European Council agrees on SPC manufacturing waiver 

Universities Allied for Essential Medicines-UAEM Europe Conference: Hamburg 26th to 28th April 2019 

DNDi PORTFOLIO UPDATES 

BMJ: Innovation for neglected diseases in South Asia 

Are we making progress on the use of antimicrobials in animals? 

The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: A cluster randomised trial 

New cholera tracking tool could provide more accurate picture of outbreaks 

New Tool for Tracking Cholera Outbreaks Could Make It Easier to Detect and Stop Deadly Epidemics 

World TB Day 2019 

How Ebola treatment has changed 

DRC Ebola: latest numbers as of 20 February 2019 

Pregnant women to be given Ebola vaccine in WHO policy U-turn 

Outrage as cystic fibrosis drug firm posts big profit 

How Big Pharma’s free samples encourage your doctor to prescribe more expensive drugs 

Hot topics in vaccination: efficacy, impact and attitudes 

Global conference calls for action to prevent suffering and disability from mycetoma 

Critical birth drug mired in Nigeria 

Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming 

Countries are spending more on health, but people are still paying too much out of their own pockets 

Broadening its donor base and non-state actors – Does WHO really have a choice when it comes to financing? 

SDGs ‘failing to create transformational change’ 

Gridlock, Innovation and Resilience in Global Health Governance 

Aid spending should compensate those who have been most impoverished by the unfair global economic system we have helped to create, not be used to further its ends 

170 clinical trials run by NHS Trusts violate disclosure rules 

Human Rights Reader 473 

Trump administration launches global effort to end criminalization of homosexuality

How Development Excludes Adivasi Peoples 

UN announces roadmap to Climate Summit in 2019, a ‘critical year’ for climate action 

‘No Way to Defend Ourselves Against the Onslaught of Climate Change’ 

Special issue of Critical Public Health journal: “Public health activism in changing times: Re-locating collective agency” Call for abstracts, deadline 1 May 2019

The Original ‘7-Year Itch’ – Coming to an Infestation Near You!

The WHO estimates that around 200 million people are infected globally at any point in time, with up to 71% prevalence in crowded or institutional settings. Annually 0.2% of global disability-adjusted life years (DALYs) are attributed to scabies, a greater burden than leprosy, schistosomiasis, or dengue. These figures may be an underestimate since there is a global lack of high-quality prevalence data and significant amounts of misdiagnosis and under-reporting. In 2017, the WHO deplored the global paucity of evidence, designated scabies as a category-A NTD, and recommended prevalence studies

By  Michael Head *

Senior Research Fellow

Clinical Informatics Research Unit and Global Health Research Institute

Faculty of Medicine, University of Southampton, UK

The Original ‘7-Year Itch’ – Coming to an Infestation Near You!

As cross-posting this article also appears on the blog site of the Royal Society for Tropical Medicine and Hygiene - RSTMH

 

It’s currently burrowed under the skin of about 200 million people around the world right now, and is spreading abuse, stigma and shame wherever it goes. Your friendly local doctor often cannot recognise it, which is perhaps fair enough given it’s less than 0.5mm long. It’s brewing up a cocktail of ongoing misery including a fair few wounds as a result of people frantically scratching themselves, fair amount of renal disease, and the occasional bout of sepsis.

Public health burden

So, let’s have a chat about the massive public health burden of scabies then. What’s that? You’d rather not? Afraid that’s all I’ve got. No, I don’t mind, do carry on eating your lunch. Oh, yes there are pictures actually. Right here, in fact.

Scabies presentations from our UK care home study (Cassell et al, Lancet Infectious Diseases, 2018)

Scabies is (if you hadn’t guessed by now) an intensely itchy skin condition, transmitted by mites. It causes rashes, and can lead to significant secondary complications including bacterial infections and renal complications. A disease of poverty, it is highly stigmatised as being “dirty” and attracts significant social stigma – the Ethiopian word for scabies “ekek” is used as a term of abuse.

The WHO estimates that around 200 million people are infected globally at any point in time (anecdotally, recent conversations with the WHO suggest that may be a significant underestimate), with up to 71% prevalence in crowded or institutional settings.

Greater burden 

Annually 0.2% of global disability-adjusted life years (DALYs) are attributed to scabies, a greater burden than leprosy, schistosomiasis, or dengue. In Ethiopia, there is an ongoing outbreak with over 400 000 scabies cases. There, 1.2 million doses of ivermectin (anti-parasitic drug) have been administered, there is a median prevalence of 33%, duration of symptoms is five months (that’s over 20 weeks of itching), and over half of cases were in children who typically did not go to school during this time.

There is a global lack of high-quality prevalence data and significant amounts of misdiagnosis and under-reporting. In 2017, the WHO deplored the global paucity of evidence, designated scabies as a category-A NTD, and recommended prevalence studies.

For our contributions – colleagues at Brighton & Sussex Medical School are leading on scabies research studies in Ethiopia and Papua New Guinea.

Pilot study on scabies diagnosis in Ghana

I have a pilot study starting in 2019 covering improved diagnosis of scabies in Ghana. This is working with public health directors in the Volta and Greater Accra regions, and includes training from Ghanaian dermatologists (from the University of Ghana, Ghana Dermatology Society, and the Rabito Clinic).

Previously, between us, we prospectively reported on scabies outbreaks in care homes in the UK (yes, there’s plenty of it in high-income countries too). This was a complex study where we were urged to exclude patients with dementia since that would make the research ethically tricky. We continued to include dementia patients. It certainly did make the ethics very tricky indeed, but we did discover that the most vulnerable patients in care homes are the ones who are most at risk of (among virtually every co-morbidity going) scabies infestation.

Lack of bathing not a cause of scabies

Oh and one further point – a lack of bathing is not a cause of scabies. It’s a common myth (being ‘unclean’), that is spread even by healthcare workers (I myself recently reviewed a paper that stated precisely that). Overcrowding and poverty are key factors (and these populations are likely to wash less). But bathing in itself is not a factor, and the WHO have in fact written to ourselves to thank us for our response (linked above).

There are effective drugs (such as ivermectin), but little in the way of diagnostics and no vaccine and plenty of misinformation and stigma. There is little in the way of policy and guidance, due to the lack of data upon which to base any guidance. Which leads us to conclude…

Scabies, perhaps the biggest global public health problem you know very little about. Now it’s an NTD, we can hopefully start to make progress on this truly neglected disease.

——————————-

 

*Dr Michael Head is a Senior Research Fellow, based in the Clinical Informatics Research Unit at the University of Southampton. He has research interests in analyses of the financing of research, evidence-informed policymaking, pneumonia and this probably-unhealthy obsession with scabies (for which he has Professor Jackie Cassell, Brighton & Sussex Medical School to thank).

m.head@soton.ac.uk
@michaelghead

 

BY THE SAME AUTHOR ON PEAH

Equity in Investments – a Need to Map the Research Landscape for Health

 

Health Breaking News 321

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 321

 

What the recent discussions on access to medicines at WHO’s Executive Board tell us 

Campaigners across EU slam MEPs vote to approve ‘corporate stitch up’ Singapore deal 

Captured states: When EU governments are a channel for corporate interests 

MEPs take note: EU-Singapore deal could hinder fight against fraud and corruption 

The EU-Singapore Investment Protection Agreement 

Can a Virtual Reality Video Help Fight Anti-HIV Stigma? 

Setting targets for HIV/AIDS—What lessons can be learned from other disease control programmes? 

Trump’s HIV strategy faces potential minefield 

The U.S. & The Global Fund to Fight AIDS, Tuberculosis and Malaria  

Deadly drug-resistant TB a ‘blinking red’ global threat 

TB activists for first time challenge TB drug patent in India

Pre-Grant Opposition Filed Against Janssen’s Bedaquiline Fumarate Application In India  

Malaysia’s compulsory license for sofosbuvir is a positive step for public health and innovation 

Malaysia Still Under Pressure To Make Hepatitis C Medicine More Expensive 

Unitaid launches new grants for innovative vector control, adding to its robust malaria portfolio 

Unitaid seeks innovative, long-lasting technologies to help tackle diseases  

Nearly 100 children dead as world’s 2nd-largest Ebola outbreak surpasses 800 cases 

DRC Ebola: latest numbers as of 11 February 2019 

Gavi Going Forward: Immunization for Every Child Everywhere? 

Strategies to increase adoption of animal vaccines by smallholder farmers with focus on neglected diseases and marginalized populations 

Wellcome commits £10 million to DNDi to develop new generation of oral drugs to treat leishmaniasis 

MMV and DNDi make 400 compounds available to stimulate research into new drugs for pandemic diseases 

‘No More Paying For The Rich World’s Medicine’ – White House 

New High-Tech System Against Falsified Medicines Goes Live In Europe 

A Foundation Looks to Curb Opioid Deaths by Improving Addiction Treatment 

Are Sustainable Development Goals Reaching Indigenous Peoples? 

UNPO Hmong Newsletter #9, February 2019 

Malnutrition: a pervasive problem, but one that can be fixed 

Drought and rising costs to leave 2.4 million Zimbabweans needing food aid 

EU renewables on the up, but 2020 target looms large 

Health Breaking News 320

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 320

 

Further funding to support Research Leaders in sub-Saharan Africa: MRC/DFID African Research Leader scheme 2019 

Achieving health gains on the way to universal health coverage in Africa 

TRIPS Debated As WHO Board Reaches Agreement On Universal Health Coverage 

Business-Friendly & Rights-based Approaches to Achieve SDGs 

Thursday 14 February 2019 – Friday 15 February 2019 Challenges and Needs of SDGs’ Implementation in Europe. Organised by the Global Health Centre and ISGlobal Barcelona, Spain 

WHO’s Transformative Agenda: A few reflections from the 144th WHO Executive Board Meeting 

EPHA: The Top 5 Issues in Medicines Policy for 2019 

Current R&D Causes High Prices In Drugs; New Model Needed To Make Drugs More Affordable, Speakers Say 

Switzerland Receives Request For Compulsory Licence On Breast Cancer Drug 

WTO TRIPS Council: South Africa considers strict patentability criteria to address abuses in the pharmaceutical industry 

Trump Highlights IP, Trade, Drug Prices In Speech To Congress 

Trump Administration Releases Long-Awaited Drug Rebate Proposal 

Health Care Spending In The US And Taiwan: A Response To It’s The Prices, And A Tribute To Uwe Reinhardt 

New EPHA study reveals more needs to be done on AMR National Action Plans in Europe 

European Medicines Agency challenged to support better clinical trial reporting 

As Ebola outbreak marks 6 months, health centers a concern 

DRC Ebola: Latest numbers as of 6 February 2019 

Why can’t pregnant women be vaccinated during epidemics? 

Will a sugar tax solve Southeast Asia’s growing diabetes problem? 

Galvanizing the Action to Protect and Promote the Rights of Mentally-Disabled Individuals in the Key Populations: a Pathway to Achieve Health for All by Denis Bukenya and Michael Ssemakula 

Overcoming the colonial development model of resource extraction for sustainable development in Africa 

Rosia Montana and corporate courts 

China’s changing approach to Africa 

Human Rights Reader 472 

Oxford University Press: The Health of Refugees Public Health Perspectives from Crisis to Settlement. Second Edition edited by Pascale Allotey and Daniel Reidpath 

Confronting the Challenges of Migration in West & Central Africa 

House by house, telling girls and families the dangers of female circumcision in Kenya 

The United States Maternal Mortality Rate Will Continue To Increase Without Access To Data 

No silver bullet for arsenic in groundwater 

Look to the sky – the top 5 priorities on European air quality and health in 2019 

Why a Major Climate Funder is Backing Movement Building and Shifting Away from the U.S. 

‘Action Alliance “Training 2020” – An Alliance for Independent Continuing Medical Education’ by Christiane Fischer 

Action Alliance “Training 2020” for Independent Continuous Medical Education

MEZIS (Mein Essen zahl ich selbst – I pay for my own lunch) has long been calling for Continuous Medical Education (CME) programs to be free of conflict of interest. On this long journey MEZIS has been able to reach an important milestone: The Alliance for Action 2020 - Alliance for Independent Continuing Medical Education

Christiane Fischer

By Christiane Fischer MD, MPH, PhD*

 Founder and Medical Managing Director at MEZIS

Action Alliance “Training 2020”

An Alliance for Independent Continuing Medical Education

 

In 2018, MEZIS (Mein Essen zahl ich selbst – I pay for my own lunch) successfully launched another tool to achieve the goal of continuing medical education without any sponsoring by the pharmaceutical industry: The Alliance for Action 2020 – Alliance for Independent Continuing Medical Education. It complements MEZIS strategy to achieve change through committees and media.

What is the background?

Organizers of Continuous Medical Education (CME) Programs such as hospital departments and professional associations often welcome support of human and financial resources from the pharmaceutical industry. An implementation of CME-Programs without sponsorship seems unthinkable for many. However, is that really true?

At the same time, more and more CME-Programs are being organized  independently and without any sponsoring by the pharmaceutical industry. Even conferences of large associations such as  the German Society of General and Family Medicine are successfully carried out without pharmaceutical support- and teach the eternal skeptics of the better. This shows there are already some good alternatives. However, they are not well-known and overarching concepts and structures for independent training are still missing.
Independent organizers also have to compete in a market place highly distorted by exorbitant sponsorship sums from the pharmaceutical industry with organizers such as Omniamed, which used to receive up to 250,000 Euros from the pharmaceutical industry for one day. In August, the Medical Chamber Stuttgart denied Omniamed any CME certification for the first time. Omniamed consequently withdrew from Germany in December 2018, hopefully paving the way for independent organizers of CME events to overtake their sponsored counterparts.

Goal

The goal of the Action Alliance is to provide independent continuing medical training. Continuing medical training must take place independently of the interests of the industry and solely in the responsibility of hospitals, professional societies, professional associations and other organs of the medical self-government. This requires a rethinking by physicians and a change in the medical training culture.

Commitment

The partners joining the Alliance commit to providing sufficiently high quality training without industry participation or financial support. In addition, in agreement with the founding members, there are criteria for content quality that are based on existing ones.

Who is already there?

We are already pleased to have the Drug Commission of the German Medical Association (AkdÄ), the German Society for General Medicine (DEGAM), the neurologist initiative “NeurologyFirst” as well as the two independent training organizations HD Med and Libermed as founding members.

Our aims until 2020

  • Bundling of existing independent concepts and structures for CME-Programs (AkdÄ, DEGAM, NF, medical chambers, HD Med, Libermed).
  • Development of a guideline for  CME-Programs as well as financing concepts (meaningful and necessary amount of annual training, quality features, requirements, practical organization, calculations).
  • The Allies provide guidance to their members in the organization and delivery of independent medical trainings.
  • Creating structures and sharing structures for organizing independent events.
  • Creating a common internet platform: https://cme-sponsorfrei.de/
  • Establishment of a quality label “Partner in the Action Alliance for Further Education 2020”.

———————————————–

Dr. Christiane Fischer was born in 1967 in Emden and grew up in the black forrest in Germany. She studied medicine in Homburg/Saar and Heidelberg and is from her postgraduation Master of Public Health (MPH). From 1999 untill 2013 she worked as the executive director of the BUKO Pharma-Kampagne focussing the impact of patents on access to drugs in poor countries. In 2007 she founded MEZIS and was part of the board until  2013. Since then she works as the Medical Director.  Since 2012 she is member of German Ethics Council.

*On the same topic on PEAH:

Interview to Christiane Fischer: MEZIS (Mein Essen zahl ich selbst – I pay for my own lunch) 

 

To Protect and Promote the Rights of Mentally-Disabled in Uganda

...Obsolete mental health legislation in Uganda has a number of deficiencies such as failure to differentiate voluntary and involuntary care, inadequate protection and promotion of the human rights of people with mental illness and the presence of slurring and stigmatizing language; and henceforth not in line with the draft mental health policy as well as current trends in mental health care...

 

By Denis Bukenya

and Michael Ssemakula

Health Rights Researchers & Advocates

Human Rights Research Documentation Center (HURIC), and PHM-Network, Uganda

Galvanizing the Action to Protect and Promote the Rights of Mentally-Disabled Individuals in the Key Populations: a Pathway to Achieve Health for All

 

Although there are efforts to improve mental health in Uganda, there remains a heavyweight number of deficiencies especially in terms of stigma and misconceptions about the predicament. There is limited appreciation of the mental health illnesses predominantly in low resource settings. Many societies in Uganda tend to demonize mental health illnesses which has resulted into human rights violations such as incarceration of persons with the mental disequilibrium. This is at the expense of the much needed psyche-socio support. Instead people with mental illnesses are subjected to unfair discrimination, detestable beatings, and poor treatment out of ignorance. This eventually results into denial of access to institutional mental health services (such as psychiatric services and  psychotherapy treatment like psychotic drugs) hence the prevalence of the traditional and spiritual divine healers, a mechanism that has been renowned for lack of a regulation thus exploitation of the victims. This increases the urgency for an inclusive prevention and rehabilitation multi-stakeholder levels of assistance through community inclusiveness in addressing the current burden of mental health disorders and the functioning of mental health programs and services in Uganda.

According to research by (Lumbuye-Guba, 2003), over 45 per cent of the youths have used drugs or alcohol. Sadly the indigenous demand for hard drugs has also unrelentingly continued to increase, with an approximation of 5-10 per cent of the populace being reliant on and consistent users; 18 per cent of men and 2 per cent of women both smoke and drink. Other drugs of abuse include cannabis, which grows extensively in the green equatorial climate of Uganda and abuse is common especially among young urban elites and juveniles. The national mental hospital shows that 30 per cent of hospital admissions are associated with drug abuse. Inhalants such as paint thinner, and glue are also common among street and slum youth. Eating of marungi (Khat) is also spreading hastily. Heroin use cases have also been reported in the country.  Services are dispersed and staff ability to address this is largely deficient.

A report by (Basangwa, 2004) assessed that 35 per cent of Ugandans suffer from some form of mental disequilibrium, of which 15 per cent need treatment. Although data proximities on mental illnesses in Uganda are very scanty, anecdotal research study evidence shows an upsurge in the occurrence of mental disorders. According to (UBOS, 2006), an envisaged 7 per cent of the households in the country had disabled members, of which 58 per cent had at the very least one individual with a mental disorder. This indicates that about 4 per cent of the households had at least a member with a mental disorder. Juveniles on the streets think drugs improve their socio-psyche lives and a major risk for street youths in Uganda today is a combination of drugs, HIV/AIDS and reckless sexual behavior.

Alliance forming in efforts to assist people affected is lacking. Worsened by gaps in the policy on the mental health such as offensive derogatory terms, which call victims, “persons suffering from mental derangement”, and existence of forced medical intervention without consent, the mental health legislation is therefore outmoded. The mental health system operates on an outdated mental health Law that was last revamped in the 1964. The legislation focuses on detention care of mentally-ill persons and is not in accordance with contemporary international human rights standards regarding mental health care. This obsolete legislation has a number of deficiencies such as failure to differentiate voluntary and involuntary care, inadequate protection and promotion of the human rights of people with mental illness and the presence of slurring and stigmatizing language; and henceforth not in line with the draft mental health policy as well as current trends in mental health care.

Services are still significantly underfunded (with only 1 per cent of the health expenditure going to mental health), and skewed towards urban areas, and mental disorders are not covered in any social insurance schemes we have in Uganda at the moment. Although mental health is one of the key components in the Health Sector Development Plan 2015/2016-2019/2020, we have no comprehensive mental health plan, and there is no information to draw a clear strategy for mental health treatment and prevention. Therefore, there is need for increased stakeholder engagement, through community involvement and participation, if national and global targets for mental health are to be attained. The mental health collaborative interventions are not moving as fast as would be expected. There is low utilization of mental health services. Health workers infrequently discuss the relationship between drug abuse and mental illnesses with populations and patients there in. Health care providers largely display negative attitudes towards mental health patients. At this prevalence rate, the gains made in prevention and control of mental illnesses could easily be reversed; yet the conditions are preventable through provision of appropriate information and ensuring the effective interventions are in place. Communication interventions through Participatory Reflection and Action methods are important means to engage policy enabling powers, government officials, public and private health professionals, traditional and religious leaders, community leaders, patients and their families in bringing about political, behavioral and societal change in reverence to mental health.

Mental-disability implications in Uganda mainly affect the youths, women, and sex workers. The majority of the young people and juveniles get affected through excessive drug use as a result of a gap in parental control and lack of guidance. Many of them end up in juveniles’ remand centres and prisons where they learn adverse behaviors and turn into intransigent criminals; therefore, we need to offer communities and parents with guidance to prevent and reduce drug use by their children and also emphasize the importance of use of clear, positive communication between parents and children. All young people deserve the best start in life. But too often, young people with mental health disorders are unable to fulfil their potential. Mental-illness unsympathetically costs individuals and society especially on the human development index.  People with mental health problems have too often in the past experienced unfair discrimination and poor treatment. In recent years however, we have seen a mild shift in attitudes towards mental health, but the stigma and misconceptions surrounding mental-illnesses still hold strong in many vulnerable settings which is an entombment towards achieving Universal Health Coverage in Uganda.

In order to address challenges facing vulnerable populations with mental disorders, emphasis should be on modifying the approaches towards appreciating the prevalence of mental disability, creating awareness, and treatment through regionalization of mental health service provision system at district level. This is an imperative mechanism that will ease access to psychosomatic health to enhance the attainment of the global goal of health for all and Sustainable Development Goal #3.5 of strengthening the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of the alcohol. Such methodologies should be purely community based through decentralization of the mental health services as a significant approach to address mental health challenges. This enables victims to continue receiving social support from their families and communities which reduces the stigma.

Owing from the above is the necessity of the egalitarian system of health service provision which needs to incorporate ways to ease accessibility of mental health services. In the Ugandan perspective is the proposition of the National Health Insurance Scheme (NHIS) to minimize the adverse implications of the catastrophic health expenditures on household welfare. However, mental health is not explicitly included in the NHIS. The challenge lies in the fact there is not known NHIS policy in Uganda today. There is light at the end of the tunnel with the NHIS Bill at the floor of parliament awaiting approval, and it is hoped that this will provide the legal framework though, as usual, the process has stagnated for a long period close to a decade.

As activists working with the People’s Health Movement in the Ugandan chapter it is incumbent upon us to acknowledge the Astana Declaration in regard to Mental Health owing to the fact that there needs to be the inclusion of Primary Health Care in Mental Health concerns in Uganda in a bid to ease access to proper mental health care. The declaration is the current guide to the attainment of strengthened UHC by mean of preventive, palliative, rehabilitative and curative care. Delivery of care to mental health in this perspective targets individuals, family, community and finally the national health system. This form of care is easily accessible since it is near people.

 

References

Lumbuye-Guba, C. (2003). Challenges of Intervening in Drug Abuse in Uganda. Kampala: National Institute on drug abuse.

Basangwa, D. (2004). Understanding Mental Health Relapse. Kampala: digitalcollections.sit.edu.

UBOS. (2006). Uganda Demographic Health Survey Preliminary report. Kampala: www.ubos.org.

 

Health Breaking News 319

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 319

 

Taking stock of global development: What’s working and what’s stuck 

Davos 2019: four reasons for optimism despite the gloom 

European Parliament Calls for Regular Evaluation of SPC System, Including its Effect on Access to Medicines in Europe by Dimitri Eynikel 

Pharma industry raises the alarm about stockpiling of generic drugs 

More than 1,600 clinical trials run by UK universities violate reporting rules 

The Lancet: On results reporting and evidentiary standards: spotlight on the Global Fund 

144th WHO EB: Follow-up to the high-level meetings of the United Nations General Assembly on health-related issues: Ending tuberculosis 

144th WHO EB: Medicines, vaccines and health products: Cancer medicines 

EB144: KEI statement on the WHO Cancer report  

MPP Statement at 144th session of the WHO Executive Board on Access to Medicines 

WHO Draft Resolution On Universal Health Coverage Shows Efforts At Consensus 

WHO Opens Discussions On Roadmap For Improving Access To Medicines 

EB144: KEI statement on the WHO roadmap access to medicines, vaccines and health products 

WHO Executive Board, 144th Session, January 2019 MSF Statement: Agenda item 5.7.1 (EB144/17) – Medicines, vaccines and health products: Access to medicines and vaccines  

WHO’s Access Roadmap And The Art Of Accommodation Of Pharma Interest 

Will Ever WHO’s Roadmap for Medicines Move into Action? by Daniele Dionisio 

Drugs for Neglected Diseases initiative and The BMJ launch a special collection on neglected diseases and innovation in South Asia 

DNDi, MMV Make 400 Compounds Available To Boost Pandemic Disease Research 

To Halt Malaria Transmission, More Research Focused on Human Behavior Needed 

The Medicines Patent Pool welcomes findings of crucial Lancet Commission into accelerating elimination of viral hepatitis 

Cabo Verde leads the way in ending new HIV infections in children in West and Central Africa 

DRC Ebola: Latest numbers as of 27 January 2019  

Women are key in Ebola response 

DRC Ebola crisis serves as test for WHO health reform 

Health for All Kenyans by 2022: Are we going to be trailblazers like our long distance runners?  

Will 2019 Be the Year of Making Primary Health Care Happen? 

ANKE VAN DAM: “AFEW WILL CONTINUE TO BE THE BRIDGE BUILDER” 

Indonesia and global health diplomacy: a focus on capacity building 

Environmental laws only look good on paper, UN says 

Billions of Dollars Available for Reducing and Reversing Land Degradation 

German coal phase-out criticised but welcomed on whole 

Youth Bridge the Gap Between Climate Change and Climate Awareness in Guyana 

 

EU Parliament Calls for Regular Evaluation of SPC System

This post refers to just adopted amendments to a waiver proposed by the European Commission to allow pharmaceutical companies in Europe to produce generic versions of medicines that are under SPC exclusivity in Europe, for export to countries where the medicine is no longer under patent protection or where no SPC applies

By Dimitri Eynikel*

EU Policy and Advocacy Advisor for the MSF Access Campaign

European Parliament Calls for Regular Evaluation of SPC System, Including its Effect on Access to Medicines in Europe

 

Yesterday (23 January 2019), the European Parliament’s Committee on Legal Affairs (JURI) adopted important amendments to a proposal for the introduction of a manufacturing waiver for Supplementary Protection Certificates (SPC’s).  Particularly, amendments introducing stockpiling and regular evaluations of the overall impact of the SPC system, including on access to medicines, stand out. SPCs are intellectual property rights that extend patent protection up to five years for certain products, including medicines, beyond the original twenty-year patent term. The waiver as proposed by the European Commission would allow pharmaceutical companies in Europe to produce generic versions of medicines that are under SPC exclusivity in Europe, for export to countries where the medicine is no longer under patent protection or where no SPC applies.

The adopted proposal for a waiver shouldn’t obscure the fact that SPCs limit people’s access to treatment by enabling pharmaceutical companies to extend their patent monopolies and delay or block the production of generic and biosimilar medicines. In several European countries, for example, an SPC on Truvada hampers people at risk of contracting HIV from getting access to preventive medication (PrEP), as you can read in my earlier blog post. Many civil society groups have called for the SPC system to be abolished and for the European Commission to refrain from promoting the use of SPCs beyond the EU. Despite these concerns, the European Union continues to actively promote the adoption of patent term extensions as SPCs outside Europe, including in developing countries, through trade agreements.

Regular, transparent evaluations of the SPC system may eventually lend more weight to important concerns that have been raised about the public health impact of SPCs – and can inform and improve the European Union’s policies on the granting of intellectual property rights for medicines.

In the discussions leading up to yesterday’s vote, Members of the European Parliament (MEPs) across a range of committees helped to amplify the health needs of people and to raise awareness about the harm that intellectual property rights can inflict when they are granted without an assessment of public health impacts.  All too often, the EU’s intellectual property policies have been dominated by economic and industrial perspectives, while not sufficiently taking into account the effects on public health. It’s important to note that also the SPC manufacturing waiver proposal primarily seeks to rebalance the competing commercial interests of originator and generic pharmaceutical industries in Europe, and as such does not aim to address the challenges of access to affordable medicines in Europe or elsewhere.

Yet, the amendments to SPC manufacturing waiver proposal clearly show the need and willingness by the European Parliament for greater scrutiny and involvement in evaluating the impact of intellectual property rights on access to medicines. The debates surrounding the SPC manufacturing waiver have brought access to medicines issues to the forefront in the European Parliament, and could catalyse more significant improvements in the EU’s intellectual property policies for the benefit of patients in the EU and elsewhere.

 

 Republished from

https://dimitrismusings.wordpress.com/2019/01/24/european-parliament-calls-for-regular-evaluation-of-spc-system-including-its-effect-on-access-to-medicines-in-europe/

Views presented here by the author are his personal opinions

————————————————-

On the same topic recently on PEAH:

The Contradictory Case of EU SPC Mechanism and Waiver by Daniele Dionisio

 

Health Breaking News 318

Health Breaking News Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Health Breaking News 318

 

The Brief – Why Davos? 

Reframing planetary health & towards a planetary health diet 

Global agendas set to fail unless something changes: Helen Clark 

Partner for Progress: Advancing private sector approach to achieve the SDGs 

STOP TTIP Newsletter 

WHO Executive Board, 144th session 24 January- 1 February 2019 

WHO Executive Board, 144th session: Main Documents 

Global rules should follow outcry over China’s gene-edited babies 

NICE: Opaque patient groups and industry fees raise concerns over conflicts of interest 

Economic transformation in Africa: key trends in 2019 

The Rhetoric In Achieving The Universal Health Coverage Under Public-Private Partnerships In Uganda by Denis Bukenya and Michael Ssemakula

Scientists Make Progress on Ebola Virus Treatment 

DRC Ebola: Latest numbers as of 20 January 2019 

Nigeria Activates Emergency Response Over Lassa Outbreak 

G- FINDER 2018 Report: Neglected Disease Research and Development: Reaching new heights 

Association between severe drought and HIV prevention and care behaviors in Lesotho: A population-based survey 2016–2017 

Progress in the HIV epidemic: Identifying goals and measuring success 

Ghana: Accelerating neglected tropical disease control in a setting of economic development 

Chikungunya as a paradigm for emerging viral diseases: Evaluating disease impact and hurdles to vaccine development 

HAI: Estimates for People Requring Insulin – Type 2 Diabetes

WHO Cancer Report Stirs Debate On Eve Of Board Meeting 

WHO Cancer Report – Key findings

Discussion heats up over stockpiling of generic drugs under patent protection 

WHO: 10 things to know about the health of refugees and migrants 

Human Rights Reader 471 

Gap between rich and poor growing, fueling global anger: Oxfam 

Bots on the ground: How tech can help us beat hunger 

Oxfam’s water and sanitation work in Chad: why your support is vital

Meeting Individual Social Needs Falls Short Of Addressing Social Determinants Of Health  

Supporting UHC And Better Explaining IP – The 2019 Pharma Industry Agenda 

Indigenous people to have say in UN climate policy 

The Rhetoric In Achieving UHC Under PPPs In Uganda

UHC has remained in a shackled unachievable dream in Uganda due to the wave of liberalization and improper incorporation of the PPPs during the early 1990s into the health system with unclear regulations, objectives and conflicting interests. 
The woe with the PPPs in Uganda is that the lack of proper laws that can regulate their work framework adds to the absence of a well streamlined policy in place that directs how these partnerships should be designed and controlled …at a time when… most of the decisions undertaken by the government consider less the public engagement concerns and rely more on the interests and choices of the private sector

 

By Denis Bukenya

and Michael Ssemakula

Health Rights Researchers & Advocates

Human Rights Research Documentation Center (HURIC), and PHM-Network, Uganda

The Rhetoric In Achieving The Universal Health Coverage Under Public-Private Partnerships In Uganda

 

Public Private Partnerships (PPPs) are broadly applied in several purposes with diverse approaches in them. However, there are so many split-ups among the academics, governments and health economists about the uses of PPPs in health governance and financing, and demarcating their extent of synergy in health. Some scholars focus on PPPs as an inter-organizational planning and arrangement between institutional bodies in which PPPs are applied as management and governance instruments to enhance development strategies.

Therefore PPP is a model of governance and management used by governments in building strong-novel approaches towards delivering goods and services to the citizenry through financial planning and arrangements between the public and private players. PPPs can also be defined as a lens of organizational relationships supported by cooperation of some sort of durability between the public and private individuals/institutions in which they conjointly develop and improve products and services, share risks, costs, and resources that are related to these products and services (Van Ham & Koppenjan, 2001).

The contemporary forces of leadership have replaced the social progressive provision of state based health services with the mixed market-based health service provision. This has been propelled by the dormancy of the private forces determining the fundamental economic questions of what, when, how, where, and who to provide the health services in the trajectory of profit whims in Uganda. This is a private health system mechanism that comprises private healthcare packages cognizant of the logic of benefits and costs, and this has been mainly adopted by the private players under public private partnerships.

Universal Health Coverage (UHC) is influenced by several social, economic and physical determinants of health which, when combined together, affect the health of individuals and societies. Whether people are healthy or not is determined by their circumstances and environment factors surrounding them. To a greater degree, factors such as where people live, the look of their environment, heredities, their income level and education status level, and their relations with family and friends have a substantial influence on their health. But the most outstanding influence of these factors is based on accessibility of health, which is directed by the health leadership and governance that apportions the powers of health service delivery to certain individuals or companies especially in the high expensive investment functions of  the health sector such as insurance.

UHC has remained in a shackled unachievable dream in Uganda due to the wave of liberalization and improper incorporation of the PPPs during the early 1990s into the health system with unclear regulations, objectives and conflicting interests which has been reflected through choosing inappropriate nature of unclear priorities, schemes and projects with solicitation of inappropriate PPPs in them, selecting wrong partners to work with, and making erroneous assumptions and forecasts about the future (Faria, 2018).

The woe with the PPPs in Uganda is that the lack of proper laws that can regulate their work framework adds to the absence of a well streamlined policy in place that directs how these partnerships should be designed and controlled. Unlike Uganda, countries such as Cuba have used PPPs to strengthen their Gross National Product through exporting labor especially Human Resources for Health who in turn remit the money back to the government in form of taxes to strengthen their health sector and build their economy in its entireness.

UHC-centered political commitment for healthcare is a very influential initiative in transforming healthcare systems especially in directing the PPPs synergies and their extent in certain functions of the health sector (OLUGA, 2018).

Due to the wide vacuum in the domestic health financing of Uganda, certain health services have been left for the private sector or a synergy with the public sector, so disregarding the lingering questions:

-Who should be held to account for the health infrastructural and healthcare financing in Uganda?

-With the diverging approaches between public and private sector missions, how should Uganda successfully meet the global healthcare financing commitments and the SDG #3 of ensuring healthy lives and promote wellbeing for all at all ages (WHO, 2015)?

In the modest stands, PPPs should be taken for what they really are or be reframed. They generally lack the fundamental public element and are more frequently profit-oriented, large-scale business ventures between the private sector and government of Uganda. For instance, the national health insurance scheme (NHI) in Uganda has delayed to be brought into effect due to the fact that the insurance service sector is dominated by the private players for whom NHI could be a threat to their business. This is worsened by the ownership of the biggest shares in the private insurance companies by the political state managers who direct the health governance of Uganda. They have applauded the fairly charged NHI service to be provided by the government but with two differing perceptions.

In the high income developed countries in the global-north such as European countries like United Kingdom which have experimented PPPs for quite a long while, PPPs are termed as PFIs (Private Financing Initiatives), as the term PPPs was found unsuitable due to the lack of shared goals between public and private sector towards improving accessibility, acquirebility and availability of quality healthcare to achieve UHC global goal.

In Uganda PPPs have become a driveway for politicians to propel fast their promises to their electorates in the constituencies they were voted without appropriate financial planning and, more terrifying, with exclusion of the active citizenship participation and questioning on the practicability, sustainability and the long-term financial costs on the taxpayers in paying for the private provided services. This is more eminent in the budget process of Uganda, where the views and priorities of the key force drivers of the economy such as the private players are prioritized first and overshadow the key public health issues of the majority population: most of the decisions undertaken by the government consider less the public engagement concerns and rely more on the interests and choices of the private sector (Zawedde, 2015).

The drive path for the PPPs has been sturdily built by the G20, the UN and the World Bank as a means for consistent financing of the Sustainable Development Goals. But, are these partnerships as effective and health focused as they were envisioned?

The approach through which they were presented and the neocolonialism economic intentions from the global north advanced economies inevitably show it was a tactic to stimulate global trade and diffuse the developing low- and middle- income countries into western multinationals’ and conglomerates’ expanding models.  The research discoveries on emerging and developing markets portray PPPs as conduits for commodifying basic public services and shift the incidence of taxes to private companies, which has made PPPs a strong breeding ground for corruption especially in awarding contracts to companies that are aligned to the prominent political figures.

The inadequacies of the PPPs are quite often revealed late when the impact misses the mark to be identified or when the not documented adverse implications emanate to bare.

For PPPs to be meaningful, we must embrace a positive political commitment for healthcare as a powerful affirmative major drive in transforming healthcare system outlook in Uganda to achieve UHC. Certainly, high-level policymaking consultations and dialogues around both domestic and external health financing for health care access for all should identify the extent to which public health provision should follow the pattern of PPPs arrangement. This is because UHC entails a comprehensive health sector system transformational approach for which PPPs should be profoundly checked. However, this requires an atmosphere of good transparency, voice and accountability, consensus orientation, responsiveness, a strategic vision for health care provision and good effective governance with shared values and goals centered on refining healthcare results and strengthening the health system. Nowhere in the advanced or developing low-income settings across the globe have PPPs been long-established to be positively effective as a financing mechanism for the social services such as health care provision. This is a big caution to the way Africa is embracing them.

 

References

Van Ham, H., & Koppenjan, J. (2001). Building Public-Private Partnerships: Assessing and managing risks in port development. Public  Management Review, 3 (4), 593-616.

Faria, J. R. (2018). The Triple Win: Rethinking public private partnerships for universal healthcare. London: KPMG.

OLUGA, D. O. (2018). Healthcare: The dark side of public-private partnerships. Nairobi: Nation Media Group.

WHO. (2015). SDG 3: Ensure healthy lives and promote wellbeing for all at all ages. Geneva: WHO.

Zawedde, T. M. (2015). Budget allocation and community participation in Uganda’s health sector. Kampala: CEHURD.