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Pharma Companies Improving Access To Medicines But Lack Oversight Of Outsourced Clinical Trials, Analysis Says

Pharmaceutical companies are showing “greater accountability in the boardroom today over access to medicines, with more openness, targets and investment in drugs relevant to the poor,” but they “show no evidence that they adequately supervise the conduct of outsourced clinical drug trials, according to a new analysis released on Wednesday,” the Financial Times reports (Jack, 11/28). Published every two years, the Access to Medicine Index “ranks the world’s 20 biggest drug companies,” BBC News notes, adding, “GlaxoSmithKline remains at the top of the index, followed closely by Johnson & Johnson and Sanofi.”

Blog Posts Discuss World Prematurity Day

November 17 marked the second annual World Prematurity Day, sponsored by the Partnership for Maternal, Newborn & Child Health (PMNCH). The Bill & Melinda Gates Foundation’s “Impatient Optimists” blog published two posts discussing premature birth.

Wall Street Journal Examines Program In Pakistan Looking To Provide Health Insurance For Poor Urban Residents

The Wall Street Journal examines how “some local social entrepreneurs are coming up with new ideas to provide the poor with access to better medical services” in Pakistan, where the health care system is “split between low-cost government-funded hospitals offering basic services and expensive private-sector medical institutions … [b]ut the majority of the country’s 190 million people have little access to health care.” The newspaper describes how one program, called Naya Jeevan — “a non-profit micro-insurance program for the urban poor” that “offers an insurance program at subsidized rates under a national group health-insurance model” — operates to help ensure affordable medical care for the poor and how it has come “under scrutiny from the country’s insurance regulator” (Bahree, 11/6).

Emergency Obstetric Care Reduced Maternal Mortality Rates Up To 74% In Two African Projects, MSF Reports

According to a new briefing paper (.pdf) from Medecins Sans Frontieres (MSF), access to emergency obstetric care, including ambulance service, could help save the lives of up to three quarters of women who might otherwise die in childbirth, AlertNet reports (Batha, 11/19). In two projects, one in Kabezi, Burundi, and the other in Bo, Sierra Leone, MSF showed “that the introduction of an ambulance referral system together with the provision of emergency obstetric services can significantly reduce the risk of women dying from pregnancy related complications,” according to an MSF press release. The services, which cost between $2 and $4 per person annually, are offered 24 hours a day, seven days a week, and are free of charge, the press release notes (11/19). The projects “cut maternal mortality rates by an estimated 74 percent in Kabezi and 61 percent in Bo,” Reuters writes, adding, “The charity hopes its model could serve as an example for donors, governments and other aid agencies considering investing in emergency obstetric care in countries with high maternal mortality rates” (11/19).

Growing Concern In Asia Over Resistance To Artemisinin-Based Antimalarial Medicines

“Growing resistance to a key anti-malarial drug derived from a shrub used in traditional Chinese medicine is threatening to roll back gains made in combating the disease,” according to experts attending a U.N.-sponsored malaria conference that concluded on Friday in Sydney, Australia, the U.N. News Centre reports. Malaria “therapies based on artemisinin — an extract from the sweet wormwood bush used for centuries in Chinese medicine as a fever cure — were” formulated in combination with other antimalarials to form artemisinin-based combination therapies (ACTs) that the WHO thought would be effective for years, but resistance to the ACTs has begun to appear in some areas, the news service notes. “Specifically, [the Roll Back Malaria Partnership] noted, artemisinin resistance has been detected in Cambodia, Myanmar, Thailand and Vietnam,” the news service writes (11/2). Agence France-Presse examines efforts to fight drug-resistant malaria on the Thai-Myanmar border (Rook, 11/4).

Wall Street Journal Reports On Challenges Of Fighting Multi-Drug Resistant TB In India

“More than one-quarter of people diagnosed with tuberculosis [TB] at a clinic in India’s largest city of 18 million have a strain that doesn’t respond to the main treatment against the disease, according to preliminary data from a new diagnostic being tested,” the Wall Street Journal reports. The newspaper obtained “preliminary and not peer reviewed” data from TB clinics in Mumbai, and Puneet Dewan with the Bill & Melinda Gates Foundation TB program in India “said the WHO and Indian authorities are taking the data seriously because it appears to confirm other studies in recent years of similarly high rates of multi-drug-resistance, in which patients don’t respond to the two most powerful TB medicines.” According to the newspaper, “The WHO and India currently estimate India has about 100,000 of the 650,000 people in the world with multi-drug-resistance” (Anand/McKay, 11/23).

Health Technology Assessment Can Assist In Determining Effective Funding Allocation

In the Center for Global Development’s (CGD) “Global Health Policy” blog, Amanda Glassman, director of global health policy at CGD, and Denizhan Duran, a CGD research assistant in global health, examine a new report (.pdf) by the IMS Institute, which focuses on how countries can advance the responsible use of medicines. “Today, one-fifth of total health spending goes to medicines,” they write, adding, “Figuring out how to realize efficiencies in medicines spending is therefore crucial for every country, and for the international funders that support them.” They discuss the conclusions and limitations of the report, which supports the findings “of our recent work on priority-setting in health.” In effect, they say improved health technology assessment (HTA) agencies “could weigh cost-effectiveness, affordability and other factors in order to decide which medical interventions should receive higher priority in the allocation of scarce public and donor money” (11/14).

Pilot Program In India Using Traditional Practitioners To Fill Health Care Worker Gap

The New York Times’ “India Ink” blog examines how “a growing number of ‘affordable health care’ entrepreneurs are focused on developing new solutions for the rural and remote parts of the country.” According to the blog, “Across India, access to health care remains a pressing problem, exacerbated by the country’s large population and shortage of doctors. Nowhere is this challenge more acute than in rural India, which is experiencing a severe shortage of qualified health care practitioners.” But one pilot program in Tamil Nadu is training and certifying traditional medical doctors “to serve as ‘independent care providers’ in a rural setting,” the blog states, noting the program was developed in conjunction with the University of Pennsylvania School of Nursing (Lavakare, 11/29).

Indonesia Must Work To Empower Women In Order To Improve Maternal Health Standards

Though Indonesia is “widely seen as a development success story — indeed, it is sometimes referred to as one of Asia’s ‘rising powers’ … in the area of maternal health, the successes have been modest and much remains to be done,” Andrew Rosser, associate director of the Indo-Pacific Governance Research Centre at the University of Adelaide, writes in an Inside Indonesia opinion piece. “Indonesia is on track to meet many of these goals,” including those related to poverty, child nutrition and mortality, education, and tuberculosis and malaria, “[b]ut it is well off track when it comes to goals related to maternal health,” he states. The country also is “failing to meet its targets on the use of modern methods of contraception and reducing the ‘unmet need’ for family planning — that is, the proportion of couples who want to limit the number of children they have but do not have access to contraception,” Rosser notes.

ARV Drug Resistance Levels Steady In Low-, Middle-Income Countries, WHO Report Says

More widespread use of antiretroviral drugs (ARVs) to treat HIV infection has led to drug resistance in low- and middle-income countries, but the level “is not steep enough to cause alarm, said a survey released by the World Health Organization on Wednesday,” Agence France-Presse reports. “In low- and middle-income countries, drug resistance stood at 6.8 percent in 2010, the WHO said in its first-ever report on the matter,” the news agency writes, adding, “High-income countries, many of which began widescale treatment for HIV years earlier and used single or dual therapies that can also encourage resistance, face higher rates of resistance, from eight to 14 percent, said the study” (Sheridan, 7/18).