“The worldwide counterfeit drug market is huge and growing,” Tim Mackey and Brian Liang of the Institute of Health Law Studies at the California Western School of Law and Thomas Kubic of the Pharmaceutical Security Institute write in a Foreign Policy opinion piece, noting such “drugs occupy a wide spectrum of medications, and their quality is suspect; they can be mislabeled, tainted, adulterated, ineffective, or, in the worst cases, all of the above.” They argue for a new framework for fighting the illegal drug trade because “[g]lobal policy has not kept up with the burgeoning counterfeit drug trade.” The authors say that although initial results of the WHO IMPACT (International Medical Products Anti-Counterfeit Taskforce) are “encouraging,” they note that “[s]ome WHO member states, including India and Brazil (both top producers of generic drugs) and other developing countries, have questioned whether WHO can rightly take on enforcement operations” because it “is not a global law enforcement agency.”
Quality of Care
“Counterfeit, falsified, and substandard drugs are a dangerous threat to people around the world, including Americans,” therefore “we have a vital interest in ensuring the safety of an ever more complex global drug supply chain,” Jennifer White, a foreign service officer in the Office of International Health and Biodefense in the Bureau of Oceans and International Environmental and Scientific Affairs, writes in a post in the State Department’s “DipNote” blog. She notes that the “Department of State engages in the fight against counterfeit medicines using a multi-faceted approach,” including training foreign drug regulators; funding consumer outreach to raise awareness of the problem; being active in international bodies that address counterfeiting, such as the WHO; and “work[ing] in partnership with other U.S. government agencies, the health care community, patients, civil society, and the pharmaceutical industry to ensure that patients receive safe medicines and that those who put patients’ lives at risk can be prosecuted” (5/22).
More Research Needed Into How Transgender Persons In Asia, Pacific Affected By HIV, Stigma, Report Says
A report released Thursday in Bangkok by the United Nations Development Programme (UNDP) and the Asia Pacific Transgender Network (APTN) says more research needs to be conducted to determine the extent to which transgender persons in Asia and the Pacific are affected by HIV, are socially ostracized, and lack fundamental rights, including access to basic health care, a UNDP press release reports. The report, released to mark the International Day Against Homophobia and Transphobia, is “a comprehensive review of material gathered from across the region over the past 12 years” and “emphasizes that inclusive research, designed and implemented in partnership with the transgender community, is critical to enable governments, community-based organizations and supporting organizations to enhance HIV and sexual health care services specific to the needs of transgender people, and foster action by governments to adopt more socially equitable policies and practices to protect their rights,” according to the press release (5/17).
“Despite pledges from governments across Eastern Europe and Central Asia to fight HIV/AIDS — one of the eight Millennium Development Goals — the region has the world’s fastest-growing HIV epidemic,” Inter Press Service reports in an article examining challenges to stemming the spread of the disease, particularly among injection drug users. “Punitive drug policies, discrimination and problems with access to medicines and important therapy are all driving an epidemic which is unlikely to be contained, world experts say, until governments in countries with the worst problems change key policies and approaches to the disease,” the news service writes. According to experts and activists, a lack of opiate-substitution therapy (OST) and needle-exchange programs, as well as discrimination against and “active persecution” of drug users who try to access therapy programs, contributes to the spread of HIV, IPS notes (Stracansky, 9/3).
“The non-communicable disease [NCD] community always talks about the importance of prevention; many consider it the Holy Grail in the fight against NCDs. Why was it so hard to also accept treatment as part of the solution?” Princess Dina Mired, director general of the King Hussein Cancer Foundation in Amman, Jordan, asks in the Huffington Post “Impact” blog, noting only one target of the 2011 U.N. High-Level Meeting on NCDs “deals with treatment, the target on ‘essential medicines and basic technologies for treatment.'” She continues, “Treatment and prevention are heavily interrelated. The success of one is directly related to the other.” She adds, “A person in the developing world will not buy in to the importance of prevention if there is no treatment option available should that person get the disease.”
Ugandan Parliamentarians Threaten To Hold Up National Budget Unless More Funding Committed To Health Care
In Uganda, where “there are fewer than two health workers for every 1,000 people — a level the World Health Organization defines as a severe shortage” — the nation’s parliamentary “social services committee, which has initial oversight of the country’s health budget, pushed a resolution through parliament last week threatening to hold up approval of the entire budget unless funding to recruit and retain new health workers is increased,” VOA News reports. “Committee members, with support from the Women’s Parliamentary Association, called for a specific increase of at least $103 million to the sector,” the news service notes. “In addition to the funding increase, the parliamentarians are calling for an end to a wage freeze for current employees and a ban on recruiting new health workers,” as well as “demanding a supplementary pool of money to improve health care in communities that are particularly short staffed,” according to the news service.
In a 200th anniversary article for the New England Journal of Medicine, Salmaan Keshavjee of the Department of Global Health and Social Medicine at Harvard Medical School and Paul Farmer of Partners in Health “seek to elucidate the reasons for the anemic response to drug-resistant tuberculosis [TB] by examining the recent history of tuberculosis policy,” they write. The authors outline the history of TB drug development and how the disease became resistant to myriad drugs, and write that by the 1970s, “[t]uberculosis, whether caused by drug-susceptible or drug-resistant strains, rarely made even medical headlines, in part because its importance as a cause of death continued to decline in areas in which headlines are written. They continue, “In the United States, federal funding for tuberculosis research was cut; consequently, drug discovery, development of diagnostics, and vaccine research ground almost to a halt.”
“Following criticism over a spate of patient deaths from adverse events during clinical trials, India has begun tightening up rules for clinical research and compensation as well as expanding its pool of medical experts,” SciDev.Net reports. A health ministry official said the ministry would submit to Parliament amendments to existing laws with the aim of strengthening the approval process for clinical trials, according to the news service. In addition, the Central Drugs Standard Control Organisation (CDSCO) is expanding its pool of experts, “has asked ethics committees for tougher inspection regimes,” and in August “issued guidelines on compensation to be paid in case of clinical trials-related death or injury,” the news service notes. According to SciDev.Net, “These steps follow the report of a parliamentary committee, in May 2012, which found that a large number of imported drugs had been cleared without trials,” “includ[ing] drugs that had failed to be cleared for use in the parent countries” (Sreelata, 9/12).
“As many as 200 million children across the world fail to reach their full potential because their early brain development is held back by poverty, disease and malnutrition, global health experts said on Thursday,” Reuters reports (Kelland, 9/13). The Canadian government-funded Grand Challenges Canada on Thursday “announced $11.8 million CAD [$12 million] in funding over two years for 11 bold ideas from innovators in the developing world, to address health conditions causing diminished cognitive potential and stunting,” according to a Grand Challenges Canada press release (9/13). The projects, which will be implemented in developing countries such as Thailand, Pakistan, Bangladesh, and Colombia, “include plans to encourage so-called ‘kangaroo mother care,’ where low-weight newborns are held skin to skin rather than put into incubators, and ways of combating maternal depression to boost interaction between mothers and babies,” Reuters notes (9/13).
Approximately one-third of children under the age of five in southern Afghanistan, about one million, have acute malnutrition, “with a level of deprivation similar to that found in famine zones, a government survey has found, despite the hundreds of millions of dollars in foreign aid that has been poured into the region,” the Guardian reports. The U.N.-supported “Afghanistan Multiple Indicator Cluster Survey (MICS) found 29.5 percent of children are suffering from acute malnutrition there,” the newspaper states, noting that a level of more than 30 percent is one indicator of famine, as are death rates and families’ access to food.