Improving distribution of pharmaceuticals in developing countries: A case study of The Gambia project

Without sufficient sanitation, nutrition and primary health care infrastructures, developing nations must depend on pharmaceuticals as the principal defense against debilitating diseases such as malaria, schistosomiasis, river blindness, tetanus, and leprosy. Yet the distribution of pharmaceuticals within many developing countries is severely inadequate to meet the health care needs of large sectors of the population, particularly those persons living in rural areas. The result is that with 80% of the world's population, and an even greater share of the world's serious illnesses and disease, the Third World consumes only 20% of the global supply of pharmaceuticals. One of the major obstacles confronting individuals in developing countries that need pharmaceuticals is access — the drug delivery infrastructure is often inadequate. Problems exist in the entire range of drug management: Ordering, receipt, storage, distribution, and resupply. To help combat the problems, a unique collaboration began in 1981 at the initiation of several members of the Pharmaceutical Manufacturers Association (PMA), and Africare, a private voluntary organization, to improve the drug distribution and management system in The Gambia in Africa. The purpose of this article is to demonstrate the feasibility of transferring The Gambian model of cooperation between governments in developing countries, private voluntary organizations, and the international pharmaceutical industry to other Third World nations given different cultural, political and economic parameters. Last year, after observing how effectively The Gambia project had improved record keeping and management, the government of Sierra Leone invited Africare to help set up similar improvements in its drug distribution and inventory program. Although the multinational pharmaceutical corporations are often criticized by Third World governments for overpricing and dumping drugs, and excessive marketing schemes, The Gambia project demonstrates how the industry can work with health ministries to alleviate the problem of an inadequate supply and storage of pharmaceuticals particularly to poor, rural areas in Less Developed Countries.     

The Doha Round's Public Health Legacy: Strategies for the Production and Diffusion of Patented Medicines under the Amended TRIPS Provisions

The entry into force of the World Trade Organization (WTO) TRIPSAgreement in 1995 transformed the international intellectualproperty system. The harmonization of basic intellectual propertystandards has operated to protect investment in innovation,limiting risks from unjustified ‘free riding’. Yetthese same harmonized IP standards sharply curtailed the traditionalcapacity of suppliers of public goods, such as health care andnutrition, to address priority needs of less affluent membersof society, particularly in (but not limited to) developingcountries. In the Doha Declaration, the Waiver Decision of 30August 2003 and the Article 31bis Protocol of Amendment, stakeholdersconcerned with re-opening policy space for the supply of newerpharmaceutical products pushed back against restrictive elementsof the TRIPS Agreement. Governments around the world are in the process of decidingwhether to ratify and accept the Article 31bis Amendment. Basedon their Study for the International Trade Committee of theEuropean Parliament, the authors argue that acceptance of theAmendment will provide a ‘net benefit’ for countriesseeking to improve access to medicines. At the insistence ofWTO delegations acting on behalf of the originator pharmaceuticalindustry lobby, Article 31bis regrettably is saddled with unnecessaryadministrative hurdles. Nonetheless, through skillful lawyering,political determination and coordinated planning, the systemcan be made to work. Among other options, expeditious back-to-backcompulsory licensing linked with pooled procurement strategiesmay effectively achieve economies of scale in production anddistribution of medicines. The authors doubt that the international political environmentwould support renegotiation of an ‘improved’ solution.They express concern that failure to bring the Amendment intoforce will open the door to a campaign to undermine the WaiverDecision. Recent events in Brazil and Thailand illustrate boththe opportunities and risks associated with implementing TRIPSexception mechanisms, and help to inform views on the negotiatingenvironment. Specific proposals for regional cooperation inimplementing the Amendment are laid out, and the authors emphasizethe importance of pursuing concrete transfer of technology measuresin support of developing country pharmaceutical manufacturing.Over-reliance on private market mechanisms for the supply ofpublic health goods leaves the international community withan unresolved collective action problem on a large scale.     

Different countries, different needs: the role of private health insurance in developing countries

This article discusses the role of private health insurance (PHI) in developing countries. Three broad regional clusters are identified that share similar characteristics and policy challenges for the effective integration of private insurance into national health care systems: (1) Latin America and Eastern Europe, where there are already developed insurance industries facing important market and policy failures; (2) the Middle East/North Africa region and East Asia, where there is a projected strong growth of PHI that needs to be accompanied by efficient regulation; and finally, (3) South Asia and Sub-Saharan Africa, where PHI will only play a marginal role in the foreseeable future while the scaling up of small-scale, nonprofit insurance schemes appears to be of critical importance. Overall, this survey shows that the role of private insurance varies depending on the economic, social, and institutional settings in a country or region. Private health insurance schemes can be valuable tools to complement existing health-financing options only if they are carefully managed and adapted to local needs and preferences.     

Tax treaties with developing countries and the allocation of taxing rights

Worldwide income taxation in the country of residence is a legal dogma of international taxation. We question this dogma from the perspective of relations between developed and developing countries from legal and economic perspectives, and make a modern and fair proposal for tax treaties. We show under which conditions a developing and a developed country will voluntarily sign a tax treaty where the developing country is more inclined to share the information with the developed country and whether they should share revenues. Moreover, we demonstrate how the conclusion of a tax treaty can assist in the implementation of a tax audit system in the developing country.     

E‐government and developing countries: an overview

E‐governance is more than just a government website on the Internet. The strategic objective of e‐governance is to support and simplify governance for all parties; government, citizens and businesses. The use of ICTs can connect all three parties and support processes and activities. In other words, in e‐governance electronic means support and stimulate good governance. Therefore, the objectives of e‐governance are similar to the objectives of good governance. Good governance can be seen as an exercise of economic, political, and administrative authority to better manage affairs of a country at all levels. It is not difficult for people in developed countries to imagine a situation in which all interaction with government can be done through one counter 24 hours a day, 7 days a week, without waiting in lines. However to achieve this same level of efficiency and flexibility for developing countries is going to be difficult. The experience in developed countries shows that this is possible if governments are willing to decentralize responsibilities and processes, and if they start to use electronic means. This paper is going to examine the legal and infrastructure issues related to e‐governance from the perspective of developing countries. Particularly it will examine how far the developing countries have been successful in providing a legal framework.     

Multinational corporations and foreign owned media in developing countries

This essay is concerned with the impact of foreign-owned media upon the body politic of Kenya. It is argued that foreign ownership undermines both national sovereignty and even the rudiments of political freedom. The primary focus is on the British corporate conglomerate, Lonrho.     

TRIPS协议与公众健康—评WTO《“TRIPS协议和公共健康宣言”第六段的执行》

本文对WTO成员就多哈《“TRIPS协议和公共健康宣言”第六段的执行》达成的协议进行了评述。指出本议案的达成一方面是说明TRIPS框架下的知识产权体系并非完美无缺,二是说明修改TRIPS的协调或谈判即将开始。本文分析了谈判前景,建议发展中国家抓住机遇,尽早完成对TRIPS协议的有关修改,利用TRIPS提供的灵活性进一步开拓有利于自己的知识产权保护环境,尽快提高自己的科技发展水平和竞争实力。     

Uncertainty and technological innovation: evidence from developed and developing countries

Economic Change and Restructuring - Uncertainty will not only harm the economy but may also provide an opportunity for technological innovation. It is well established from past studies that...     

TRIPS协议与知识产权的司法保护

1999年11月15日,中美就中国加入世界贸易组织达成双方协议,这是一个具有重大现实意义和深远历史意义的事件。这一协议的签署将有利于中国入世进程,有利于改革开放和现代化建设事业,并将为世界经济的发展与变革注入新的活力。与贸易有关的知识产权协议（以下简称TRIPS协议）是世界贸易组织中一个极为重要的协议。它对入世后的中国知识产权审判必将产生重大的挑战与影响。本文将简要回顾和探讨与贸易有关的知识产权协议的背景、若干法律问题、TRIPS协议对中国知识产权司法保护的影响及对策与建议。一、TRIPS协议产生的历史背景关贸…     

TRIPS协定与国际贸易中的知识产权壁垒

TRIPS协定为世界范围内的知识产权保护建立了统一可执行的最低标准,打破了知识产权所固有的地域性的限制,在很大程度上促进了国际贸易的自由化进程。但是,由于TRIPS协定规定的统一标准过于维护权利人利益,部分超出了发展中国家的能力范围,给国际贸易造成了新的障碍和壁垒。新的知识产权壁垒的产生,又在一定程度上限制了国际贸易的自由化。因此,TRIPS协定对于国际贸易来说无疑是一把“双刃剑”。     

气候变暖与能源的开发及利用--发展中国家的机遇和挑战

燃烧化石燃料(石油、煤和天然气)所排出的温室气体,特别是二氧化碳(CO2),可能导致全球气候变暖,发达国家与发展中国家皆有不可推卸的责任.随着经济发展与人口增长,寻求一种有利于环境的能源开发模式对双方乃至全世界将具有重大的现实意义.本文首先从改革能源价格、推进现有能源的有效利用、开发可替代能源等方面,对发展中国家为减排所作的努力进行简要回顾,然后对其所面临的一些问题,如目标相互抵触、排污标准不切实际、鼓励措施缺乏灵活性及公众环保意识淡漠等,逐一进行论述,并试图提出可供选择的方案与建议.     

Mineral investment and the regulation of the environment in developing countries: lessons from Ghana

This article examines the relationship between foreign direct investment in the mineral sector and environmental regulation in developing countries. It argues that two major trends in global mineral investment have emerged in recent years: increased competition amongst developing countries to attract mineral investment, and the development and proliferation of a standard set of legal protections for mineral investors including access to international arbitration, prohibitions of expropriation without compensation, and commitments to stability of the regulatory regime. Both of these trends may have implications for environmental policy, which are examined in the paper both in general terms and in the context of a detailed case study concerning mineral exploitation in Ghana’s forest reserves.