Prizes for innovation of new medicines and vaccines

This article argues that prizes can help stimulate medical innovation, control costs and ensure greater access to new medicines and vaccines. The authors explore four increasingly ambitious prize options to reward medical innovation, each addressing flaws in the current patent system. The first option promotes innovation through a large prize fund linked to the impact on health outcomes; the second option rewards the sharing of knowledge, data, and technology with open source dividends; the third option awards prizes for interim benchmarks and discrete technical problems; and the final option removes the exclusive right to use patented inventions in upstream research in favor of prizes. The authors conclude that a system of prizes to reward drug development would break the link between R&D incentives and product prices, and that such a reform is needed to improve innovation and access to new medicines and vaccines.     

Parentage of Hydatidiform Moles

We were presented with the STR (short tandem repeat) profiles from two separate paternity trios. Each trio consisted of a mother, an alleged father, and products of conception (POC) that contained a hydatidiform mole but no visible fetus. In both cases , antecedent pregnancies had followed alleged sexual assaults. Mole classification and pathogenesis are described in order to explain the analyses and statistical reasoning used in each case. One mole exhibited several loci with two different paternal alleles, indicating it was a dispermic (heterozygous) mole. Maternal decidua contaminated the POC, preventing the identification of paternal obligate alleles (POAs) at some loci. The other mole exhibited only one paternal allele/locus at all loci and no maternal alleles, indicating it was a diandric and diploid (homozygous) mole. In each case, traditional calculations were used to determine paternity indices (PIs) at loci that exhibited one paternal allele/locus. PIs at mole loci with two different paternal alleles/locus were calculated from formulas first used for child chimeras that are always dispermic. Combined paternity indices in both mole cases strongly supported the paternity of each suspect.     

An Ethic of Care: A Valuable Political Tool?

Since Gilligan first interpreted women's moral position as an ethic of care, feminists have wondered what this means for political action. While some view it as a way of introducing forms of understanding and appreciation which are missing in the public sphere, others have worried about the universalisation and romanticization of women's abilities which it appears to contain. This paper argues that interpretations of an ethic of care which are situated in resistance and which conceptualise its abilities as the skills of subordinated groups can hold out visions of group solidarity of benefit to politics.     

Corporate wealth or public health? WTO/TRIPS flexibilities and access to HIV/AIDS antiretroviral drugs by developing countries

Between 1994 and 2003, the TRIPS (Trade-Related Aspects of Intellectual Property Rights) Agreement of the WTO was refined to allow for flexibilities in the use of compulsory licences to import and export ‘generic’ varieties of pharmaceutical products, including ARV drugs for the treatment of HIV/AIDS. After summarising this process, and assessing its implications in practice for developing countries, this article briefly places the current regime in a longer-term context of the institutional protection of patents in Britain and Europe dating from the nineteenth century. It traces how that pattern, which benefits major patent holders, continues to be present in TRIPS. The article goes on to demonstrate the continuity of corporate influence over the state, as expressed in the ‘TRIPS-plus’ conditions, which are appearing in bilateral free-trade agreements between the USA and either individual developing countries or regional groupings. This array of what amount to institutional obstacles to the sustained availability of cheap drugs presents serious problems for future operations of the supply chain for many imported medicines and, in the case of HIV/AIDS, has negative implications for the long-term clinical effectiveness of the most widely used drugs.     

Personnel reorganization in the Canadian public service: some observation on the past

Abstract. This paper addresses the history of public personnel reorganization of the federal level of government in Canada and focuses on two periods of fundamental change. The first of these periods revolved around the Civil Service Act of 1918 and was associated with the introduction of the merit principle. The second period revolved around the public service legislation in 1967 and was associated with introduction of the principle of collective bargaining. The significance of these two watersheds, and of less important developments in the intervening years, is described. The author concludes that the forces required to bring about another period of fundamental change in public service personnel management are not in evidence and cautions against proposals that would, by diminishing the statutory powers of the Public Service Commission, undermine the merit principle governing public service appointments.     

Elizabethan ‘Spinning’ and Penelope’s Weaving: The Political, the Common Law and Stately Bodies

This paper examines the public, private and political in the work of Adriana Cavarero by drawing upon the situations of two women whose lives feature in her work: Elizabeth I and Penelope. It includes an analysis of the way in which Cavarero is rethinking Hannah Arendt’s view of ‘the political.’ Cavarero’s exposition of the metaphor of the King’s two bodies in the common law is explored, along with her critique of hylomorphism. Finally, it extends her work in Stately Bodies by considering different images of the power of the body in later political discourses regarding the worker’s body and the effect of the advance of techno-science. This paper was presented at ‘The State He’s In – Political Philosophy and the Figural: A Conference with Adriana Cavarero on her book Stately Bodies: Literature, Philosophy and the Question of Gender’ at Warwick University, Department of Philosophy in May 2004. I would like to thank Adriana and all the conference participants for their comments. Thanks also to the referees of this paper. I have kept the informal style of presentation from the conference, along with the emphasis upon theoretical, rather than historical, analysis.     

Recognition of Skeletal Fractures in Infants: An Autopsy Technique

Abstract:  Complete recognition and documentation of injury pattern is crucial in the diagnosis of child abuse. Skeletal fractures regarded as highly specific to nonaccidental injury in infants include posterior rib, scapular, metaphyseal, and spinous process fractures. These injuries are often occult, especially when acute, to standard radiologic and autopsy procedures. The presented autopsy technique requires incising and reflecting skeletal muscles to expose the bones and costal osseous joints in situ , increasing the opportunity to recognize skeletal injury. Fractured or atypical appearing bones are removed and processed for complete evaluation. The bones are processed by macerating the soft tissue in a water soap bath at an elevated temperature. To aid in reconstruction of the decedent, long bones are replaced with wooden dowels and the chest cavity is packed with the organ bag. The technique is invasive and recommended for cases in which the pathologist has reasonable suspicion of acute or remote trauma.     

Export instability: An alternative analysis of causes

Numerous studies into the causes of the export instability experienced by developing countries have failed to establish any significant relationships. This paper suggests that the widely‐used technique of cross‐country regression analysis is inappropriate and that the typical explanatory variable set is inadequately specified. Accordingly, analysis is shifted to a time‐series basis at the level of individual countries, and explanatory variables are developed which correspond more closely to the supply and demand determinants of instability. Applying this alternative model to data for a sample of developing countries produces results which suggest that this approach has considerable explanatory power.