Pharmaceutical industry sponsorship of academic conferences: ethics of conflict of interest

2020 ◽  
pp. medethics-2020-106224
Author(s):  
Saroj Jayasinghe
Keyword(s):  
Developing Countries ◽  
Pharmaceutical Industry ◽  
Ethical Issues ◽  
Social Trust ◽  
Medical Profession ◽  
Codes Of Conduct ◽  
Developed Countries ◽  
Professional Judgment ◽  
Conflicts Of Interests ◽  
Core Issue

Sponsorship of medical conferences by the pharmaceutical industry has led to many ethical issues, especially in resource-poor developing countries. The core issue in these instances is to reduce or avoid conflicts of interests (COIs). COI is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by secondary interests. Disruption of social trust should also be considered. This deontological approach should be complemented by a consequentialist approach. Towards this, the concept of distal interests (DI) is introduced. DI lies beyond the immediately visible COIs and the consequences of immediate decisions. They are ‘distal’ in time or place: ‘DI in time’ means consequence of the decision in future scenarios, while ‘DI in space’ means those that impinge on other institutions or bodies. In judging the consequences, it is also necessary to consider the reality of the existing relationship between the pharmaceutical industry and organisers of conferences. In more developed countries, these relationships are governed by stricter regulations, adherence to codes of conduct by both parties and stronger institutional oversights. In contrast, developing countries such as Sri Lanka the regulatory environment is lax and the demarcation of interests between the pharmaceutical industry and the medical profession is considerably blurred. Therefore, establishing clear rules of engagement between the stakeholders should be considered as an attempt to clear the muddy waters. The paper proposes a set of guidelines to capture these approaches.

Ethics Review on Externally- Sponsored Research in Developing Countries

2009 ◽  
pp. 112-125 ◽  
Author(s):  
Alireza Bagheri
Keyword(s):  
Developing Countries ◽  
Local Community ◽  
Ethical Issues ◽  
Human Subjects ◽  
Ethics Committees ◽  
Developed Countries ◽  
Ethics Committee ◽  
Benefit Sharing ◽  
Sponsored Research ◽  
Poor Countries

This chapter elaborates on some of the existing concerns and ethical issues that may arise when biomedical research protocols are proposed or funded by research institutes (private or public) in developed countries but human subjects are recruited from resource-poor countries. Over the last two decades, clinical research conducted by sponsors and researchers from developed countries to be carried out in developing countries has increased dramatically. The article examines the situations in which vulnerable populations in developing countries are likely to be exploited and/or there is no guarantee of any benefit from the research product, if proven successful, to the local community. By examining the structure and functions of ethics committees in developing countries, the article focuses on the issues which a local ethics committee should take into account when reviewing externally-sponsored research. In conclusion, by emphasizing capacity building for local research ethics committees, the article suggests that assigning the national ethics committee (if one exists) or an ethics committee specifically charged with the task of reviewing externally-sponsored proposals would bring better results in protecting human subjects as well as ensuring benefit-sharing with the local community.

scholarly journals Doctor in the Dock

1970 ◽  
pp. 27-31
Author(s):  
Biju C Mathew ◽  
Reji Susan Daniel ◽  
Jamal Al Baylool Bordom ◽  
Ian W Campbell
Keyword(s):  
Developing Countries ◽  
Medical Profession ◽  
Developed Countries ◽  
Vital Role ◽  
Tobacco Prevention ◽  
Global Epidemic ◽  
Leading Role ◽  
Stop Smoking ◽  
Important Position ◽  
School Curricula

Tobacco smoking is one of the greatest threats to human health. The global epidemic of tobacco killed 100 million in the 20th century, and if not dealt with on a war- footing shall entice and kill another one billion in this century. In the society , physicians play a leading role as ambassadors of promoting issues related to health. They play a vital role in helping patients to stop smoking as they occupy an important position as tobacco control exemplars. Unfortunately, the rate of smoking in the medical profession in some developed countries and newly-developing countries is still high. Considering the staggering cost of smoking in terms of human lives, physicians should not rest until they have successfully kicked the habit. Tobacco-related issues are to be included in the medical school curricula, as medical students can play decisive roles in tobacco-prevention programs.   doi:10.3329/jom.v10i3.2013 J Medicine 2009; 10 (Supplement 1): 27-31

The Political Economy of Controlling Transnationals: The Pharmaceutical Industry in Sri Lanka, 1972–1976

1978 ◽  
Vol 8 (2) ◽  
pp. 299-328 ◽  
Author(s):  
Sanjaya Lall ◽  
Senaka Bibile
Keyword(s):  
Drug Delivery ◽  
Developing Countries ◽  
Quality Control ◽  
Sri Lanka ◽  
Pharmaceutical Industry ◽  
Medical Profession ◽  
Political Leadership ◽  
The Political ◽  
Great Care ◽  
Set Up

This paper describes the experience of Sri Lanka in reforming the structure of production, importation, and distribution of pharmaceuticals in the period 1972–1976. It highlights the actions and reactions of transnational pharmaceutical corporations to these reforms, and traces the achievements and problems of the State Pharmaceuticals Corporation which was set up to implement the reforms. The roles of political leadership in regulating the power of drug transnationals, and of the medical profession in resisting reform, seem to be of crucial significance. Developing countries wishing to lower the present high cost of drug delivery must proceed with great care and immense caution, since complex problems of quality control, bioequivalence, medical acceptance, and consumer reeducation are involved.

scholarly journals Expanded Newborn Screening and Genomic Sequencing in Latin America and the Resulting Social Justice and Ethical Considerations

2021 ◽  
Vol 7 (1) ◽  
pp. 6
Author(s):  
Juan F. Cabello ◽  
Fernando Novoa ◽  
Hanalise V. Huff ◽  
Marta Colombo
Keyword(s):  
Developing Countries ◽  
Latin America ◽  
Newborn Screening ◽  
Rare Diseases ◽  
Ethical Issues ◽  
Developed Countries ◽  
Global Scale ◽  
Genomic Sequencing ◽  
Ethical Considerations ◽  
Expanded Newborn Screening

Newborn screening (NBS) has widely been utilized in developed countries as a cost-effective public health strategy that reduces morbidity and mortality. Developing countries, however, are new to the NBS scene and have their own unique challenges, both in instituting the program as well as effectively acting on the results. NBS offers numerous ethical issues on a global scale, however, here we argue that there are unique ethical issues surrounding the development and expansion of newborn screening in Latin America given its highly heterogenous population. Once a NBS program is effectively instated, ethical considerations continue when pursuing expansion of screening to include further conditions. While Latin America grapples with the ethics of expanded newborn screening (ENBS), some developed countries discuss utility of genomic sequencing technologies in the newborn population. When the ability to detect further pathology is expanded, one must know what to do with this information. As rare diseases are identified either on ENBS or via genome sequencing, access to treatments for these rare diseases can be a real challenge. If we consider newborn screening as a global initiative, then we need more than a deontology approach to analyze these challenges; we need an approach that considers the unique characteristics of each territory and tremendous heterogeneity that exists prior to the implementation of these programs. As genomic technology advances further in the developed world, while some developing countries still lack even basic newborn screening, there is a further widening of the gap in global health disparities. The question is posed as to who has responsibility for these newborns’ lives on an international level. Without an approach towards newborn screening that accounts for the diverse global population, we believe optimal outcomes for newborns and families across the world will not be achieved.

scholarly journals COMPLEXITIES OF MEDICAL RESEARCH IN DEVELOPING COUNTRIES: STANDARD OF CARE: RESPONSIBILITIES OF ETHICS COMMITTEES

1970 ◽  
Vol 7 (2) ◽  
pp. 117-121
Author(s):  
Inayat Ullah Memon
Keyword(s):  
Developing Countries ◽  
Ethical Issues ◽  
Standard Of Care ◽  
Ethics Committees ◽  
Developed Countries ◽  
Biomedical Ethics ◽  
Western World ◽  
For Profit ◽  
Eastern Hemisphere ◽  
Human Participants

Increased awareness of human rights particularly those of vulnerable and emphasis on protection of less strong from stronger groups, have extended the limits of biomedical ethics where human participants are involved in the research. Inequalities amongst various global groups and subgroups in respect to financial resources and healthcare with increased collaborative biomedical research, particularly for-profit institutions have raised ethical issues one being the standard of care in research in developing countries. Emergence of newer and complex infectious diseases and resurgence of older ones in recent past has prompted Western world to undertake research in the Eastern hemisphere of the globe. But it has generated complex and various ethical dilemmas. Ethics demands that enrollees of research in developing countries not only be judiciously remunerated but outcomes of the studies be directly beneficial and affordable to them along with provision of parallel benefits. The core point of discussion amongst various partners is the selection from possible choices of standard of care to human participants in less developed countries. While some authors have argued for alternate standards whereas others suggest to compromise on this demand in particular conditions with permission from Ethics Committees. These suggestions, besides empowering the ERCs have put more burden on them to prepare guidelines and resolve the encountered issues where presently available guidelines are inadequate or insufficient. This work provides in-depth discussion and analyses possible alternatives to this complex dilemma.

scholarly journals Academic detailing

1970 ◽  
Vol 8 (1) ◽  
pp. 126-134
Author(s):  
PR Shankar ◽  
N Jha ◽  
RM Piryani ◽  
O Bajracharya ◽  
R Shrestha ◽  
...  
Keyword(s):  
Developing Countries ◽  
Pharmaceutical Industry ◽  
Rural Areas ◽  
Positive Reinforcement ◽  
Developed Countries ◽  
Evidence Based ◽  
Academic Detailing ◽  
Prescribing Practices ◽  
Educational Materials ◽  
Face To Face

There are a number of sources available to prescribers to stay up to date about medicines. Prescribers in rural areas in developing countries however, may not able to access some of them. Interventions to improve prescribing can be educational, managerial, and regulatory or use a mix of strategies. Detailing by the pharmaceutical industry is widespread. Academic detailing (AD) has been classically seen as a form of continuing medical education in which a trained health professional such as a physician or pharmacist visits physicians in their offices to provide evidence-based information. Face-to-face sessions, preferably on an individual basis, clear educational and behavioural objectives, establishing credibility with respect to objectivity, stimulating physician interaction, use of concise graphic educational materials, highlighting key messages, and when possible, providing positive reinforcement of improved practices in follow-up visits can increase success of AD initiatives. AD is common in developed countries and certain examples have been cited in this review. In developing countries the authors have come across reports of AD in Pakistan, Sudan, Argentina and Uruguay, Bihar state in India, Zambia, Cuba, Indonesia and Mexico. AD had a consistent, small but potentially significant impact on prescribing practices. AD has much less resources at its command compared to the efforts by the industry. Steps have to be taken to formally start AD in Nepal and there may be specific hindering factors similar to those in other developing nations. Key words: Academic detailing; pharmaceutical industry; evidence-based information DOI: 10.3126/kumj.v8i1.3235 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29,126-134

scholarly journals Healthcare systems, the State, and innovation in the pharmaceutical industry

2016 ◽  
Vol 32 (suppl 2) ◽  
Author(s):  
Ignacio José Godinho Delgado
Keyword(s):  
United States ◽  
Developing Countries ◽  
Pharmaceutical Industry ◽  
Health Systems ◽  
Developed Countries ◽  
The United States ◽  
Healthcare Systems ◽  
Catching Up ◽  
Pharmaceutical Industries ◽  
Brazilian Health System

Abstract: This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist), in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry.

Emerging Nutrition Gaps in a World of Affluence - Micronutrient Intake and Status Globally

2011 ◽  
Vol 81 (4) ◽  
pp. 238-239 ◽  
Author(s):  
Manfred Eggersdorfer ◽  
Paul Walter
Keyword(s):  
Developing Countries ◽  
Human Health ◽  
Old Age ◽  
Molecular Basis ◽  
Health Benefit ◽  
Developed Countries ◽  
Micronutrient Deficiencies ◽  
New Science ◽  
Health And Nutrition ◽  
Micronutrient Intake

Nutrition is important for human health in all stages of life - from conception to old age. Today we know much more about the molecular basis of nutrition. Most importantly, we have learnt that micronutrients, among other factors, interact with genes, and new science is increasingly providing more tools to clarify this interrelation between health and nutrition. Sufficient intake of vitamins is essential to achieve maximum health benefit. It is well established that in developing countries, millions of people still suffer from micronutrient deficiencies. However, it is far less recognized that we face micronutrient insufficiencies also in developed countries.

Country Rankings of Women's Status: An Alternative Index

1995 ◽  
Vol 34 (4III) ◽  
pp. 1025-1039 ◽  
Author(s):  
Yasmeen Mohiuddln
Keyword(s):  
Developing Countries ◽  
Composite Index ◽  
Developed Countries ◽  
Women's Status ◽  
Current Status ◽  
Implicit Assumption ◽  
Women’S Status ◽  
Country Rankings ◽  
Population Crisis ◽  
Status Of Women

The purpose of the present paper is to formulate a composite index of the status of women and to rank both developed and developing countries on the basis of that index. This index is presented as an alternative or complement to the current status of women index, published by the Population Crisis Committee (PCC) and used by the World Bank and the United Nations, which focuses on indicators measuring health, education, employment, marriage and childbearing, and social equality. The paper argues that these indicators have a poverty-bias and measure women's status in terms of structural change rather than in terms of their welfare vis-ii-vis men. The PCC index is also based on the implicit assumption that women's status in developing countries ought to be defined in a similar way as in developed countries, thus including primarily only those indicators which are more relevant for developed countries. To remedy these defects, the paper presents an alternative composite index, hereafter labelled the Alternative Composite (AC) index, based on many more indicators reflecting women's issues in both developed and developing countries. The results of the statistical analysis show that the ranking of countries based on the AC index is significantly different from the PCC index.

Sign in / Sign up

Export Citation Format

Share Document