Addressing Supply Side Barriers to Introduction of New Vaccines to the Developing World

2009 ◽  
Vol 35 (2-3) ◽  
pp. 415-441 ◽  
Author(s):  
Sean McElligott
Keyword(s):  
Low Income ◽  
Developing World ◽  
Low Income Countries ◽  
Supply Side ◽  
Significant Morbidity ◽  
Product Availability ◽  
Life Saving ◽  
Potential Adaptation ◽  
Vaccine Availability ◽  
New Vaccines

AbstractLow-income countries experience significant morbidity and mortality from avoidable infectious diseases, but all too often life-saving innovative vaccines are only available in high-income markets. The Generic Open (GO) license proposal posits that an increase in generic entry will lower prices through greater competition and increase vaccine availability in low-income markets. However, the GO proposal, as currently structured, is unlikely to function as envisioned in the vaccine market. Innovator vaccine firms will be unlikely to participate in the program because the payments in the GO license do not adequately compensate firms for all lost profits. Additionally, the price reductions from competitive entry are unlikely because the vaccine market is already characterized by low, and in some cases unsustainable, prices. I propose a potential adaptation where developing world vaccine manufacturers serve as contract suppliers to innovator firms for a given period of time. Donors could also share in the initial costs of capacity with the developing world manufacturers. Sales of developing world manufactured vaccines would be sold solely to UN procurement agencies under a confidential pricing or rebate system. This would increase overall product availability, maintain market separation, and decrease costs to UN agencies.

Reviewing the Development of Rural Finance in Vietnam

2013 ◽  
pp. 121-136
Author(s):  
Duong Pham Bao
Keyword(s):  
Low Income ◽  
Financial System ◽  
Low Income Countries ◽  
Supply Side ◽  
New Paradigm ◽  
Rural Finance ◽  
Market Mechanisms ◽  
Rural Credit ◽  
Rural Organizations ◽  
Doi Moi

The objective of this article is to review the development of the rural financial system in Vietnam in recent years, especially, after Doi moi. There are two opposite schools of thought in the literature on rural credit policies in developing countries. One is the conventional supply-side (government-led) approach while the other is called “a new paradigm” that emphasizes the importance of the viability of financial providers and the well functioning of rural credit markets. Conventional theories of rural finance contend that rural finance in low-income countries is generally accompanied by many failures. Contrary to these theories, rural finance in Vietnam does not encounter the above-mentioned failures so far. Up to the present time, it is progressing well. Using a supply-side approach, methodologically, this study reviews the development of the rural financial system in Vietnam. The significance of this study is to challenge the extreme view of dichotomizing between the old and the new credit paradigms. Analysis in this study contends that a rural financial market that, (1) is initiated and spurred by government; (2) operates principally under market mechanisms; and (3) is strongly supported by rural organizations (semi-formal/informal institutions) can progress stably and well. Therefore, the extremely dichotomizing approach must be avoided.

scholarly journals P.028 Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions

2017 ◽  
Vol 44 (S2) ◽  
pp. S20-S20
Author(s):  
S Wang ◽  
RT Muir ◽  
BC Warf
Keyword(s):  
Low Income ◽  
Developing World ◽  
Pediatric Neurosurgery ◽  
Cost Effective ◽  
Global Surgery ◽  
Low Income Countries ◽  
Global Burden ◽  
Pediatric Hydrocephalus ◽  
Cost Effective Treatment ◽  
Education Gaps

Background: Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Methods: The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. Results: Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. Conclusions: Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

Clinical Field Testing of Polyurethane Feet for Trans-Tibial Amputees in Tropical Low-Income Countries

2006 ◽  
Vol 30 (2) ◽  
pp. 182-194 ◽  
Author(s):  
J. Steen Jensen ◽  
R. Nilsen ◽  
N. H. Thanh ◽  
A. Saldana ◽  
C. Hartz
Keyword(s):  
Failure Rate ◽  
Low Income ◽  
Developing World ◽  
Compliance Rate ◽  
Field Testing ◽  
Low Income Countries ◽  
Controlled Study ◽  
Tropical Areas ◽  
Prospective Controlled Study ◽  
Better Than

In a prospective controlled study, 172 polyurethane feet of different designs were fitted to 155 amputees with trans-tibial prostheses. These were followed in respect of their durability. The amputee compliance was in general good, and 87% were satisfied with their device. After 18 months the failure rate of 20% with the CIREC spring-blade foot was significantly better than the others, but poorer craftsmanship, higher complaint rate and lower compliance rate cast some doubt on the results. The results with the conventional SACH foot constructions with polyurethane as filling and covering materials were so poor after 18 months that their use cannot be recommended in tropical areas of the developing world.

Formal assessment of teamwork among cancer health care professionals in 3 large tertiary centers in Nigeria.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18126-e18126 ◽  
Author(s):  
Abiola Falilat Ibraheem ◽  
Olutosin Alaba Awolude ◽  
Myhammad-yaqub Murtazha Habeebu ◽  
Anthonia Chima Sowunmi ◽  
Popoola Abiodun Olaniyi ◽  
...  
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Professionals ◽  
Cancer Care ◽  
Developing World ◽  
Low Income Countries ◽  
Major Barrier ◽  
Optimal Outcomes ◽  
Quality Cancer Care ◽  
Key Stakeholders

e18126 Background: Cancer is fast becoming a common cause of death in developing world. Over the last decade, there have been strategies to bring quality cancer care to underserved patients around the world. In low-income countries, poor utilization of principles of teamwork is a major barrier to achieving quality services. The intent of this study is to assess teamwork as perceived by the health care workers caring for cancer patients Methods: We conducted a survey among health care professionals involved in cancer care in 3 tertiary centers in the southwestern part of Nigeria from July to November 2016. Respondents rated teamwork using the previously validated ÒSafety Attitudes QuestionnaireÓ. For this analysis we focused on the teamwork climate subscale. This subscale is scored on a scale of 0-100 with mean (SD) values,in US ambulatory population of 69.7 (17). We compared ratings by professionals using analysis of variance Results: Overall 373 professionals completed the survey: Physicians (47%), nurses (14%), pharmacists (6%) and others (33%). Some results are shown in table Conclusions: Cancer care is complex and depends on teamwork amongst health care professionals to achieve optimal outcomes. While overall teamwork scores was consistent with US ambulatory studies , there are important variations that provide targets for intervention. Physicians rated teamwork poorly both intra and inter professionally. Pharmacists rated inter professional teamwork with nurses particularly poorly. Further data on additional subscales of the instrument and by individual centers will be presented. Efforts to transform cancer care need to focus on building trust among the key stakeholders. This is true in developing world where there is a need to maximize the use of limited resources to improve patient outcomes. [Table: see text]

SSA’s IPP Policy Dilemma

2020 ◽  
pp. 175-201
Author(s):  
James Leigland
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Developing World ◽  
Public Private Partnership ◽  
Low Income Countries ◽  
Multilateral Development Banks ◽  
Private Partnership ◽  
Development Finance ◽  
Generating Capacity ◽  
Development Banks

This chapter focuses on independent power producer (IPP) projects, by far the most successful kind of public–private partnership (PPP) in the developing world. These projects generate more investment in developing countries than all other forms of PPP combined. However, the development community exhibits ambivalence towards independent power producer (IPP) projects. They are supposed to work best in power sectors that are being reformed, where user tariffs are cost reflective and off-taker utilities are creditworthy. Yet, in practice, many influential multilateral development banks (MDBs), development finance institutions (DFIs), and donors are encouraging the use of IPP projects virtually everywhere in the developing world, whether or not sector reforms are taking place. This reflects a policy dilemma: most low-income countries desperately need more generating capacity, but should the development of IPP projects be delayed until progress is made on broader sector reforms? How can these policy dilemmas be resolved? Who can make that happen?

Headache Disorders in Developing Countries: Research Over The Past Decade

Cephalalgia ◽  
2008 ◽  
Vol 28 (11) ◽  
pp. 1107-1114 ◽  
Author(s):  
FJ Mateen ◽  
T Dua ◽  
T Steiner ◽  
S Saxena
Keyword(s):  
Low Income ◽  
Developing World ◽  
Research Policy ◽  
Primary Headache ◽  
Low Income Countries ◽  
Headache Disorders ◽  
Middle Income ◽  
Primary Headache Disorders ◽  
Study Characteristics ◽  
Number Of Publications

The majority of people with primary headache disorders live in the developing world. The contribution of low and middle income (LAMI) countries to headache research has not been previously characterized. A search was performed for clinical research publications between the years 1997 and 2006, using the search terms ‘headache’ OR ‘headache disorders’ AND ‘primary’ OR ‘migraine’ AND ‘each of the LAMI countries’ in 67 databases. Articles in English or with abstracts in English translation were included. These publications were scrutinized for study characteristics. Two hundred and twenty-seven publications from 32 LAMI countries were found. Half (50.2±) of these were from three middle-income countries (Brazil, Turkey and Iran), whereas 24 (10.6±) came from low-income countries. Most of the research focused on migraine. Only 29.5± of the articles involved treatment of headache. The understanding of headache disorders in LAMI countries is derived from a limited number of publications from relatively few countries. Identifying gaps in headache research in the developing world is strategic for targeting research policy.

scholarly journals Clinical Field Testing of Vulcanized Jaipur Rubber Feet for Trans-Tibial Amputees in Low-Income Countries

2006 ◽  
Vol 30 (3) ◽  
pp. 225-236 ◽  
Author(s):  
J. Steen Jensen ◽  
Wilfried Raab
Keyword(s):  
Low Income ◽  
Developing World ◽  
Field Testing ◽  
Low Income Countries ◽  
Prosthetic Foot ◽  
Tropical Areas ◽  
User Compliance

The purpose of this study was to check out the performance and durability of vulcanized Jaipur rubber feet in tropical areas of the developing world. Forty-one MUKTI and 40 NISHA feet were followed for 16 (8 – 17) months. The user compliance was high and nearly all were satisfied. Failure of the prosthetic foot with the need for exchange at the end of the study amounted to 27% (22/81), which is equivalent to a mixed series of rubber feet previously reported (Jensen et al. 2006b ). Failures were mostly related to skin fracture and gliding between sponge rubber layers of the heel block.

For Poor Countries' Youth, Dashed Hopes Signal Danger Ahead

2006 ◽  
Vol 105 (695) ◽  
pp. 435-440
Author(s):  
Richard Curtain
Keyword(s):  
Low Income ◽  
Developing World ◽  
Low Income Countries ◽  
Poor Countries ◽  
Youth Bulge ◽  
Job Prospects

Where the youth bulge is expanding in low-income countries …, the levels of frustration and conflict are certain to rise. The urgent question facing the developing world is how to improve young people's job prospects now.

scholarly journals Mitigating Disparity in Health-care Resources Between Countries for Management of Hereditary Angioedema

2021 ◽  
Author(s):  
Ankur Kumar Jindal ◽  
◽  
Avner Reshef ◽  
Hilary Longhurst
Keyword(s):  
Health Care ◽  
Low Income ◽  
Hereditary Angioedema ◽  
Genetic Disorder ◽  
Low Income Countries ◽  
Lower Income ◽  
Health Care Resources ◽  
Global Consensus ◽  
Life Saving ◽  
Lower Income Countries

AbstractHereditary angioedema (HAE) is a rare genetic disorder characterized by recurrent episodes of skin and mucosal edema. The main treatment goal is to enable a “normal life” for all patients. However, due to high costs, there are limited options for the management of HAE in most developing and low-income countries. As a result, most of the recommended first-line treatments are not available. In this review, we attempt to highlight the disparities in health-care resources for the management of patients with HAE amongst different countries. Data was collected from HAE experts in countries who provide tabulated information regarding management and availability of HAE treatments in their countries. We reviewed the two most recent international HAE guidelines. Using India, the world’s second most populous country, as a paradigm for HAE management in lower-income countries, we reviewed the evidence for second-line and non-recommended practices reported by HAE experts. Results suggest significant inequities in provision of HAE services and treatments. HAE patients in low-income countries do not have access to life-saving acute drugs or recently developed highly effective prophylactic medications. Most low-income countries do not have specialized HAE services or diagnostic facilities, resulting in consequent long delays in diagnosis. Suggestions for optimizing the use of limited resources as a basis for future discussion and reaching a global consensus are provided. There is an urgent need to improve HAE services, diagnostics and treatments currently available to lower-income countries. We recommend that all HAE stakeholders support the need for global equity and access to these essential measures.

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