TRIPs, TRIPs-PLUS, Developing Countries and Public Health: The Case of Egypt

2008 ◽  
Vol 5 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Mohamed Salem Abou El Farag
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Developed Countries ◽  
Degree Of Freedom ◽  
Health Needs ◽  
Pharmaceutical Drugs ◽  
Quality Health Care ◽  
The Public ◽  
Quality Health

AbstractThe article critically examines how Egyptian legislators made use of the degree of freedom left in the TRIPs Agreement for WTO Members to incorporate appropriate measures in their national laws aiming at meeting the public health needs and concerns, particularly access to quality health care and affordable pharmaceutical drugs. The article also explores and warns against the recent attempts made by a number of developed countries to impose TRIPs-plus obligations on several developing countries, including Egypt, for their detrimental effects on public health.

scholarly journals Physician-Patient Relationship: The Present Situation and Our Responsibilities

2014 ◽  
Vol 41 (1) ◽  
pp. 55-58
Author(s):  
MS Islam ◽  
ST Jhora
Keyword(s):  
Health Care ◽  
Developed Countries ◽  
Present Moment ◽  
Patient Relationship ◽  
Professional Relationship ◽  
Physician Patient Relationship ◽  
Doctor Patient Relationship ◽  
Quality Health Care ◽  
Quality Health ◽  
Physician Patient

The "doctor-patient" relationship (DPR) or the "physician-patient" relationship (PPR) has long been recognized as a complex, multifaceted, and complicated balance of engagement between the care-seeker and the care-giver. The physician-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics. In the present moment doctor-patient relationship (DPR) or physician-patient relationship (PPR) is one of the major issues in health-care throughout the world. The most common complains about the physicians of Bangladesh is their attitude towards the patients. The patients must have confidence in the competence of doctors and should feel that they can confide in him or her. For physicians, the establishment of a good relationship with the patients is also important. In developed countries students are taught from the beginning, even before they set foot in hospitals, to maintain a professional relationship with the patients, to uphold patients' dignity, and respect their privacy. These are deficient in Bangladesh. In addition to service factors, perceived treatment cost is another factor that patients may perceive as excessive. This special article reflects the importance as well as the necessary elements to establish this sacred relationship. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18786 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 55-58

scholarly journals Innovating in Health Care – Modern Challenges

2013 ◽  
Vol 3 (3) ◽  
pp. 261-266
Author(s):  
Sebija Izetbegović ◽  
Goran Stojkanović ◽  
Suvada Švrakić ◽  
Eldar Mehmedbašić
Keyword(s):  
Health Care ◽  
Prescription Drugs ◽  
Empirical Studies ◽  
Medical Science ◽  
Malignant Neoplasm ◽  
Developed Countries ◽  
Quality Health Care ◽  
National Priority ◽  
Quality Health ◽  
The Cost

Introduction: The goal of this article is to present that innovating in health care begins to become an imperative in present time. Innovating will enable the achievement of the highest quality health care results and the patients' satisfaction with the least amount of financial resources.Methods: The thorough literature review of multifaceted sources was conducted including: studies, books, monographies and peer – reviewed journals with the goal of achieving the clearer picture of today's modern challenges in the complex fi eld of health care innovation.Discussion: Theoretical and empirical studies clearly indicate that the innovation is one of the key factors in the competitiveness of the organization and its survival in the market. Developed countries of the world today are making significant efforts in order for innovation to become a national priority, with special emphasis placed on measuring innovation performance. Results of theoretical and practical studies show that in the future, treatment of the most diffi cult and complex diseases of our time, through the entirely new discoveries and results, derived from the process of innovation, will project entirely new positive forms and outcomes in the health care.Conclusion: There is no doubt that the humanity and medical science will through innovation succeed to win the battles against the majority of the most complex contemporary diseases. Malignant neoplasm of tomorrow, through the application of a new, innovative approaches to research, processes and treatments will become a chronic diseases. Among many, the particular problem in the process of innovation will represent the cost of research and development (R&D), production and the safety of prescription drugs.

Report on the Future Role of the Pediatrician in the Delivery of Health Care

PEDIATRICS ◽  
1991 ◽  
Vol 87 (3) ◽  
pp. 401-409
Author(s):  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Tertiary Care ◽  
Health Needs ◽  
Group Practice ◽  
Quality Health Care ◽  
The Future ◽  
Quality Health ◽  
Level I

The pediatrician now and in the future should be recognized as the specialist specifically trained to provide comprehensive, coordinated health care to infants, children, adolescents, and young adults throughout growth and development. This care, which can be described as primary care, encompasses problems of Level I, II, and III complexity. Although the majority of the pediatrician's practice time will be devoted to Level I and Level II services, the actual mix of a pediatrician's practice will be influenced by practice location, individual training, competency, interest, and the financial structure of the pediatric practice. The pediatrician will work with multiprofessional teams to coordinate and supervise comprehensive family-centered care for the child with multiple handicaps. The pediatrician should provide consultation to other physicians and various community child care programs. The trend toward group practice will continue. The increasing number of women in pediatrics and the desire of almost all physicians for a more balanced lifestyle will enhance group practice (part-time and shared). Pediatrics lends itself especially well to this type of care. Shared overhead and expenses will decrease costs and may allow for specialized care by individuals within the group—a development that will enhance the competency of the group as a whole and individual practice satisfaction. To ensure access of sophisticated medical knowledge and technology to all children, the number of pediatric subspecialists will continue to increase. Because of continued emphasis on education and research, most subspecialists will be located in tertiary care teaching centers, although multisystem subspecialists may also work in primary care settings. Pediatric subspecialists should diagnose and treat patients with complex illnesses and, after developing an ongoing therapeutic plan, return them to their pediatricians for ongoing care. A significant portion of the subspecialist's time should be spent in research. Enhanced networks of patient referral and regionalization of tertiary care should be encouraged to provide cost-effective care to the relatively small number of pediatric patients with complex diseases. New patterns of coordinated health care delivery for children should be considered. Currently, there is a debate about whether or not we are training too many or too few pediatricians to meet the health needs of children in the United States. The following facts should be considered: A. A large number of American children receive no health care. With better access to care, there will be an increased demand for practicing pediatricians. B. The management of increasingly complex biomedical and psychosocial disorders by pediatricians requires extended professional time and knowledge. C. An increasing number of adolescents will be seen by pediatricians. D. Increased knowledge and technological support for diagnosis and treatment of complex pediatric diseases will require the services of pediatric subspecialists in addition to pediatricians providing primary care. E. The increasing demand for a healthier lifestyle for both men and women will result in more realistic working hours for pediatricians. Consideration of these factors leads to the conclusion that there will be a need for increasing numbers of pediatricians involved in pediatric care in the next decade. Pediatricians and pediatric subspecialists have a common interest in the health and welfare of children. This should be the basis for further discussion by all pediatricians about child health needs and the type of delivery system that will provide quality health care to all children. Professional organizations interested in child health, such as the American Academy of Pediatrics and the pediatric research societies, should continue to monitor all issues related to children's access to health care, the quality of care, and the practice of pediatrics. With such monitoring and evaluation, rational decisions can be made about the number of pediatricians and subspecialists needed to provide comprehensive, quality health care. Dialogue must continue between practicing pediatricians and the academic community to ensure the relevancy of pediatric training programs in preparing pediatricians to deliver high-quality care to all children. Ongoing evaluation and research will be needed to define the role of the pediatrician and pediatric subspecialist further in meeting the future health needs of children of this nation.

scholarly journals The Abolition of User Fees in the Jamaican Public Health System: Impact on Access, Care Provided and the Work of the Professional Nurse

2021 ◽  
Author(s):  
◽  
Adella Campbell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Health System ◽  
Public Health System ◽  
User Fees ◽  
Professional Nurse ◽  
The Public ◽  
The Impact

<p>The negative impact of user fees on the utilisation of the health services by the poor in developing countries such as Uganda and Jamaica is well documented. Therefore, various governments have been engaged in reforming public health systems to increase access by underserved populations. One such reform is the introduction of free health services. In Jamaica, user fees were abolished in the public health sector in 2007 for children under 18 years and in 2008 free health care was introduced for all users of the public health system. This study evaluated the impact of the 2008 reform on the Jamaican public health system at 1) the national level, 2) the provider level, and 3) the user level. Perspectives were sought on access to care, the care provided, and the work of the professional nurse. Participants were selected from the Ministry of Health (MOH), the four Regional Health Authorities (RHAs), and urban and rural health facilities. Data collection was done during March – August 2010, using a multi-layered mixed methods evaluation approach, incorporating both qualitative and quantitative methods. Methods included individual interviews with key policymakers (eight) at the MOH and the four RHAs, as well as a senior medical officer of health (one) and pharmacists (three); focus groups with representatives of the main practitioners in the health system including nurses (six groups), pharmacists (one group) and doctors (two groups); document reviews of the MOH and RHAs‘ annual reports, and a survey of patients (200). Views on the impact of the abolition of user charges differed across the three levels and among the health authorities, facilities, and perspectives (policymakers, practitioners and users). Patient utilisation of the public health system increased exponentially immediately following the abolition of user fees, then declined, but remained above the pre-policy level. The work of health care providers, especially the professional nurse, was affected in that they had to provide the expected and required services to the patients despite an increase in workload and constraints such as inadequate resources. The research found that, while policymakers were optimistic about the policy, providers had concerns but patients were satisfied with the increased access and the quality care they were now receiving. Users also encountered challenges that constituted barriers to access. In addition to providing further evidence about the abolition of user fees in the public health system, this research provides important new insights into the impact of the nationwide abolition of user fees, as well as the impact of the policy change on the work of the professional nurse. Equally, the findings highlighted the potential benefits, gaps, and failures of the abolition of user fees‘ policy, and will serve as a catalyst to improve the policy process regarding access to health services and the work of the professional nurse. The findings of this research will be valuable in the planning of health-related programmes for the consumers of health care in developing countries. Despite the need for further research in this area, this research has contributed to the body of knowledge regarding user fees and access to health care in developing countries.</p>

scholarly journals By Her Own Authority: The Scope of Midwifery Practice under the Ontario Midwifery Act, 1991

1993 ◽  
Vol 31 (2) ◽  
pp. 349 ◽  
Author(s):  
Elizabeth Massey
Keyword(s):  
Health Care ◽  
Consumer Choice ◽  
Medical Profession ◽  
Normal Pregnancy ◽  
Professional Status ◽  
Quality Health Care ◽  
The Public ◽  
Midwifery Practice ◽  
Quality Health ◽  
Regulatory Model

Midwifery is recognized as an autonomous, self-governing profession under Ontario's Midwifery Act, 1991 and Regulated Health Professions Act, 1991. The author discusses the implications of this new legislation and addresses how the Acts define the nature and scope of midwifery practice. Although the new regulatory model grants midwives legal and professional status, their statutory scope of practice is limited to "normal" pregnancy, labour and delivery. Within the new regulatory framework, the authority to define the meaning of "normal" remains with physicians. Therefore, the capacity to control the scope and availability of midwifery services lies in the hands of the medical profession, which has historically been opposed lo the autonomous practice of midwifery. The author explores the other elements of the Midwifery Act, 1991, such as matters of assessment and diagnosis, and issues of potential liability, and whether or not these could hind midwifery practice by established medicine within the Ontario health care system. In implementing the Acts, much consultation remains to be done among members of the relevant professional bodies and the public to balance competing interests and views, while ensuring quality health care and consumer choice.

Labels, Lawyers, & Logic

2015 ◽  
Vol 21 (2) ◽  
Author(s):  
Peter J. Pitts
Keyword(s):  
Health Care ◽  
Monetary Incentives ◽  
Quality Health Care ◽  
American Health Care System ◽  
The Public ◽  
American Health Care ◽  
Achievable Goal ◽  
Quality Health ◽  
Corporate Liability ◽  
Excessive Risk

America deserves access to high-quality health care without avoidable medical errors and complications. This achievable goal begins with harnessing and using the power of information. And that begins with clear, accurate, and usable labeling.The American health care system is undermined, underserved, and undervalued when labeling is written more for corporate liability protection than as a valuable tool for health care providers.Today, labeling includes excessive risk information and exaggerated warnings. And this has set into motion a dangerous dynamic: labeling that does not accurately communicate to either the health care professional or the patient the conditions in which any given product can be used safely and effectively. This is nothing less than a grave menace to the public health. America is suffering from a legal system that is dangerous to its health. Why has this happened? There is, unfortunately, a simple answer - fear of liability. Manufacturers have significant monetary incentives to add dense and confusing legalese because, under current law in most states, they can be found liable for failing to provide "adequate" warnings about therapeutic products. Money, not medicine, is driving this dangerous practice. When it comes to labeling written for lawyers rather than doctors, more is less.

Preventing overdiagnosis in mammography screening – a public health perspective

2017 ◽  
Vol 32 (1) ◽  
Author(s):  
Hans Concin ◽  
Gabriele Nagel
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Risk Groups ◽  
Public Health Issue ◽  
Public Health Perspective ◽  
Quality Health Care ◽  
The Public ◽  
Quality Health ◽  
Long Time ◽  
High Quality Health Care

AbstractPrevention and management of breast cancer in order to provide high quality health care is an important public health issue. The existence of overdiagnosis for breast-cancer was controversial for a long time but is now broadly accepted. Overdiagnosis is defined as the diagnosis of “disease” that will never cause symptoms or death during a patient’s ordinarily expected lifetime. Estimates of the overdiagnosis rate for breast cancer range up to 54% of screen-detected localized tumors. New approaches, such as the identification of high risk groups or primary prevention approaches could be more relevant from the public health perspective.

scholarly journals Editorial: Fighting Infections in Developing Countries by Cost-Affordable and Sustainable Means

2010 ◽  
Vol 3 (1) ◽  
pp. 72-73
Author(s):  
Gadi Borkow
Keyword(s):  
Public Health ◽  
Health Care ◽  
Developing Countries ◽  
Nosocomial Infections ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Public Health Care ◽  
Treatment Modalities ◽  
Disease Rate ◽  
Prevention And Treatment

In developing areas around the globe it is extremely hard for health related institutions and governments to implement prevention and treatment policies, to improve public health, due to poor economical resources and infrastructures; low awareness; inadequate personnel; high prevalence of parasites and pathogens with extreme infection burdens, as well as sociopolitical factors. Central government programs essential for the improvement of the general public health are limited in developing countries. These include mass vaccination programs, which are cornerstones of primary health-care [1]; programs to reduce waterborne and water-associated vector-borne diseases [2]; routine surveillance activities [3,4]; regulation of pesticide usage (e.g. developing countries use only 20% of the world's agrochemicals, yet they suffer 99% of deaths from pesticide poisoning [5]); programs to reduce malnutrition [6]; programs to educate the public (e.g. use of condoms to reduce sexually transmitted diseases); and funding of medical care. However, the high disease rate itself possesses a very significant economic burden on developing countries. This burden exacerbates the incapacity of the governments to address the critical need for better health care. For example, malaria alone costs sub-Saharan Africa US$100 billion in lost annual gross domestic product (GDP) [1]. The combination of high infection rates together with poor public health care has become a vicious cycle that needs to broken. While in developed countries prevention and treatment modalities have significantly improved public health, the standard of living and life expectancy [1,7-9], this is not the case in developing countries, where the improvement of health care is multifaceted and extremely complicated. Assistance from world organizations together with the developed and affluent countries is essential. However, it has to be taken into consideration that solutions that have been successful in developed countries may not be appropriate for those that are developing. For example, vaccines that may confer protection against HIV-1 in Europe and USA, may fail to do so in Africa and other developing countries due to the significantly different pre-existing immune background of the population [10-12]. Another problem is the extremely high illiteracy and poverty rate that prevails in many rural areas in these countries. Thus, simple, cost affordable, wide spectrum, immediate and applicable means, which accommodate the particular constraints of developing countries, must be developed and applied in order to specifically and rapidly address key issues of public health in these volatile regions. The current Hot Topic issue presents several cost-affordable and sustainable means that may help fight the high infections rates in developing countries. Doucoure and Farcy propose novel membrane systems that can be applied in small rural communities and remote areas in developing countries aimed at reducing water-borne diseases and pollutants. Borkow and Gabbay suggest the use of biocidal textiles in hospitals in order to reduce the high rates of nosocomial infections. Togo and his colleagues from a hospital in Bamako - Mali make a robust attempt to identify the causes of nosocomial infections in a developing country and recommend measures aimed at reducing these infections in hospital settings. Ole Skovmand discusses the use of insecticidal bednets for the fight against malaria in developing countries. Finally, Bentwich and colleagues present the hypothesis that the relatively straightforward treatment of helminthic parasites may have very wide ramifications in improving the treatment and prognosis of other diseases, and in enhancing the capacity to achieve effective immunization.

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