scholarly journals Ethical Dilemmas Associated With Profit-Driven Research in Developing Countries

2019 ◽  
Vol 5 (1) ◽  
pp. 22-35
Author(s):  
EVangel Sarwar
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Ethical Issues ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Personnel ◽  
Research Subjects ◽  
Double Standards ◽  
Ethical Decisions ◽  
Set Up

The phenomenal growth of the global pharmaceutical sales, which exceeded $US one trillion in revenues in 2014 alone, has resulted in the growing ethical concerns associated with the need for the unprecedented search for human test subjects to participate in clinical drug trials - particularly in middle and low-income countries – and concerns about possible exploitation. While this expansion has provided access to vital medical resources that would have otherwise been unattainable for this population - this outsourcing also created problems which may be termed as exploitation – such as faulty trials at times, and manipulation of data about the benefits and risks of the drugs being tested on the populations in developing countries. Although the United States and European countries have sponsored much biomedical research in developing countries, they considered their work done once the trials concluded, and this has been criticized and termed as “safari research,” – which is a form of exploitation of developing countries and their populations from which research subjects are recruited. These trials do not address the needs of the developing countries and contribute to the exploitation of some of the most “vulnerable” populations. It is unethical to enter a country, set up facilities for research then leave with the healthcare personnel and equipment after giving hope to its people of some form of benefit. Several historical events have led to the awareness of the need for protecting research subjects. There is a need for a better understanding of what constitutes as exploitations, to ensure researchers make ethical decisions with planning and implementation of research involving research participants. The paper looks at the ethical issues and their importance in international research, and the double standards that are of growing concern in profit-driven research in low-income countries by developed sponsor countries, while also making recommendations for preventing exploitations.

scholarly journals The Rotavirus Vaccine Landscape, an Update

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 520
Author(s):  
Roberto Cárcamo-Calvo ◽  
Carlos Muñoz ◽  
Javier Buesa ◽  
Jesús Rodríguez-Díaz ◽  
Roberto Gozalbo-Rovira
Keyword(s):  
Developing Countries ◽  
Mortality Rate ◽  
Low Income ◽  
State Of The Art ◽  
The State ◽  
Cold Chain ◽  
Low Income Countries ◽  
Rotavirus Vaccine ◽  
Oral Vaccines

Rotavirus is the leading cause of severe acute childhood gastroenteritis, responsible for more than 128,500 deaths per year, mainly in low-income countries. Although the mortality rate has dropped significantly since the introduction of the first vaccines around 2006, an estimated 83,158 deaths are still preventable. The two main vaccines currently deployed, Rotarix and RotaTeq, both live oral vaccines, have been shown to be less effective in developing countries. In addition, they have been associated with a slight risk of intussusception, and the need for cold chain maintenance limits the accessibility of these vaccines to certain areas, leaving 65% of children worldwide unvaccinated and therefore unprotected. Against this backdrop, here we review the main vaccines under development and the state of the art on potential alternatives.

scholarly journals Why Do Developing Countries Tax So Little?

2014 ◽  
Vol 28 (4) ◽  
pp. 99-120 ◽  
Author(s):  
Timothy Besley ◽  
Torsten Persson
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
News Media ◽  
Weak Sense ◽  
Cultural Factors ◽  
Low Income Countries ◽  
Tax Revenue ◽  
Weak Institutions ◽  
Social And Cultural Factors ◽  
A Share

Low-income countries typically collect taxes of between 10 to 20 percent of GDP while the average for high-income countries is more like 40 percent. In order to understand taxation, economic development, and the relationships between them, we need to think about the forces that drive the development process. Poor countries are poor for certain reasons, and these reasons can also help to explain their weakness in raising tax revenue. We begin by laying out some basic relationships regarding how tax revenue as a share of GDP varies with per capita income and with the breadth of a country's tax base. We sketch a baseline model of what determines a country's tax revenue as a share of GDP. We then turn to our primary focus: why do developing countries tax so little? We begin with factors related to the economic structure of these economies. But we argue that there is also an important role for political factors, such as weak institutions, fragmented polities, and a lack of transparency due to weak news media. Moreover, sociological and cultural factors—such as a weak sense of national identity and a poor norm for compliance—may stifle the collection of tax revenue. In each case, we suggest the need for a dynamic approach that encompasses the two-way interactions between these political, social, and cultural factors and the economy.

scholarly journals Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries

2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Undergraduate Students ◽  
Low Income ◽  
Access To Health Care ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Needs ◽  
Care System

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

Application of high-throughput serological tests for controlling zoonotic viral infection in Amazon rainforest and as a strategy to prevent future pandemics (Preprint)

2021 ◽  
Author(s):  
Marcela Santiago Pacheco De Azevedo ◽  
Daniela Gomes Ribeiro ◽  
Felipe Rocha Da Silva Santos ◽  
Siomar De Castro Soares ◽  
Vasco Ariston De Carvalho Azevedo ◽  
...  
Keyword(s):  
Developing Countries ◽  
High Throughput ◽  
Low Income ◽  
Dna Sequences ◽  
Scientific Information ◽  
Preventive Health Care ◽  
Amazon Rainforest ◽  
Low Income Countries ◽  
Sequencing Data ◽  
Serological Tests

UNSTRUCTURED From the bubonic plague on the 14th century to the new Coronavirus disease 2019 (COVID-19), pandemics have profoundly changed societies function. Infectious disease outbreaks are getting shorter and shorter due to our densely populated cities, global travel, and nature mass exploration. In this regard, there is a particular concern about fires occurring in Brazil's Amazon rainforest, one of the most biodiverse places on earth that facilitates cross-species transmission giving rise to the emergency of new virulent pathogens. Situation is further complicated because Amazon spans across eight developing countries with limited preventive health care services. In this perspective, this review highlights the role of new methodologies best suited for epidemiological monitoring in low-income countries, such as high-throughput serological tests. Phage immunoprecipitation sequencing (Phip-Seq), for example, can evaluate antibody-repertoire binding specificities using oligonucleotides libraries encoding epitopes covering the DNA sequences from all human pathogenic viruses or all Arboviruses already described. After incubation with an individual's serum, these libraries can be immunoprecipitated for subsequent analysis by DNA sequencing. Data are analyzed revealing peptides recognized by the antibodies present in the sample. Being a technique at a relatively low cost, its implementation in developing countries is feasible and can generate very interesting scientific information.

INTERNATIONAL DEVELOPMENT ISSUES

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 395-395
Author(s):  
Keyword(s):  
International Development ◽  
Low Income ◽  
Development Aid ◽  
Military Expenditure ◽  
World Health ◽  
Low Income Countries ◽  
River Blindness ◽  
Eradication Programme ◽  
Set Up ◽  
Health Organization

The annual military bill is now approaching 450 billion US dollars, while official development aid accounts for less than 5 per cent of this figure. Four examples: 1. The military expenditure of only half a day would suffice to finance the whole malaria eradication programme of the World Health Organization, and less would be needed to conquer river-blindness, which is still the scourge of millions. 2. A modern tank costs about one million dollars; that amount could improve storage facilities for 100,000 tons of rice and thus save 4000 tons or more annually; one person can live on just over a pound of rice a day. The same sum of money could provide 1000 classrooms for 30,000 children. 3. For the price of one jet fighter (20 million dollars) one could set up about 40,000 village pharmacies. 4. One-half of one per cent of one year's world military expenditure would pay for all the farm equipment needed to increase food production and approach self-sufficiency in food-deficit low-income countries by 1990.

A Systems Approach for Sustainably Reducing Childhood Diarrheal Deaths in Developing Countries

2016 ◽  
pp. 1208-1227
Author(s):  
Monica Gray
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Systems Approach ◽  
Developed Countries ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Crisis ◽  
Industrialized Nations ◽  
Sub Saharan

Diarrhea is the second leading cause of death and is the major cause of malnutrition in children under age 5 worldwide. More than 50 percent of the cases occur in developing countries, particularly in sub-Saharan Africa and Southeast Asia. Open defecation, substandard fecal disposal systems, and contaminated water supplies are the typical causes of diarrheal diseases. This public health crisis in low income countries mirrors the experiences of today's industrialized nations two centuries ago. The lessons learned from their sanitary evolution can be instructive in charting a sustainable path towards saving the lives of almost 2 million children annually. In this chapter a case study of Cuba's sanitary reformation is also presented to showcase successes, similar to those of developed countries, within a developing country and economically challenging context.

scholarly journals Hypertensive Urgency in Tanzanian Adults: A 1-Year Prospective Study

2020 ◽  
Author(s):  
Karl G Reis ◽  
Raymond Wilson ◽  
Fredrick Kalokola ◽  
Bahati Wajanga ◽  
Myung-Hee Lee ◽  
...  
Keyword(s):  
Medication Adherence ◽  
High Risk ◽  
Prospective Study ◽  
Low Income ◽  
Hypertensive Crisis ◽  
The United States ◽  
Low Income Countries ◽  
Improve Medication Adherence ◽  
Hypertensive Urgency ◽  
Poor Outcomes

Abstract BACKGROUND Hypertensive urgency is associated with a high risk for cardiovascular events and mortality in the United States and Europe, but data from low-income countries and interventions to improve outcomes are lacking. METHODS We conducted a 1-year prospective study of the prevalence and outcomes of hypertensive urgency (blood pressure (BP) ≥180 mm Hg/120 mm Hg without end-organ damage) in a busy outpatient clinic in Tanzania. RESULTS Of 7,600 consecutive adult outpatients screened with 3 unattended automated BP measurements according to standard protocol, the prevalence of hypertensive crisis was 199/7,600 (2.6%) (BP ≥180 mm Hg/120 mm Hg) and the prevalence of hypertensive urgency was 164/7,600 (2.2%). Among 150 enrolled patients with hypertensive urgency, median age was 62 years (54–68), 101 (67.3%) were women, and 53 (35%) were either hospitalized or died within 1 year. In a multivariate model, the strongest predictor of hospitalization/death was self-reported medication adherence on a 3 question scale (hazard ratio: 0.06, P &lt; 0.001); 90% of participants with poor adherence were hospitalized or died within 1 year. CONCLUSIONS Patients with hypertensive urgency in Africa are at high risk of poor outcomes. Clinicians can identify the patients at highest risk for poor outcomes with simple questions related treatment adherence. New interventions are needed to improve medication adherence in patients with hypertensive urgency.

scholarly journals Evaluating farm-level livestock interventions in low-income countries: a scoping review of what works, how, and why

2020 ◽  
pp. 1-14
Author(s):  
Johanna F. Lindahl ◽  
Florence Mutua ◽  
Delia Grace
Keyword(s):  
Developing Countries ◽  
Scoping Review ◽  
Low Income ◽  
Controlled Trial ◽  
Animal Health ◽  
Well Being ◽  
Good Evidence ◽  
Low Income Countries ◽  
Livestock Products ◽  
Development Outcomes

Abstract Livestock interventions can improve nutrition, health, and economic well-being of communities. The objectives of this review were to identify and characterize livestock interventions in developing countries and to assess their effectiveness in achieving development outcomes. A scoping review, guided by a search strategy, was conducted. Papers needed to be written in English, published in peer-reviewed journals, and describe interventions in animal health and production. Out of 2739 publications systematically screened at the title, abstract, and full publication levels, 70 met our inclusion criteria and were considered in the study. Eight relatively high-quality papers were identified and added, resulting in 78 reviewed publications. Only 15 studies used randomized controlled trial designs making it possible to confidently link interventions with the resulting outcomes. Eight studies had human nutrition or health as outcomes, 11 focused on disease control, and four were on livestock production. Eight interventions were considered successful, but only four were scalable. We found good evidence that livestock-transfer programs, leveraging livestock products for nutrition, and helping farmers manage priority diseases, can improve human well-being. Our report highlights challenges in garnering evidence for livestock interventions in developing countries and provides suggestions on how to improve the quantity and quality of future evaluations.

Immigration and Contract Problems Experienced by Foreign-Educated Nurses

2012 ◽  
Vol 69 (3) ◽  
pp. 351-365 ◽  
Author(s):  
Patricia Pittman ◽  
Carolina Herrera ◽  
Joanne Spetz ◽  
Catherine R. Davis
Keyword(s):  
United States ◽  
Health Care ◽  
Low Income ◽  
The United States ◽  
Low Income Countries ◽  
Labor Rights ◽  
Care Practice ◽  
Quality Health Care ◽  
International Recruitment ◽  
The Impact

More than 8% of employed RNs licensed since 2004 in the United States were educated overseas, yet little is known about the conditions of their recruitment or the impact of that experience on health care practice. This study assessed whether the labor rights of foreign-educated nurses were at risk during the latest period of high international recruitment: 2003 to 2007. Using consensus-based standards contained in the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Health Professionals to the United States, this study found 50% of actively recruited foreign-educated nurses experienced a negative recruitment practice. The study also found that nurses educated in low-income countries and nurses with high contract breach fees, were significantly more likely to report such problems. If, as experts believe may occur, the nursing shortage in the United States returns around 2014, oversight of international recruitment will become critically important to delivering high-quality health care to Americans.

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