The Cost of Universal Free Access for Treating HIV/AIDS in Low-Income Countries: The Case of Senegal

Medical policy analysts and oncologists have cautioned against the high price of anticancer drugs. They argue that the current drug development model that relies on patents and short-term shareholder value is proving unsustainable, since the cost of the new generation of drugs puts many of them out of reach for the average consumer. The high price of cancer drugs is especially troubling in the context of middle- and low-income countries, where the burden of cancer carries disproportionate impact. To analyse the pricing of anticancer drugs, we examined legal controversies, regulatory treaties and documents, as well as the history of pricing data in India. We also conducted interviews with policy consultants and surveyed financial data filings of major global and Indian pharmaceutical corporations. Our research revealed that global trade agreements have become key barriers to lowering anticancer drug prices. This article argues that in the shadow of the World Trade Organization (WTO) and with Trans-Pacific Partnership (TPP) imminent, serious policy changes are necessary to ensure the survival of generic production in the market for anticancer drugs.

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The Economics of HIV/AIDS in Low-Income Countries: The Case for Prevention

The Journal of Economic Perspectives ◽

10.1257/jep.20.3.121 ◽

2006 ◽

Vol 20 (3) ◽

pp. 121-142 ◽

Cited By ~ 38

Author(s):

David Canning

Keyword(s):

Cost Effectiveness ◽

Low Income ◽

Low Income Countries ◽

Middle Income ◽

Middle Income Countries ◽

Treatment And Prevention ◽

Prevention And Treatment ◽

Acquired Immunodeficiency ◽

Immunodeficiency Syndrome ◽

Hiv Aids

There are two approaches to reducing the burden of sickness and death associated with the human immunodeficiency virus (HIV), which leads to acquired immunodeficiency syndrome (AIDS): treatment and prevention. Despite large international aid flows for HIV/AIDS, the needs for prevention and treatment in low- and middle-income countries outstrip the resources available. Thus, it becomes necessary to set priorities. With limited resources, should the focus of efforts to combat HIV/AIDS be on prevention or treatment? I discuss the range of prevention and treatment alternatives and examine their cost effectiveness. I consider various arguments that have been raised against the use of cost-effectiveness analysis in setting public policy priorities for the response to HIV/AIDS in developing countries. I conclude that promoting AIDS treatment using antiretrovirals in resource-constrained countries comes at a huge cost in terms of avoidable deaths that could be prevented through interventions that would substantially lower the scale of the epidemic.

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Child Maltreatment and associated Sociodemographic factors among Children affected by HIV/AIDS in Ghana: A Multi-Informant Perspective

10.21203/rs.3.rs-368841/v1 ◽

2021 ◽

Author(s):

Paul Narh Doku

Keyword(s):

Child Maltreatment ◽

Low Income ◽

Sociodemographic Factors ◽

Low Income Countries ◽

Health Concern ◽

Vulnerable Children ◽

Cross Sectional ◽

Orphans And Vulnerable Children ◽

Systemic Risks ◽

Hiv Aids

Abstract Background: Child maltreatment and its consequences are considered a major public health concern among children because they can cause significant physical and psychological problems. Child maltreatment is widespread but often underestimated. Surprisingly, there is hardly any data on the frequency of child maltreatment in general and particularly on orphans and vulnerable children in low-income countries. Method: This study employed cross-sectional, quantitative survey that involved 291 children aged 10–17 years in Lower Manya Krobo District, Ghana and examined their exposure to and experience of child maltreatment. The survey also examined parents/caregivers’ exposure and perpetuation of child maltreatment. Results: Some form of maltreatment within the household was reported by approximately 90% of children, and it was significantly higher among orphans and vulnerable children (OVC) as compared with comparison children. Children living with HIV/AIDS-infected parents and orphans of any type reported higher exposure to domestic violence and experienced significantly more neglect, psychological and physical abuse than the comparison children. Conclusion: The results of this survey demonstrate that maltreatment among children affected by HIV/AIDS are not rare, and that the dysfunction family conditions that they find themselves bear systemic risks for maltreatment. It is important that culturally appropriate and evidence-based interventions are implemented to address the maltreatment.

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Is physiotherapy an underused approach to prevent surgery in selective musculoskeletal disorders?

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v20i2.51557 ◽

2021 ◽

Vol 20 (2) ◽

pp. 409-413

Author(s):

Junaid Amin ◽

Sameer Gohir ◽

Umer Qaiser ◽

Ammar A Siddiqui ◽

Freah Alshammary ◽

...

Keyword(s):

Cost Effectiveness ◽

Musculoskeletal Disorders ◽

Low Income ◽

Medical Science ◽

Low Income Countries ◽

Long Term Outcomes ◽

Physiotherapy Intervention ◽

Musculoskeletal Problems ◽

The Cost

Objectives: The purpose of the literature review was to appraise the evidence that an early physiotherapy intervention helps to prevent the surgery in selective musculoskeletal disorders. A search of Google Scholar, Web of Science, Scopus, and PubMed was carried out utilizing the terms (“physiotherapy”, “surgery” OR “exercise, surgery” OR “rehabilitation”, “surgery”). Methods: The article titles and abstracts were screened for eligibility and included in the review. The recent literature evidently emphasized that physiotherapy has opted in selective musculoskeletal problems to avoid and delay surgeries. Results: Regardless of recommended conservative treatment option and effectiveness of physiotherapy, a massive gap can be observed between its evidence and practice. Conversely, overuse of diagnostic imaging, surgeries, and medications is present in clinical practice. In most of the clinical problems the long-term outcomes were reported the same with surgical and physiotherapy intervention. Likewise, patients can also get the advantage of better clinical outcome and cost-effectiveness with physiotherapy as compared to surgical intervention. Conclusion: The cost-effectiveness is an important factor in low-income countries where economic aspects of health care are highly considered. These advantages of physiotherapy should be considered by the clinicians, policymakers, patients, and included in the clinical guidelines. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.409-413

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The development of a nano-sized eggshell and titanium dioxide desensitising paste to re-mineralise teeth

10.51415/10321/3720 ◽

2019 ◽

Author(s):

◽

Stanley Chibuzor Onwubu

Keyword(s):

Calcium Carbonate ◽

Low Income ◽

Logistic Equation ◽

Low Income Countries ◽

Hydrated Silica ◽

Dentin Tubule ◽

The Cost ◽

Bovine Enamel ◽

New Evidence

in). Manuscript I established that as the brushing days increase the remineralisation or dentin tubule occluded by each respective desensitising agent improved. It was found that the occluding capabilities of EB@TiO2 were more superior to both Pro-argin and NovaMin products in both saliva and without saliva. Manuscript II described the use of the logistic equation to predict the remineralisation of the EB@TiO2. Manuscript II established that the logistic equation effectively predicted the remineralisation trends of EB@TiO2 and Pro-argin toothpaste (Colgate Pro-relief). Manuscript III assesses the abrasivity of EB@TiO2 in comparison with calcium carbonate, and hydrated silica containing toothpaste. Bovine enamel specimen was used for the in vitro experiment. Manuscript III established that enamel loss from the brushed surface, regardless of the sample group, were statistically different when compared to the covered surface. The study found that the abrasivity of EB@TiO2 were comparable with the calcium carbonate toothpaste. It was also established that EB@TiO2 was less abrasive when compared against hydrated silica containing toothpaste. In conclusion, the experimental finding has exhaustively provided evidence on the suitability of EB@TiO2 as an active ingredient in toothpaste formulation. The study, therefore, provides new evidence and approach for the management of DH, particularly in low-income countries where the cost of oral healthcare may be too high.

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From printing to Scielo and Pubmed Central

Colombia Medica ◽

10.25100/cm.v45i1.1552 ◽

2014 ◽

pp. 5-6 ◽

Cited By ~ 2

Author(s):

Luis Eduardo Bravo

Keyword(s):

Low Income ◽

Low Income Countries ◽

Multidisciplinary Teams ◽

Free Access ◽

Research Activity ◽

Digital Repository ◽

Pubmed Central ◽

The Us ◽

Academic Communication ◽

The Impact

The first issue of Philosophical Transactions from the Royal Society published in 1665 is widely regarded as the beginning of modern academic communication through journal articles. This form of presentation was an alternative to books for facilitating the exchange of ideas among scholarly circles. Soon journal collections and scientific libraries were created and eventually an evaluation of the quality of research activity was sought through noting the impact of their publications1. With guidance from the National University of Colombia and support from Scielo Brazil, in 2013 the standards of the US-NLM were implemented and technical endorsement by Pubmed Central was attained. Colombia Médica´s retention over time is guaranteed by the US-NLM; as of 2014 it will become part of PubMed Central, the free digital archive of biomedical and biological sciences of the U.S. National Institute of Health, which is considered to be the most important digital library in the world. The guidance of the journals by multidisciplinary teams, the policy of free access to its contents, and the technological transfer with the use of free software will help the journals of middle and low-income countries to overcome barriers to diffusion and to maintain technological independence from commercial publishers. Colombia Médica makes an impassioned plea to WHO/PAHO to support BIREME, Brazil and convert SciELO into a certified digital repository.

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A review on Development and Characterization of a Cost-Effective Targeted Quality-Driven Antimalarial Product with an Emphasis on Phytosomes

Current Drug Targets ◽

10.2174/1389450122666210204203132 ◽

2021 ◽

Vol 22 ◽

Author(s):

E. Bhargav ◽

Y. Padmanabha Reddy ◽

K.B. Koteshwara

Keyword(s):

Low Income ◽

Cost Effective ◽

Low Income Countries ◽

Development Of Resistance ◽

Infected Rbcs ◽

Resistant Strains ◽

The One ◽

The Cost ◽

Neural Network Technology

Abstract : Malaria, a protozoan disease led to numerous deaths and several new million cases raised due to the development of resistance as per the WHO malaria report 2019. This can be overcome by the development of an effective targeted plant-based delivery system through phytosomes that are effective in permeation and bioavailability to treat infected RBCs (parasitic cells). This review article explained the development of targeted Nanophytosomes to overcome resistance, to improve efficacy. This review paper also emphasized various quality-driven developmental approaches in developing an antimalarial product at a reasonable cost. By implementing molecular modeling techniques in development, a significant phytoconstituent with the capability of acting at the target (receptor or enzymes) of the parasite and the one with the capability to overcome drug resistance against resistant strains of parasites can be identified. Absorption Distribution Metabolism Excretion and Toxicity (ADMET) studies information provide a route to the design and formulation of a potent antimalarial agent. Efficient targeted Nanophytosomal formulations can be formulated by functionalizing or conjugating with suitable targets to direct the phytoconstituent to the infected RBCs thereby achieving complete parasitic eradication. Artificial Neural Network technology (ANN), Quality by Design (QbD), molecular dynamics, and simulation studies implementation improves quality and reduces the cost of the product, as these malarial products are much utilized in low-income countries. Hence it can be concluded that targeted developmental quality-driven approaches implementation is essential for effective malarial treatment.

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Prevention and Treatment of Doxorubicin-Induced Cardiotoxicity by Dexrazoxane and Schisandrin B in Rabbits

International Journal of Toxicology ◽

10.1177/1091581811415873 ◽

2011 ◽

Vol 30 (6) ◽

pp. 681-689 ◽

Cited By ~ 3

Author(s):

Feifei Che ◽

Yu Liu ◽

Caigang Xu

Keyword(s):

Low Income ◽

Troponin I ◽

Low Cost ◽

Serum Levels ◽

Low Income Countries ◽

Schisandrin B ◽

Protective Effects ◽

Alternative Drug ◽

Echocardiographic Parameters ◽

The Cost

The cost of dexrazoxane, a drug used to provide protection from doxorubicin-induced cardiotoxicity, limits its use in low-income countries. We aimed to see whether schisandrin B, an inexpensive drug, could provide protection equivalent to that provided by dexrazoxane. New Zealand white rabbits were randomly divided into groups and treated with saline, doxorubicin, doxorubicin + dexrazoxane, or doxorubicin + schisandrin B. Doxorubicin-induced damage and the protective effects were studied by recording the echocardiographic parameters and serum levels of superoxide dismutase, malondialdehyde, cardiac troponin I, and brain natriuretic peptide and observing the histology and degree of apoptosis. Schisandrin B had dose-dependent effects in decreasing the magnitude of doxorubicin-induced indicators of cardiomyopathy to a degree that approximated the decrease produced by dexrazoxane treatment. Schisandrin B might be a useful, low-cost alternative drug for this application.

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Evaluation of Head Computed Tomography Assessment of Brain Swelling after Acute Traumatic Brain Injury: A Pilot study

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0039-1698785 ◽

2019 ◽

Vol 38 (04) ◽

pp. 257-262

Author(s):

Robson Luis Amorim ◽

Barbara Albuquerque Morais ◽

Francisco Otávio Camargo Pereira ◽

Matheus Fernandes Oliveira ◽

Almir Ferreira Andrade ◽

...

Keyword(s):

Computed Tomography ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Low Income ◽

Interobserver Reliability ◽

Tertiary Hospital ◽

Low Income Countries ◽

Brain Swelling ◽

Good Reliability ◽

The Cost

Abstract Objective To evaluate the interobserver reliability of a new scale created for quantitatively assessing brain swelling in traumatic brain injury (TBI) patients using the computed tomography (CT) findings in three levels. Methods Computed tomography scans of severe head injury patients were randomly selected from a tertiary hospital image database and evaluated by independent groups of neurosurgeons, neurosurgery residents, radiologists, and intensivists from the same hospital. Each specialist assessed the tomographic findings, applying zero to six points in a new scale. The Kappa coefficient was calculated to assess interobserver agreement. Results The highest reliability coefficient was obtained by the neurosurgeons group (0.791; 95% confidence interval [CI]: 0.975–0.607; p < 0.001), followed by the neurosurgery residents group (0.402; 95%CI: 0.569–0.236; p < 0.001) and by the radiologists group (0.301; 95%CI: 0.488–0.113; p < 0.002). The lowest coefficient was found among the intensivists (0.248; 95%CI: 0.415–0.081; p = 0.004). Conclusion The proposed scale showed good reliability among neurosurgeons, and moderate overall reliability. This tomographic classification might be useful to better assist severe TBI victims, allowing to identify the worsening or amelioration of brain swelling, which should be further investigated. The scale seems to be feasible, even in low income countries, where the cost of intracranial pressure (ICP) monitoring is higher than that of CTs.

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