Pharmacy Education: What Matters in Learning and Teaching by Lynne Sylvia and Judith Barr is an essential resource for any pharmacy faculty member. More than a narration of the philosophical aspects of teaching and personal perspectives on life as a faculty member, it explores ‘what matters”, “why it matters”, and “how to apply” the matter to teaching, learning, and assessment in pharmacy education.
A Practical Approach to Pharmaceutical Policy, by: Andreas Seiter
Pharmaceuticals are an essential component of health care. But for many people in low- and middle-income countries, access to the medicines they need to prevent or treat severe illnesses is limited. Typical problems are lack of availability, costs that exceed the individual’s purchasing power or lack of competent “agents” – health workers that are well trained to give the correct advice on which medicines to take.
Access to care and medicines, burden of health care expenditures, and risk protection: Results from the World Health Survey
Anita K. Wagner, Amy Johnson Gravesa, Sheila K. Reissa, Robert LeCatesa, Fang Zhanga and Dennis Ross-Degnan
Objectives: We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden.
Methods: We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries.
Results: Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13–32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden.
Conclusion: To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems.
Health Policy, Article in Press, Available online 9 September 2010.
Does personality determine socioeconomic status and therefore health inequalities? The comments by Johan Mackenbach suggests that it does but it rests on the thought that personality is a genetic phenomena and therefore fairly stable and predictable. But personality is also a product of circumstance, time, social interactions, resources, and social institutions. Personality is socially constructed and it responds to the reality created by a mix of factors. This would mean that personality changes are these factors change but such change is slow in the context of a fairly stable arrangement of factors. How society arranges these factors causes health disparities and not only personality as the article suggests. Moreover, how personal are “personal characteristics” such as gender, race, age, etc? Not much, given that personality is influenced by social forces. Gender is an objective attribute of an individual but this attribute does not explain the normative attribute of gender, that is, the part of gender created by society and not under the control of the individual. The same applies to personality, and it’s questionable to refer to personality as a personal characteristic.
New trends in health inequalities research: now it’s personal, by: Johan Mackenbach
The Lancet, Volume 376, Issue 9744, 11 September 2010-17 September 2010, Pages 854-855
As biotech companies in emerging markets move from imitation to innovation, they will reach a decision point – focus on local health demands or develop medicines for industrialized countries with larger markets. The authors suggest that biotech companies can meet both demands through an entrepreneurial model. However. the logic of the entrepreneurial model is such that it drifts to markets with significant demand particularly where this is coupled to a population with disposable income. How do we ensure biotech companies in emerging markets continue focusing on local population needs? Given the logic of the entrepreneurial model, it would mean growing the economies of developing countries and the size of the medicine market. It would also require ensuring that economic growth is broadly shared and that poverty reduction and lifestyle improvement initiatives succeed. Through this disposal income and local demand will grow to support local biotech companies and enable their ongoing focus on local demands. Improving medicine access through the logic of the entrepreneurial model is inevitably a long-term pursuit. It depends on economic growth and market size to incentivize local biotech companies. In the interim, there are other avenues to improving access such as supply chain interventions, improving financing mechanisms, and restructuring the regulatory environment.
Global health or global wealth? by: Rahim Rezaie and Peter A Singer
Thieves that divert medicines from government stores prevent many thousands of patients from receiving care. The article below suggests that thieves are also calculating in that they only steal medicines nearing their expiration date. Such thoughtful thefts are great stock controllers but why would they loot government stores of near-expired medicines? If the purpose of the act is to resell medicines then “fresh” medicines would fetch a better price than those nearing expiration? It just does not make sense, does it? The article also suggests that stolen medicines are transported by ship from East African ports to West Africa. From Dar Es Salaam to Lagos is 5035 nautical miles around the tip of southern Africa and a vessel travelling at 14 knots would take 15 days. That’s a 15 day reduction in the life of the medicine and many medicines are sure to be expired by the time they reach Lagos. If expired medicines are landing on the shores of Nigeria why are officials not blocking their entry? The answer is multifaceted and it suggests that the networks coordinating such activities are trans-African and that they are protected and facilitated by strategically positioned and influential individuals. The answer is also linked to the lack of donor organization oversight of medicines purchased for patients in developing countries which is partly a function of what is being measured. That which is measured is known and that which is known is monitored. We’re always happy to know that an additional million dollars of life-saving medicines was purchased and supplied to a certain country. We measure the success based on the “additional million dollars” spent, issue press releases, and stop. Seldom do we hear something like this, an additional million dollars of medicines was bought AND consumed by the targeted patients. This second portion is far more difficult and is a significant gap in what we measure and how we monitor donor organization activities in developing countries. Plug this gap with systems to improve accountability and ensure target groups are reached and we’ll be well on our way to reducing the effectiveness of medicine thefts and their strategically positioned and influential facilitators.
