Anderson, S., Huss, R., Summers, R., Wiedenmayer, K.
2004, XIV, 232 p.
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"One third of the world's population lack effective access to quality assured essential medicines used rationally". When WHO first made this statement fifteen years ago, there was general concern that medical miracles such as antibiotics, antiparasitic medicines, vaccines and anal gesics would not be available to many people. Today, the proportion of those lack ing access is lower in Asia and Latin America and higher in Africa but there are probably about two billion people in this situation. This book describes the many problems involved, and then puts together possible solutions based on country expe riences in a comprehensive and coherent manner. Many people lack access to essential medicines because they and their countries are poor, and because of inefficiencies in their health systems. We know that in low and middle income countries between 25 and 40 per cent of health expenditure is on medicines, and that most of that expenditure is out of pocket. Often this amounts to less than US $ 2 per head per year! In contrast, high income countries spend only 8 to 15 per cent of health expenditure on medicines, and this is mostly paid for by health insurance or social security funds. High income country expen diture may be over US $ 400 per person per year! So managing the scanty resources available in low income countries becomes all the more important.
Content Level »Research
Keywords »Europe - International Health - Pharmaceutical Policy - Public Health - World Health Organization - assessment
1 Issues in the Management of Pharmaceuticals in International Health.- 1.1 Introduction.- 1.2 Pharmaceuticals, medicines and drugs.- 1.3 International health.- 1.4 The emergence of medicines.- 1.5 Global inequity and the medicines life cycle.- 1.6 The study of pharmaceuticals in international health.- 1.7 Approaches to managing pharmaceuticals.- 1.8 Layout of the book.- 1.9 Conclusion.- 2 Access and Availability of Pharmaceuticals in International Health.- 2.1 Introduction.- 2.2 Access to essential medicines.- 2.3 Neglected diseases.- 2.4 Strategies for developing medicines and ensuring access.- 2.5 Conclusion.- 3 Assessing the Pharmaceutical Needs of Patients and Populations.- 3.1 Introduction.- 3.2 Public health pharmacology.- 3.3 Incidence of disease.- 3.4 Needs and priorities for medicines.- 3.5 Culture and the use of medicines.- 3.6 Patients as consumers.- 3.7 Compliance, adherence and concordance.- 3.8 Empowerment.- 3.9 Conclusion.- 4 The Role of Health Professionals.- 4.1 Introduction.- 4.2 Classifying health professionals.- 4.3 Health professionals and medicine responsibilities.- 4.4 The role of the doctor.- 4.5 The role of the pharmacist.- 4.6 Traditional healers.- 4.7 Integrating traditional medicine and Western medicine.- 4.8 Conclusion.- 5 The Role of the Pharmaceutical Industry.- 5.1 Introduction.- 5.2 The origins and development of the pharmaceutical industry.- 5.3 Structure of the industry today.- 5.4 Pharmaceutical company partners.- 5.5 The activities of the industry.- 5.6 Pharmaceutical markets.- 5.7 The pharmaceutical industry and international health.- 5.8 Conclusion.- 6 The Role of Governments.- 6.1 Introduction.- 6.2 The development of national drug policies.- 6.3 The drug supply process.- 6.4 Health systems that support drug supply.- 6.5 Pharmaceutical legislation and regulation.- 6.6 Research, monitoring and evaluation.- 6.7 Conclusion.- 7 The Role of the European Union, National Assistance Agencies and NGOs.- 7.1 Introduction.- 7.2 The European Union.- 7.3 The national aid agencies.- 7.4 International and national NGOs.- 7.5 Some non-governmental organizations.- 7.6 Equitable pharmaceutical supply and distribution.- 7.7 Conclusion.- 8 The Role of International Organizations.- 8.1 Introduction.- 8.2 WHO and other UN organizations.- 8.3 Industry organizations.- 8.4 Other organizations.- 8.5 Essential drugs.- 8.6 Pharmaceutical procurement.- 8.7 International agreements and intellectual property rights.- 8.8 Case study-HIV/AIDS and antiretroviral treatment in South Africa.- 8.9 Conclusion.- 9 Rational Use of Medicines.- 9.1 Introduction.- 9.2 Consequences of non-rational medicine use.- 9.3 Medicine use behaviour.- 9.4 Investigating medicine use problems.- 9.5 Medicine use interventions.- 9.6 Effectiveness of interventions.- 9.7 Conclusion.- 10 Medicine Quality, Adverse Reactions and Antimicrobial Resistance.- 10.1 Introduction.- 10.2 Quality of medicines.- 10.3 Counterfeit medicines.- 10.4 Adverse drug reactions.- 10.5 Antimicrobial resistance.- 10.6 Conclusion.- 11 Managing Medicines Information.- 11.1 Introduction.- 11.2 The users of medicine information.- 11.3 Sources of information.- 11.4 The quality of medicines information.- 11.5 The assessment of information.- 11.6 Classification systems.- 11.7 Conclusion.- 12 Investigating the Use of Medicines.- 12.1 Introduction.- 12.2 Drug utilization studies.- 12.3 Pharmacoeconomics.- 12.4 Pharmacovigilance.- 12.5 Pharmacoepidemiology.- 12.6 Health systems and policy studies.- 12.7 Conclusion.- 13 Trends and Developments.- 13.1 Introduction.- 13.2 Trends in the use of herbal remedies.- 13.3 The contribution of pharmacogenetics and pharmacogenomics.- 13.4 The changing role of the internet.- 13.5 Changes in the health care workforce.- 13.6 Conclusion.- 14 Policy Initiatives and their Implications.- 14.1 Introduction.- 14.2 The role of public-private partnerships.- 14.3 The Global Fund and other initiatives.- 14.4 Global procurement of medicines.- 14.5 AIDS drugs post Doha.- 14.6 Conclusion.- Selected Websites and Webportals.