Your search found 32 Results

  1. 1

    Global health and the new bottom billion. What do shifts in global poverty and the Global Disease Burden mean for GAVI and the Global Fund?

    Glassman A; Duran D; Sumner A

    Washington, D.C., Center for Global Development, 2011 Oct. [37] p. (Center for Global Development Working Paper No. 270)

    After a decade of rapid growth in average incomes, many countries have attained middle-income country (MIC) status. At the same time, the total number of poor people hasn’t fallen as much as one might expect and, as a result, most of the world’s poor now live in MICs. In fact, there are up to a billion poor people or a ‘new bottom billion’ living not in the world’s poorest countries but in MICs. Not only has the global distribution of poverty shifted to MICs, so has the global disease burden. This paper examines the implications of this ‘new bottom billion’ for global health efforts and recommends a tailored middle-income strategy for the Global Fund and GAVI. The paper describes trends in the global distribution of poverty, preventable infectious diseases, and health aid response to date; revisits the rationale for health aid through agencies like GAVI and the Global Fund; and proposes a new MIC strategy and components, concluding with recommendations.
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  2. 2
    Peer Reviewed

    Changing global essential medicines norms to improve access to AIDS treatment: lessons from Brazil.

    Nunn A; Fonseca ED; Gruskin S

    Global Public Health. 2009; 4(2):131-49.

    Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today.
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  3. 3

    Contraceptive procurement policies, practices, and options. Paraguay.

    Quesada N; Dayaratna V; Abramson W; Gribble J; Siman Betancourt V

    Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov. [25] p. (USAID Contract No. HRN-C-00-00-00010-00)

    In light of the phaseout of donor funds for family planning in Latin America and the Caribbean, Paraguay will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The Government of Paraguay will need to look at regional and international procurement opportunities to ensure that contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of different procurement options to identify efficient, economical, high quality and timely distribution of contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
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  4. 4

    Contraceptive procurement policies, practices, and options. Nicaragua.

    Agudelo J; Morales C; Quesada N; Sarley D; Abramson W

    Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov. [25] p. (USAID Contract No. HRN-C-00-00-00010-00)

    In light of the phaseout of donor funds in Latin America and the Caribbean, Nicaragua will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The Government of Nicaragua needs to look at regional and international procurement opportunities to ensure that contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of various procurement options to identify efficient, economical, and timely distribution of high-quality contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
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  5. 5

    Contraceptive procurement policies, practices, and options. Dominican Republic.

    Agudelo J; Dayaratna V; Morales C; Quesada N; Sarley D

    Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov. [26] p. (USAID Contract No. HRN-C-00-00-00010-00)

    In light of the phaseout of donor funds in Latin America and the Caribbean, the Dominican Republic will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The government of the Dominican Republic needs to look at regional and international procurement opportunities to ensure that contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of various procurement options to identify efficient, economical, and timely distribution of high-quality contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
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  6. 6

    Contraceptive procurement policies, practices, and options. Bolivia.

    Quesada N; Abramson W; Siman Betancourt V; Dayaratna V; Gribble J

    Arlington, Virginia, John Snow [JSI], DELIVER, 2006 Nov. [30] p. (USAID Contract No. HRN-C-00-00-00010-00)

    In light of the phaseout of donor funds in Latin America and the Caribbean, Bolivia will be facing increasing responsibility to finance and procure contraceptive commodities in the near future. The Government of Bolivia needs to look at regional and international procurement opportunities to ensure contraceptive security is not compromised during this transition period. This report presents findings from a legal and regulatory analysis and pricing study of various procurement options to identify efficient, economical, and timely distribution of high-quality contraceptives. A summary of the current country situation, procurement practices, laws, policies, and regulations is presented along with a comparison of regional contraceptive prices. Options and recommendations are presented for next steps. (author's)
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  7. 7

    AIDS is not a business: A study in global corporate responsibility -- securing access to low-cost HIV medications.

    Flanagan W; Whiteman G

    Journal of Business Ethics. 2007 Jun; 73(1):65-75.

    At the end of the 1990s, Brazil was faced with a potentially explosive HIV/AIDS epidemic. Through an innovative and multifaceted campaign, and despite initial resistance from multinational pharmaceutical companies, the government of Brazil was able to negotiate price reductions for HIV medications and develop local production capacity, thereby averting a public health disaster. Using interview data and document analysis, the authors show that the exercise of corporate social responsibility can be viewed in practice as a dynamic negotiation and an interaction between multiple actors. Action undertaken in terms of voluntary CSR alone may be insufficient. This finding highlights the importance of a strong role for national governments and international organizations to pressure companies to perform better. (author's)
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  8. 8

    Evaluation of the United Nations Declaration on HIV / AIDS resource targets.

    Teixeira L

    Revista de Saude Publica / Journal of Public Health. 2006 Apr; 40 Suppl:52-59.

    This study evaluates the targets of the United Nations Declaration on HIV/AIDS Resource Targets, the attainment of which are premised on promoting three fronts: reduction of material and services costs, increased efficiency in access to and management of funds, and the channeling of new funds. Data were derived from studies of National Accounts of HIV/AIDS in Latin America and the Caribbean and from the recent available literature on the global dynamics of HIV/AIDS resources. The economic concept of global public good occurs throughout the text. The article discusses factors that constrain funding, and thus compel the adoption of new strategies in Brazil. The issues addressed include: difficulties in maintaining the downward tendency in the cost of items related to the HIV/AIDS epidemic, the incorporation each year of thousands of persons needing antiviral therapy, the rise in patient survival and increased diagnosis for the control of HIV/AIDS transmission. It is concluded that, in order to guarantee additional resources to combat the epidemic, the discussion on funding must necessarily focus on both the share of AIDS support for the Brazilian Ministry of Health, and, more importantly, on an increase in health funding as a whole. The recognition that HIV/AIDS control contributes to the global public good should facilitate increases in development assistance from international funding sources. (author's)
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  9. 9

    The female condom and AIDS: UNAIDS point of view.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1997 Apr. 7 p. (UNAIDS Best Practice Collection; UNAIDS Point of View)

    A woman's equivalent of the traditional condom seems a simple idea, yet the "female condom" (worn within the vagina rather than on the penis) has been around for less than a decade. Available in an increasing number of countries around the world, it offers great promise for reducing the spread of HIV and AIDS. Cheap and reliable, the traditional condom (or male condom) is used by millions all over the world to avoid pregnancies. Until recently, it has also been the only barrier method for preventing the passing of sexually transmitted diseases (STDs), including HIV, between two sex partners. Used correctly every time people have sex, it is over 95% effective against the transmission of HIV. The fact that the condom prevents transmission of other STDs such as syphilis or gonorrhoea is of additional importance to the fight against HIV and AIDS because people who have another STD are more vulnerable to being infected by HIV. The traditional condom is not the perfect method for everyone, however. For example, many couples dislike having to interrupt sex in order for a man to put one on. Up to 8% of people are allergic to latex, the main ingredient in most condoms. And many feel that it dulls sexual pleasure. In family planning programmes, it has been proven that a wider choice of contraceptive methods results in fewer pregnancies. The same has been found in testing of the female condom: adding this new option for protected sex results in fewer cases of unprotected sex. (excerpt)
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  10. 10

    Water for thirsty cities is demand management the solution?

    Ray K

    Habitat Debate. 2000; 6(3):[4] p..

    Africa and Asia are the most rapidly urbanizing regions in the world. The city authorities in these regions are often overwhelmed by this growth and the burgeoning pressure on public services. A recent report of the United Nations Secretary General states that at the current rate of progress, providing safe water to all cannot be anticipated before 2050 in Africa and 2025 in Asia. That is still a generation away! In the meantime, those without access to public supplies — the urban poor — will continue to pay a heavy price for lack of easy access to safe water. Let us take a closer look at the situation in Africa which is the fastest urbanizing continent today. Africa’s urban population will nearly quadruple from 138 million in 1990 to 500 million by 2020. How is it managing its growing urban water demand from the competing industrial, commercial and domestic sectors? The answer is not simple. The task of the city manager is made more complex by the fact that most of the rapidly growing cities are located in water stress or water scarce regions, with diminishing per capita water availability. Several of the larger cities on the continent (Johannesburg, Dakar and Nairobi, for example), have outgrown the capacity of local sources and are forced to carry water from a distance of 200 to 600 kilometres. Others (such as Abidjan, Lusaka and Addis Ababa) are drawing deeper and deeper, often over-abstracting the ground aquifers. (excerpt)
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  11. 11

    Global AIDS treatment drive takes off. Rapid increase in number of people receiving ARV medicines.

    Fleshman M

    Africa Renewal. 2005 Apr; 19(1):[12] p..

    When a reporter first met seven-year-old Bongani in a hardscrabble shantytown near Johannesburg in 2003, it was evident the child was dying. He was too weak for school, stunted and racked by diarrhoea. There was little question that he, like his deceased parents, was infected with the human immunodeficiency virus that causes AIDS. It seemed equally certain that he would soon lie in a tiny grave next to theirs -- joining the 370,000 South Africans who died from the disease that year. But when the journalist, Mr. Martin Plaut of the BBC, returned a year later, he found a healthy, laughing Bongani poring over his lesson book. “The transformation,” Mr. Plaut wrote last December, “was remarkable.” That transformation -- and the difference between life and death for Bongani and a growing number of people living with HIV and AIDS in Africa -- has resulted from access to anti-retroviral drugs (ARVs) that attack the virus and can dramatically reduce AIDS deaths. For years high costs severely limited their use in Africa. The Joint UN Programme on HIV/AIDS (UNAIDS) estimated that only about 50,000 of the 4 million Africans in urgent need of the drugs were able to obtain them in 2002. But with prices dropping in the face of demands for treatment access and competition from generic copies of the patented medications, the politics and economics of AIDS treatment have finally begun to shift. (excerpt)
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  12. 12

    With condoms at 3 cents a unit, why can't supply meet global demand?

    Population 2005. 2004 Sep-Oct; 6(3):12.

    Notwithstanding major gains made in advancing the globally agreed upon agenda of the 1994 Cairo International Conference on Population and Development, there are today some 123 million couples in the world’s poorer countries who still lack access to contraception. Stated in more graphic terms, men in sub-Saharan Africa only have access to an average of three condoms a year— this despite the fact that the cost of condoms is just about three cents a unit. The issues behind the problem were highlighted at a number of international meetings recently, including the Washington and Wuhan Global Forums on Population and Development, held in May and September, respectively, and the September London Roundtable for Countdown 2015. (excerpt)
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  13. 13

    World Bank Task Force on Accelerating the Development of an HIV / AIDS Vaccine for Developing Countries. HIV vaccine industry study, October-December 1998. Draft.

    Batson A

    [Unpublished] 2000 Mar 20. 13 p.

    Industry’s decision to invest in the development of a vaccine is a function of the risks and uncertainty of “cracking the science” to develop a viable product and the promise of the future market and revenue stream. Although vaccines have proven to be one of the most cost-effective intervention available to control disease with measles, polio, Diphtheria-Pertussis-Tetanus, BCG and tetanus toxoid 5 vaccines preventing 3 million deaths per year in developing countries, they represent less than 2% of the total pharmaceutical market. The availability of these vaccines to the world is dependent on the capacity and pricing decisions of industry. Development of new vaccines against diseases such as HIV/AIDS, malaria and tuberculosis will also depend on the investment decisions of industry. Unfortunately, investment in the development of these high priority new vaccines is low. Understanding industry’s perception of the risks and potential returns for specific vaccines is essential for public sector agencies such as the World Bank. With this information, the Bank and other partners can work with agencies and private industry to develop new strategies which “push” the development of these priority products by reducing the cost or risk of investment or “pull” them by providing market incentives. In April 1998, the World Bank created a Bank-wide AIDS Vaccine Task Force to explore the market failure resulting in under-investment in an HIV/AIDS vaccine. The Task Force commissioned a study by Mercer Management to understand the biotechnology, vaccine and pharmaceutical industries’ perspectives on R&D investment in an HIV vaccine for developing countries. The study was conducted during the fall of 1998 and was co-funded by the International AIDS Vaccine Initiative (IAVI). (excerpt)
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  14. 14

    HIV / AIDS medicines and related supplies: contemporary context and procurement. Technical guide.

    Tayler Y; Abbott F; Perez Casas C; Fink C; Green C

    Washington, D.C., World Bank, 2004 Feb. 103 p.

    This Guide sets out principles and advice for the procurement of HIV/AIDS medicines and related supplies for programs scaling up antiretroviral therapy (ART) and associated health services, such as basic and palliative care, disease prevention, treatment of opportunistic infections, and laboratory tests. ART includes the treatment of infected adults and children and the prevention of mother-to-child transmission. A wide range of other commodities— particularly condoms and support for basic living and care—are also essential to support the treatment and prevention of HIV. The primary audience for this guide is World Bank staff and those responsible for procuring HIV/AIDS medicines and related supplies in Bank-funded programs and projects. That could include either procurement agency staff or technical agency staff. Policymakers and Bank partners will also benefit from the information and advice in the guide. (excerpt)
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  15. 15
    Peer Reviewed

    WHO insists it can meet its target for antiretrovirals by 2005.

    Fleck F

    BMJ. British Medical Journal. 2004 Jul 17; 329:129.

    A huge international effort is under way to get lifesaving antiretroviral treatment to three million people with AIDS in poor countries by the end of 2005, said the World Health Organization, but added that its six month campaign had fallen short of interim targets. In all, 400 000 AIDS patients in developing countries were receiving antiretrovirals when WHO launched its "3 by 5 strategy." That figure has edged up to 440 000, said WHO's progress report, presented at the international AIDS conference this week. "Although this was disappointing, the absolute increase of 40,000 people in a few months dose indicate that country and international efforts to scale up HIV- AIDS treatment are resulting in progress report. The progress report is likely to fuel critics of WHO's 3 by 5 campaign, who contend that it is overambitious, poorly managed, and too focused on lowering drug prices. (excerpt)
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  16. 16

    Glaxo's AZT announcement welcomed, but detail is yet to follow. mother-to-child transmission.

    Worthington H

    AIDS ANALYSIS AFRICA. 1998 Apr; 8(2):2.

    Following recently completed trials of AZT in Thailand among pregnant women which showed that a short course of AZT can significantly reduce the mother-to-child transmission of HIV, Glaxo Wellcome recently announced that it will supply the antiretroviral drug AZT at a preferential price for pregnant women infected with HIV in developing countries. Since the size of the HIV/AIDS epidemic and the quantity of AZT needed cannot be predicted, Glaxo Wellcome has stated that it is unfeasible to implement a mass donation program of the drug. The preferential public sector pricing was instead arrived at after 3 years of discussions and collaboration with UNAIDS, governments, and nongovernmental organizations (NGOs). Glaxo and UNAIDS both agree that the pricing will be a price reduction and not a subsidy, but additional details remain unclear. Eligible countries will be defined according to World Health Organization guidelines, with UNICEF likely to play a key role in the AZT's distribution.
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  17. 17

    Condoms becoming more popular.

    Manuel J

    NETWORK. 1993 May; 13(4):22-4.

    Social marketing is a strategy which addresses a public health problem with private-sector marketing and sales techniques. In condom social marketing programs, condoms are often offered for sale to the public at low prices. 350 million condoms were sold to populations in developing countries through such programs in 1992, and another 650 million were distributed free through public clinics. The major donors of these condoms are the US Agency for International Development, the World Health Organization, the UN Population Fund, the International Planned Parenthood Federation, the World Bank, and the European Community. This marketing approach has promoted condom use as prevention against HIV transmission and has dramatically increased the number of condoms distributed and used throughout much of Africa, Latin America, and Asia. Donors are now concerned that they will not be able to provide condoms in sufficient quantities to keep pace with rapidly rising demand. Findings in selected countries, however, suggest that people seem willing to buy condoms which are well promoted and distributed. Increasing demand for condoms may therefore be readily met through greater dependence upon social marketing programs and condom sales. Researchers generally agree that a social marketing program must change for 100 condoms no more than 1% of a country's GNP in order to sell an amount of condoms equal to at least half of the adult male population. Higher prices may be charged for condoms in countries with relatively high per-capita incomes. Since prices charged tend to be too low to cover all promotional, packaging, distribution, and logistical management costs, most condom distribution programs will have to be subsidized on an ongoing basis.
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  18. 18

    Fresh water.

    Rogers PP

    In: The global possible: resources, development, and the new century, edited by Robert Repetto. New Haven, Connecticut, Yale University Press, 1985. 255-98. (World Resources Institute Book)

    Everyone uses fresh water. Water is the most used substance by industry. Even though industry only makes up 5-10% of current worldwide water use, it contributes a disproportionate amount of toxic contaminants to the water supply. The most important socioeconomic factors of municipal water demand are household income and size. Agricultural demand is the single largest demand for water. In the US, it makes up 83% of annual total water consumption. Water demand has resulted in some of the world's biggest construction and weather modification projects which greatly alter basic ecosystems. Multinational institutions such as the World Bank and the International Development Association support most of these projects in developing countries. We have abused water perhaps more than any other resource. These abuses have caused considerable adverse effects. For example, after farmers in Africa and Asia began irrigating fields, many people fell ill with schistomosiasis. Other waterborne diseases include typhoid fever and diarrheal diseases. Investments in water supplies as well as in wastewater treatment are needed to improve public health. The largest consumers of fresh water in the world are those countries with the largest populations (49% of the world's population) and largest total land area (32% of the this area): China, India, the US, and the USSR. These 4 countries have 61-70% of the world's total irrigated land, but China and India have most of it (54%). Most US water expenditures are for water pollution control. The US has a very efficient agricultural system but the efficiency is technical rather than economic. Most water expenditures in the USSR and India are for irrigation. China spends most of its water resource funds on irrigation and drainage systems. All countries in the world should conduct a rational analysis of fresh water uses, implement rational water pricing policies to conserve water use, and stabilize water supplies such as capturing surface runoff.
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  19. 19

    The position of women and changing multilateral policies.

    Joekes S

    Development. 1989; (4):77-82.

    Contemporary multilateral loan agreements to developing nations, unlike previous project and program aid, have often been contingent upon the effective implementation of structural adjustment programs of market liberalization and macroeconomic policy redirection. These programs herald such reform as necessary steps on the road to economic growth and development. Price decontrol and policy change may also, however, generate the more immediate and undesirable effects of exacerbated urban sector bias and plummeting income and quality of life in the general population. This paper considers the resultant changes expected in the political arena, product and input pricing, small business promotion and formation, export crop production, interest rate policy reform and financial market deregulation, exchange rate and public sector expenditure, and the labor market, and their effect upon women's economic position. The author notes, however, that women are not affected uniformly by these changes and sectoral disruptions, but that some women will suffer more than others. To develop policy to effectively meet the needs of these target groups, more subpopulation specificity is required. Approaches useful in identifying vulnerable women in particular societies are explored. Once identified, these women, especially those who head poor households, should be afforded protection against the turbulence and short- to medium-term economic decline associated with adjustment.
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  20. 20

    Marketing family planning services in New Orleans.

    Bertrand JT; Proffitt BJ; Bartlett TL

    PUBLIC HEALTH REPORTS. 1987 Jul-Aug; 102(4):420-7.

    A marketing study was conducted for Planned Parenthood of Louisiana to provide information on product needs, placement of health facilities, reasonable prices for family planning services, and promotional needs. It illustrates the role that marketing research can play in the development of family planning program strategies, even for relatively small organizations. Data from telephone interviews among a random sample of 1000 women 15-35 years old in New Orleans before the clinic opened confirmed that the need for services was not entirely satisfied by existing providers. Clinic hours and cost of services were in line with client interests. The most useful findings for developing promotional strategy were the relatively low name recognition of Planned Parenthood (only 51% of respondents had ever heard of the organization) and a higher-than-expected level of interest in using the service expressed by young, low-income black women.
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  21. 21

    Essential drugs and developing countries: a review and selected annotated bibliography.

    Mamdani M; Walker G

    London, England, London School of Hygiene and Tropical Medicine, Evaluation and Planning Centre for Health Care, 1985 Winter. 97 p. (EPC Publication No. 8)

    Many developing countries spend sizeable sums on the purchase of drugs yet an estimated 60-80% of their populations, particulary in rural areas, do not have constant access to even the most essential drugs. The provision of adequate amounts of effective drugs to treat the most important and common disease conditions is crucial if health services are to be effective and credible. Many problems are associated with the provision and utilization of therapeutic drugs in developing countries: inequitable access to cost-effective safe drugs; inequitable production and consumption with market concentration in the hands of a few multinationals encouraging competition based on product differntion and not price; escalating drug costs; inefficient procurement, distribution, management; and irrational prescription and consumption. To combat these problems, the essential drug concept was introduced by the WHO in 1977. In 1981, WHO established a special Action Program on Essential Drugs. This is a worldwide collaborative program that aims at urging member states to adopt national drug policies, as well as helping developing countries procure and use essential drugs. Several countries have implemented some of the suggestions of the Drug Action Program. Though some progress has been made towards achieving an increase in the use and availability of cost-effective drugs, very few countries have succeeded in decreasing the use of unsafe drugs and those of low cost-effectiveness. Effective legislation is a prerequisite to the effective use of drugs. Recommended action for governments of developing countries to involve the private sector include: creating incentive for increased domestice production; controlling promotional practices; and exerting price controls.
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  22. 22

    SOMARC briefing book.

    Futures Group. Social Marketing for Change [SOMARC]

    Washington, D.C., SOMARC, [1985]. [58] p.

    This document contains briefing materials for the participants of an upcoming meeting of the advisory council and working groups of Social Marketing for Change (SOMARC), an organizational network, funded by the US Agency for International Development (USAID) and composed of 5 firms which work together in helping agencies, organizations, and governments develop contraceptive social marketing programs. Social marketing is the use of commercial marketing techniques and management procedures to promote social change. The briefing materials include 3 background and 18 issue papers. The background papers provide brief summaries of USAID's population activities and of the history of social marketing programs, an overview of USAID sponsored contraceptive social marketing programs in 14 countries and of 3 major non-USAID programs, and a listing of the skills and resources needed to develop effective contraceptive social marketing programs. The issue papers provide a focus for the discussion sessions which are scheduled for SOMARC's working groups on marketing communication, management, and research. USAID's objective is to promote the development of family planning programs which are completely voluntary and which increase the reproductive freedom of couples. Contraceptive social marketing programs are consistent with this objective. USAID provides direct funding for family planning programs as well as commodity, technical, and training support. USAID's involvement in social marketing began in 1971, and USAID is currently sponsoring programs in Jamaica, Bangladesh, Nepal, El Salvador, Egypt, Honduras, Ecuador, the Caribbean Region, Costa Rica, Guatemala, and Peru. In the past, USAID provided support for programs in Mexico, Tunisia, and Ghana. The Mexican project is now functioning without USAID support, and the projects in Tunisia and Ghana are no longer operating. Major non-USAID contraceptive social marketing programs operate in India, Sri Lanka, and Colombia. These programs received only limited technical support from USAID. To ensure the success of social marketing programs, social marketers must have access to the knowledge and skills of commercial marketers in the areas of management, analysis and planning, communications, and research. Social marketers must also have expertise in social development and social research. In reference to the issue papers, the working groups and the advisory council were asked to develop suggestions for 1) overcoming social marketing program management problems, 2) motivating health professionals toward greater involvement in social marketing programs, 3) improving the media planning component of the programs, 4) improving management stability and training for management personnel, and 5) improving program evaluation. Areas addressed by the issue papers were 1) whether social marketing programs should be involved in creating a demand for contraceptives or only in meeting the existing demand, 2) the development of a methodology for assessing why some programs fail and others succeed, 3) the feasibility of using anthropological and questionnaire modules for conducting social marketing research, 4) techniques for overcoming the high level of nonsampling error characteristic of survey data collected in developing countries, 5) techniques for identifying contraceptive price elasticity, 6) the feasibility of using content analysis in social marketing communications, 7) the applicability of global marketing strategies for social marketing, and 8) how to select an an appropriate advertising agency to publicize social marketing programs.
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  23. 23

    Field experience with ORT production.

    Faust H

    In: Proceedings of the International Conference on Oral Rehydration Therapy, June 7-10, 1983, Washington, D.C., edited by Richard Cash. Washington, D.C., AID, International Center for Diarrhoeal Disease Research, Bangladesh [ICDDR/B], United Nations Children's Fund [UNICEF], and the World Health Organization [WHO], 1983. 156-9. (International Conference on Oral Rehydration Therapy, 1983, proceedings)

    In 1969 the World Health Organization (WHO) arranged for trials of oral rehydration salts (ORS) production. The formula that was developed contained the following basic ingredients per liter of water: 20.0 grams of glucose anhydrous, 3.5 grams of sodium chloride, 2.5 grams of sodium bicarbonate and 1.5 grams of potassium chloride. As the product has become more widely used, a problem with its stability has been discovered, due to the interaction of glucose and sodium hydrogen carbonate. The stability problem was solved in some developing countries by packing glucose or bicarbonate separately, but the solution was not feasible in some countries due to a lack of necessary facilities or funds to maintain them. Based on WHO initiated testing, trisodium citrate offered the best prospects as a substitute for bicarbonate. It should be noted that the present ORS formulation is not discredited by the citrate alteration. If the bicarbonate formula is to be produced it should be packaged in a number of ways including aluminum foil, polyethylene bags, or 2 separate bags, depending upon where or when they will be distributed. The citrate formula should be packaged in aluminum foil, polyethylene bags, or paper/polyethylene laminations, depending upon use. Choice of formula and packing material depends also on the quantity to be produced. Small amounts of ORS can be prepared in hospital pharmacies for in and outpatients. Quantities of more than 2 million packets per year are easier to fill with semiautomatic equipment. Quantities of 4 million or more are more conveniently filled with an automatic machine. In most cases locally produced ORS is no less expensive than imported packets, but they offer advantages like the ability to respond immediately in an emergency and freedom to choose a dosage that is adapted to a standard size container for the country. Flexibility to produce ORS according to local needs and the principle of self reliance are also important advantages of locally produced ORS.
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  24. 24

    Marketing infant foods in four developing nations: trends since the W.H.O. code.

    Post JE; Smith RA; Solimano G

    In: Research Consortium for the Infant Feeding Study. The determinants of Infant feeding practices: preliminary results of a four-country study. New York, N.Y., Population Council, 1984 Apr 45-56. (International Programs Working Paper No. 19)

    The World Health Assembly, governing body of the World Health Organization (WHO), adopted a Code of Marketing of Breast Milk Substitutes in May, 1981. The question of what impact legislative, reggulatory, and voluntary actions by government and industry have had on the commercial marketing of infant food in Colombia, Indonesia, Kenya, and Thailand is addressed. The research was conducted between 1981 and 1983. This study of marketing activities was intended to analyze the direct effects of marketing activities and the interaction of marketing with other factors found to influence infant feeding practices. Research objectives were organized around 3 basic questions. 1) What are the characteristics of current marketing practices and strategies of infant food companies? 2) What factors account for the current marketing environment for infant foods? 3) What is the intensity of promotional activity at this time? Data was collected through interviews and a cross-sectional survey of mothers and infants. There have been 5 important trends in the way the marketing of infant foods has changed since 1981. They are: 1) an increased amount of price competition; 2) increased product availability; 3) discontinuance of consumer-oriented mass media advertising; 4) extensive promotion of commercial infant foods to health care workers, and through them to consumers; and 5) continued distribution of infant formula samples to mothers, directly or indirectly, many of whom live in a high-risk environment.
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  25. 25

    Major issues related to pharmaceuticals and developing countries.

    Bryant JH

    In: National Council for International Health [NCIH]. Pharmaceuticals and developing countries: a dialogue for constructive action. Washington, D.C., NCIH, 1982 Aug. 1-8.

    4 interested parties have become involved in the issue of pharmaceuticals for developing countries: the developing countries, the pharmaceutical industry, the World Health Organization (WHO), and public interest groups. Developing countries need pharmaceuticals to be available and accessible to all population groups at an affordable cost. Industry plays a vital role in fulfilling this need through research and development efforts, pricing, and assisting countries in developing quality control, logistical, and distribution systems. WHO, committed to assist poor countries, recognizes the importance of essential drugs in achieving the goal of "health for all by the year 2000." Public interest groups are working either to assist developing countries in meeting their needs or to assure international control of industry practices. The relationships between the 4 parties have been challenging. In recognition of the cost burden placed on developing countries, WHO developed an Action Program on Essential Drugs in 1978. Industry's reaction to the program was negative, accusing it of being contrary to the principles of the open market system. Concurrently, the pharmaceutical industry was being criticized by governments and public interest groups because marketing practices were not consistent with the standards of the countries of origin, e.g., false and misleading advertising, poor labelling, and exploitive pricing. The infant formula controversy also loomed at this time. Recommendations and threats to create international codes to control marketing practices resulted in industry attempts to correct abuses including the development of a voluntary code. Public interest groups gained considerable confidence during the confrontation with industry over the infant formula controversy. At the same time other participants felt additional confrontations would be destructive, possibly even to WHO. Industry has since responded more favorably to the essential drug program. The question of whether the interested parties can establish a constructive dialogue to remedy the problems associated with pharmaceuticals and developing countries remains to be answered.
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