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BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1998; 76 Suppl 1:9-19.Except for the artemisinin derivatives recently deployed in southeast Asia, resistance has emerged to all antimalarial drugs. The Task Force for Improved Use of Antimalarials was created within the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) in 1993, with the purpose of establishing, through research, measures to take to protect the few existing antimalarials in the southeast Asian region. Research was conducted in China, Myanmar, Cambodia, Thailand, Laos, and Viet Nam. The task force characterized the problems in drug compliance in southeast Asia, and developed interventions to improve drug use in the various countries. Interventions involved drug packaging, public information campaigns, and assessments of drug quality. It was found that blister packaging worked best in improving drug compliance and that the increased cost of packaged medication did not limit its use. Poor drug quality is a major problem in unregulated countries which should be improved.
Social Science and Medicine. 1992 May; 34(9):959-64.Insufficient information contributes to failure in markets. Government officials also use it to justify intervention in the health sector in the developing countries. Further, in these countries,health care workers have misused pharmaceuticals considerable as well as make improper diagnoses. Moreover both health practitioners and the general public do not always follow instructions on drug use. A shortage of information on appropriate use may indeed cause these problems. A staff member of the World Bank proposes a methodology to use to balance 2 competing risks. Either public health officials allow drugs to be available to consumers over the counter or they require a prescription from a licensed health professional. The risks include obvious diagnostic errors made my consumers untrained in medicine and patients not receiving needed, potentially life saving, drugs. Since there is a shortage of medical personnel in most developing countries, people face considerable obstacles (e.g., travel time and expense) when it comes time to go to a licensed medical facility. The proposed methodology to evaluate the tradeoff between the 2 risks involves looking at the problems as one of determining the value of a more accurate diagnosis through the intervention of a skilled professional as a specific and costly mechanism for acquiring an accurate diagnosis. The article applies the model to illustrative examples to identify the information to answer the regulatory issue question. Further the model also allows public health policy makers to determine the appropriate level of training needed for medical professionals and to evaluate projects which improve public access to information on the use of drugs.
Washington, D.C., World Bank, Population, Health and Nutrition Dept., 1987 Jun. 114,  p. (PHN Techical Note 87-15)The issue of appropriate tobacco policies for less developed countries (LDCs), based essentially on the experiences of the more developed countries, is addressed. Following an overview of current trends in tobacco consumption and production and discussion of the health consequences of tobacco use, attention is directed to the rationale for government policy within the context of neoclassical welfare economics. Issues surrounding policy instruments intended to reduce the demand for cigarettes are examined as are production related policies. Finally, focus is on the question of the propriety of the World Bank's lending for tobacco projects. Available evidence from several European nations suggests that simply the discussion of smoking and health policies can have a noticeable effect on smoking. Leu (1986) reports that smoking declined in Switzerland following the health disclosures, but it declined more substantially following a public referendum (1979) on a complete advertising ban despite the fact that the ban was defeated at the polls. The evidence for information dissemination programs is impressive, yet such approaches have been criticized as inadequate on the basis that the reductions in smoking have not been large enough and that people continue to be inadequately informed about all the risks of smoking. Information based policies to control tobacco use have several advantages, including: they are noncoercive and reinforce an individual's prerogative to control his/her own life; they improve market functions; and they have an important impact on tobacco use and tobacco induced illnesses. Specific recommendations are outlined. Setting aside health considerations, from both a longterm and global perspective, the case for promoting tobacco production on economic grounds is shaky. Tobacco now typically is a profitable crop, yet much of its advantage stems from the various subsidies, tariffs, and supply restrictions that support its high price and provide economic rents for its producers. Health considerations aside, from both a longterm and global perspective, the case for promoting tobacco production on economic grounds is weak. Tobacco typically is a profitable crop at this time, yet much of its advantage stems from the various subsidies, tariffs, and supply restrictions that support its high price and provide economic rents for its producers.