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Executive summary : globalisation and liberalisation of healthcare services. WTO and the General Agreement on Trade in Services

BALASUBRAMANIAM, K
2000

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This paper begins with a description of the evolution of the TRIPs Agreement. The TRIPs Agreement together with Trade Related Investment Measures (TRIMs) have taken away the powers of economic decision making from the national governments and handed them to the dominant actors in the international market place, namely the transnational corporations (TNCs). The international economic order has been radically restructured by the TRIPs Agreement which encompasses virtually the entire economic spectrum. To understand fully the implications of WTO/TRIPs Agreement on the access of drugs to consumers in the ASEAN region, this paper presents data on the pharmaceutical industry in the region and globally. All these countries have now changed their national legislation on patents in accordance with TRIPs Agreement. They will provide patent protection for pharmaceutical products. These countries will not be able to manufacture any drug under patent protection for a period of 20 years, resulting in the multinational drug companies having a monopoly of all patent protected drugs, leading to the collapse of the pharmaceutical industry in developing countries. The paper concludes that the only way to avoid this and strengthen the pharmaceutical sector in developing countries is through compulsory licensing and parallel imports, which are allowed in the TRIPs Agreement. This will enable consumers in the ASEAN countries to access affordable pharmaceuticals. This, consumers believe, is a short-term solution. The paper also gives a longterm solution, involving a shake up of the international governance system

Towards ethical guidelines for dealing with unsolicited patient emails and giving teleadvice in the absence of a pre-existing patient-physician relationship : systematic review and expert survey

EYSENBACH, G
2000

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A systematic review looking at email communication, solicited and unsoliticed between patient and clinician, whether these constitute medical practice and clinicians are ethically obligated to respond. The review seeks to provide a set of guiding ethical principles applicable to this interaction

Disseminating health information in developing countries : the role of the internet

TAN-TORRES EDEJER, T
2000

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This article notes that information and communication technologies have not been harnessed systematically to improve the health of populations in developing countries and that the current digital divide is more dramatic than any other inequity in health or income. It also states that the quality of health information available on the web is inconsistent, and the visibility of research from developing countries is limited and concludes that the way forward is to exploit the full interactivity of the internet, which allows rapid feedback and change to continuously mould information into useful knowledge

Maintenance and sustained use of insecticide-treated bednets and curtains three years after a controlled trial in western Kenya

KACHUR, S Patrick
et al
November 1999

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While few questions remain about the efficacy of insecticide-treated materials (ITM) intervention, operational issues around how to implement and sustain ITM projects need attention. This article describes a study of the results of a small-scale ITM intervention trial, 3 years after the project ended, to assess how local attitudes and practices had changed

Incidence of malaria among children living near dams in northern Ethiopia : community based incidence survey

GHEBREYESUS, Tedros A
et al
September 1999

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Describes a study to assess the impact of the construction of microdams on the incidence of malaria in nearby communities in terms of possibly increasing peak incidence and prolonging transmission. Found that overall incidence of malaria for the villages close to the dams was 14.0 episodes per 1000 child months at risk compared with 1.9 in the control villages: a sevenfold ratio. Incidence was significantly higher in both communities at altitudes below 1900 m. Concludes that there is a need for attention to be given to health issues in the implementation of ecological and environmental development programmes, specifically for appropriate malaria control measures to counteract the increased risks near these dams

Insecticide-treated curtains reduce the prevalence and intensity of malaria infection in Burkina Faso

HABLUETZEL, A
et al
August 1999

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Describes a large, randomized controlled trial to investigate the impact of insecticide-treated curtains (ITC) on child mortality that was conducted in an area of seasonal, holoendemic malaria in Burkina Faso. Concludes that widespread implementation of ITC in this area of high malaria transmission led to a modest reduction in the prevalence of malaria infection and to a more substantial reduction in the intensity of these infections which caused increased Hb levels

Changing home treatment of childhood fevers by training shop keepers in rural Kenya

MARSH, V M
et al
May 1999

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Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. This study examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. It concludes that this approach is both feasible and likely to have a significant impact

Integrated management of childhood illness. Course director's guide

WORLD HEALTH ORGANIZATION (WHO)
United Nations Children's Fund (UNICEF)
1999

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A series of workbooks forming the basis of a modular training course for health workers.
Two video tapes (see records 0343 and 0344 in audiovisuals database) and a set of algorithm wall charts (in health education materials drawers) accompany the training manuals

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