The ready availability of essential drugs to entire populations is a key determinant of public health in all countries. Addressing the great inequalities in drug supply is one of the major challenges in international health. Many of the problems can only be tackled at a global level by agencies, governments and pharmaceutical companies working together. Others require action at national or regional level through attention to health systems, or necessitate action at the local level by working with communities. This book aims to provide the student of international health with an introduction to the international pharmaceutical scene: Who are the key players and what are their roles? What has been achieved so far, and what remains to be done? What are the prospects for the future? The book will be of particular interest to those involved with the management of medicines at any level, and to those with an interest in improving access to medicines for all in a fair and equitable way.

Foreword

ix

Preface

xi

About the Authors

xiii

Acknowledgements

xv

Glossary of Terms

xvii

Issues in the Management of Pharmaceuticals in International Health

1

(18)

Stuart Anderson

Reinhard Huss

Introduction

1

(1)

Pharmaceuticals, medicines and drugs

2

(1)

International health

3

(1)

The emergence of medicines

4

(2)

Global inequity and the medicines life cycle

6

(6)

The study of pharmaceuticals in international health

12

(1)

Approaches to managing pharmaceuticals

13

(1)

Layout of the book

14

(2)

Conclusion

16

(3)

Access and Availability of Pharmaceuticals in International Health

19

(14)

Karin Wiedenmayer

Introduction

19

(1)

Access to essential medicines

20

(6)

Neglected diseases

26

(2)

Strategies for developing medicines and ensuring access

28

(1)

Conclusion

29

(4)

Assessing the Pharmaceutical Needs of Patients and Populations

33

(20)

Reinhard Huss

Introduction

33

(1)

Public health pharmacology

34

(1)

Incidence of disease

34

(3)

Needs and priorities for medicines

37

(5)

Culture and the use of medicines

42

(3)

Patients as consumers

45

(2)

Compliance, adherence and concordance

47

(2)

Empowerment

49

(1)

Conclusion

50

(3)

The Role of Health Professionals

53

(18)

Karin Wiedenmayer

Introduction

53

(1)

Classifying health professionals

54

(1)

Health professionals and medicine responsibilities

54

(3)

The role of the doctor

57

(2)

The role of the pharmacist

59

(4)

Traditional healers

63

(3)

Integrating traditional medicine and Western medicine

66

(2)

Conclusion

68

(3)

The Role of the Pharmaceutical Industry

71

(16)

Stuart Anderson

Introduction

71

(1)

The origins and development of the pharmaceutical industry

72

(2)

Structure of the industry today

74

(3)

Pharmaceutical company partners

77

(2)

The activities of the industry

79

(3)

Pharmaceutical markets

82

(1)

The pharmaceutical industry and international health

82

(2)

Conclusion

84

(3)

The Role of Governments

87

(18)

Rob Summers

Introduction

87

(1)

The development of national drug policies

88

(3)

The drug supply process

91

(4)

Health systems that support drug supply

95

(3)

Pharmaceutical legislation and regulation

98

(3)

Research, monitoring and evaluation

101

(2)

Conclusion

103

(2)

The Role of the European Union, National Assistance Agencies and NGOs

105

(20)

Reinhard Huss

Stuart Anderson

Introduction

105

(1)

The European Union

106

(3)

The national aid agencies

109

(4)

International and national NGOs

113

(2)

Some non-governmental organizations

115

(5)

Equitable pharmaceutical supply and distribution

120

(3)

Conclusion

123

(2)

The Role of International Organizations

125

(16)

Rob Summers

Introduction

125

(1)

WHO and other UN organizations

126

(2)

Industry organizations

128

(1)

Other organizations

129

(1)

Essential drugs

130

(2)

Pharmaceutical procurement

132

(3)

International agreements and intellectual property rights

135

(2)

Case study-HIV/AIDS and antiretroviral treatment in South Africa

137

(3)

Conclusion

140

(1)

Rational Use of Medicines

141

(12)

Karin Wiedenmayer

Introduction

141

(1)

Consequences of non-rational medicine use

142

(1)

Medicine use behaviour

143

(2)

Investigating medicine use problems

145

(1)

Medicine use interventions

146

(3)

Effectiveness of interventions

149

(1)

Conclusion

150

(3)

Medicine Quality, Adverse Reactions and Antimicrobial Resistance

153

(22)

Karin Wiedenmayer

Introduction

153

(1)

Quality of medicines

154

(6)

Counterfeit medicines

160

(3)

Adverse drug reactions

163

(4)

Antimicrobial resistance

167

(5)

Conclusion

172

(3)

Managing Medicines Information

175

(16)

Reinhard Huss

Introduction

175

(1)

The users of medicine information

176

(1)

Sources of information

177

(4)

The quality of medicines information

181

(2)

The assessment of information

183

(2)

Classification systems

185

(3)

Conclusion

188

(3)

Investigating the Use of Medicines

191

(16)

Reinhard Huss

Introduction

191

(1)

Drug utilization studies

192

(2)

Pharmacoeconomics

194

(4)

Pharmacovigilance

198

(3)

Pharmacoepidemiology

201

(2)

Health systems and policy studies

203

(1)

Conclusion

204

(3)

Trends and Developments

207

(16)

Stuart Anderson

Karin Wiedenmayer

Introduction

207

(1)

Trends in the use of herbal remedies

208

(1)

The contribution of pharmacogenetics and pharmacogenomics

209

(2)

The changing role of the internet

211

(3)

Changes in the health care workforce

214

(6)

Conclusion

220

(3)

Policy Initiatives and their Implications

223

(14)

Stuart Anderson

Rob Summers

Introduction

223

(1)

The role of public-private partnerships

224

(5)

The Global Fund and other initiatives

229

(2)

Global procurement of medicines

231

(2)

AIDS drugs post Doha

233

(2)

Conclusion

235

(2)

Selected Websites and Webportals

237

(12)

Index

249

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Managing Pharmaceuticals in International Health

9783764366018

376436601X

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