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Brazil has occupied a central role in the access to medicines movement, especially with respect to drugs used to treat those with the human immunodeficiency virus (HIV) that causes the acquired immune deficiency syndrome (AIDS). How and why Brazil succeeded in overcoming powerful political and economic interests, both at home and abroad, to roll-out and sustain treatment represents an intellectual puzzle. In this book, Matthew Flynn traces the numerous challenges Brazil faced in its efforts to provide essential medicines to all of its citizens. Using dependency theory, state theory, and moral underpinnings of markets, Flynn delves deeper into the salient factors contributing to Brazil’s successes and weaknesses, including control over technology, creation of political alliances, and instrumental use of normative frameworks and effectively explains the ability of countries to fulfill the prescription drug needs of its population versus the interests and operations of the global pharmaceutical industry Pharmaceutical Autonomy and Public Health in Latin America is one of the only books to provide an in-depth account of the challenges that a developing country, like Brazil, faces to fulfill public health objectives amidst increasing global economic integration and new international trade agreements. Scholars interested in public health issues, HIV/AIDS, and human rights, but also to social scientists interested in Latin America and international political economy will find this an original and thought provoking read.
Brazil has occupied a central role in the access to medicines movement, especially with respect to drugs used to treat those with the human immunodeficiency virus (HIV) that causes the acquired immune deficiency syndrome (AIDS). How and why Brazil succeeded in overcoming powerful political and economic interests, both at home and abroad, to roll-out and sustain treatment represents an intellectual puzzle. In this book, Matthew Flynn traces the numerous challenges Brazil faced in its efforts to provide essential medicines to all of its citizens. Using dependency theory, state theory, and moral underpinnings of markets, Flynn delves deeper into the salient factors contributing to Brazil’s successes and weaknesses, including control over technology, creation of political alliances, and instrumental use of normative frameworks and effectively explains the ability of countries to fulfill the prescription drug needs of its population versus the interests and operations of the global pharmaceutical industry Pharmaceutical Autonomy and Public Health in Latin America is one of the only books to provide an in-depth account of the challenges that a developing country, like Brazil, faces to fulfill public health objectives amidst increasing global economic integration and new international trade agreements. Scholars interested in public health issues, HIV/AIDS, and human rights, but also to social scientists interested in Latin America and international political economy will find this an original and thought provoking read.
"The research strategy, concepts, and methodologies developed in this book repay careful consideration not only for fruitful deployment to examine dynamics of health and intelectual property in other regions, but also for generating innovative insights in other fields of global regulatory governance"--Foreword.
Worldwide, adverse drug reactions are a major cause of morbidity and mortality in patients, as well as increased healthcare costs. Published data show that there are around 2 million adverse drug reactions, including 100,000 deaths, which are established as the fourth leading cause of mortality. This culminates an estimated cost of 136 billion dollars to the global healthcare system. However, these values are underestimated, because in many parts of the world there are no reliable records of pharmacovigilance. This is the case in Latin America, where the records of adverse reactions are still insufficient, and therefore it is not possible to properly establish the extent of its effects on public health. At the same time, treatment failure due to sub-therapeutic levels of drugs is not evaluated in healthcare systems, especially in Latin America, where the "importation" of dosages and results from clinical trials form the fundamental basis of the application and acquisition of pharmaceutical products. This is due mainly to current protocols, which assume that patients are a single entity; therefore, drugs effective and well-tolerated in some patients are equally effective in the rest. Clinical experience shows that drugs that work well in some patients are ineffective or cause adverse reactions in others, and may even prove fatal to intolerant patients. The main objective of this book is to catalog the most relevant information concerning healthcare drug effects in Latin America. This could provide a huge benefit for Latin American patients, where it is estimated that there are plenty of side effects and treatment failure due to the "importation" of dosages and therapies regardless of population variability. It should encourage discussion and concern about the implementation and validation of pharmacogenomic testing and clinical guidelines for specific mixed populations of the region. It will also be valuable to demonstrate this research to health professionals (prescribers, insurers and regulators) in the region and the impact of pharmacogenomics on pharmacotherapy cost-effectiveness.
At a time when the world’s wealthiest nations struggle to make health care and medicine available to everyone, why do resource-constrained countries make costly commitments to universal health coverage and AIDS treatment after transitioning to democracy? Joseph Harris explores the dynamics that made landmark policies possible in Thailand and Brazil but which have led to prolonged struggle and contestation in South Africa. Drawing on firsthand accounts of the people wrestling with these issues, Achieving Access documents efforts to institutionalize universal healthcare and expand access to life-saving medicines in three major industrializing countries. In comparing two separate but related policy areas, Harris finds that democratization empowers elite professionals, such as doctors and lawyers, to advocate for universal health care and treatment for AIDS. Harris’s analysis is situated at the intersection of sociology, political science, and public health and will speak to scholars with interests in health policy, comparative politics, social policy, and democracy in the developing world. In light of the growing interest in health insurance generated by implementation of the Affordable Care Act (as well as the coming changes poised to be made to it), Achieving Access will also be useful to policymakers in developing countries and officials working on health policy in the United States.
This book provides a clear, broad, and provocative synthesis of the history of Latin American medicine.
A comprehensive and granular insight into the challenges of promoting rational medicine, this book serves as an essential resource for health policy makers and researchers interested in national medicines policies. Country-specific chapters have a common format, beginning with an overview of the health system and regulatory and policy environments, before discussing the difficulties in maintaining a medicines supply system, challenges in ensuring access to affordable medicines and issues impacting on rational medicine use. Numerous case studies are also used to highlight key issues and each chapter concludes with country-specific solutions to the issues raised. Written by highly regarded academics, the book includes countries in Africa, Asia, Europe, the Middle East and South America.
Ensuring equity in healthcare is the main concern of health policymakers in order to provide a sustainable health system. This concern is more prominent in developing countries due to the scarcity of resources. This book provides a comprehensive analysis and discussion on the distributive pattern of out-of-pocket pharmaceutical expenditures under the health reforms in Turkey and makes comparisons with pharmerging countries. Turkey’s health reforms began in 2003 to address shortcomings related to financial protection and to improve health outcomes and the quality of healthcare services. The primary motivation was to ensure equity in the distribution of health resources, and this transformation process led to profound changes in how these resources were used, and in health financing in general. However, there is a lack of knowledge regarding the long-term effect of health reforms on the distribution patterns of health expenditures and health service use. This book offers a thorough equity analysis of the health financing system, affected by this health transformation program. Index and curve approaches are used in the equity analysis of pharmaceutical expenditures. The book examines the long-term effects of health system regulations on the health spending characteristics of households and improves the current understanding of equity in this context. It includes extensive international comparisons of healthcare services across a range of developing countries and highlights the significance of ensuring equity for emerging economies. The author explores the existing evidence as well as future research directions and provides policy and planning advice for health policymakers to contribute to establishing a more equal health system design. Additionally, the book will be of interest to scholars and professionals in the fields of health economics, public health management and health financing.
Coalitions and Compliance examines how international changes can reconfigure domestic politics. Since the late 1980s, developing countries have been subject to intense pressures regarding intellectual property rights. These pressures have been exceptionally controversial in the area of pharmaceuticals. Historically, fearing the economic and social costs of providing private property rights over knowledge, developing countries did not allow drugs to be patented. Now they must do so, an obligation with significant implications for industrial development and public health. This book analyses different forms of compliance with this new imperative in Latin America, comparing the politics of pharmaceutical patenting in Argentina, Brazil, and Mexico. Coalitions and Compliance focuses on two periods of patent politics: initial conflicts over how to introduce drug patents, and then subsequent conflicts over how these new patent systems function. In contrast to explanations of national policy choice based on external pressures, domestic institutions, or Presidents' ideological orientations, this book attributes cross-national and longitudinal variation to the ways that changing social structures constrain or enable political leaders' strategies to construct and sustain supportive coalitions. The analysis begins with assessment of the relative resources and capabilities of the transnational and national pharmaceutical sectors, and these rival actors' efforts to attract allies. Emphasis is placed on two ways that social structures are transformed so as to affect coalition-building possibilities: how exporters fearing the loss of preferential market access may be converted into allies of transnational drug firms, and differential patterns of adjustment among state and societal actors that are inspired by the introduction of new policies. It is within the changing structural conditions produced by these two processes that political leaders build coalitions in support of different forms of compliance.