Responsible practices

A new report on the pharmaceutical industry has just been released by the international NGO, Oxfam. 'Investing for life: Meeting poor people's needs for access to medicines through responsible business practices' is available to download at:

http://www.oxfam.org.uk/resources/policy/health/bp109_pharma.html [PDF
document, 57 pages, 948Kb]

Setting the background, Oxfam quotes the UN Special Rapporteur on the Right to Health: "Almost 2 billion people lack access to essential medicines. Improving access to existing medicines could save 10 million lives each year, 4 million of them in Africa and South-East Asia. Access to medicines is characterised by profound global inequity. 15% of theworld's population consumes over 90% of the world's pharmaceuticals."

"The industry must put access to medicines at the heart of its decision-making and practices," says the report.

Oxfam draws attention to "lack of research and development (R&D) to address the dearth of dedicated products for diseases that predominantly affect poor people in developing countries. This includes drug formulations that are applicable and usable in the developing world. Between 1999 and 2004, there were only three new drugs for neglected diseases out of 163 new chemical entities (NCEs)"

Examples include:
- "60 million people are at risk of contracting sleeping sickness.
Treatment is based on a highly toxic arsenic derivative in use since 1940s
and a former cancer drug from the 1980s.
- TB is responsible for nearly two million deaths each year but treatment
takes six months and is difficult to implement. The most recent medicine
is 30 years old.
- 340 million sexually transmitted infections occur every year. Simple,
effective treatment exists but many are not getting it because of lack of
simple, reliable tests."

HR4D net



Taking Action to Improve Vital Statistics

Accurate statistics on births, deaths and the causes of death generated by a functioning vital-statistics system are the foundation of rational health and public policy. Yet these data are lacking for the vast majority of the world's poorest countries. In sub-Saharan Africa, for example, fewer than 10 countries have routine vital statistics systems that produce usable data. In particular, data on both the number and causes of death in developing countries are virtually non-existent. Reliable data on levels of adult death - let alone causes of death - simply do not exist for most developing countries, where most people die at home. Mortality
estimates, particularly for adults, that are patched together and modeled from limited sources of information have not provided an adequate foundation for setting health-sector priorities or for assessing program progress and impact.

Given this reality, a major global public health goal is to move from a situation in which knowledge of most events that take place in communities and households is lost, to one in which information about those vital events is brought into the health-information system. While the preferred, long-term goal for vital-events data is to achieve civil registration of births and deaths and medical certification of causes of death with high and representative coverage, it is widely accepted that attaining this objective for most countries will take years, if not decades. Given the present inadequacies of current knowledge, what are the best ways to measure and monitor vital events and related socio-demographic information in the short- to medium-term?

The international community, including the Health Metrics Network, has made many recommendations to solve this problem. While they cannot substitute for universal civil registration, complementary methods for vital events measurement such as those contained in the SAmple Vital registration with Verbal autopsY (SAVVY) library can fill this crucial void in the public-health evidence base. Implementing these methods should help developing countries move from a situation in which no reliable routinely collected vital statistics exist to a long-term goal of having vital statistics derived from civil registration with high coverage and reliable cause of death attribution.

This resource library provides all the necessary reference materials to establish a complete system capable of generating nationally representative vital events information, including information on causes of death, or strengthening existing sources of data. All materials included are the product of extensive field application and expert review, and are consistent with agreed-upon international standards and best practices.

To download the SAVVY library and to gain more information, visit
http://www.cpc.unc.edu/measure/leadership/savvy.html.