Drug Donation Programs Research Articles

Insights into Drug Donation Practices and Public Perceptions in Saudi Arabia

Background: Effective medication management, disposal, and donation are vital for public health and environmental sustainability. Improper handling of medications can lead to drug misuse, accidental poisoning, and environmental damage. This study examines current practices and challenges in Saudi Arabia, identifying opportunities for improvement. Method: A cross-sectional survey conducted in October and November 2023 targeted the general population in Saudi Arabia. This study employed convenience sampling to explore medication usage, storage, disposal practices, and awareness of donation procedures. Data were analyzed through both descriptive and inferential statistical methods. Results: This study involved 430 respondents. Of these, 73.0% held a university degree, yet 66.3% were unaware of drug donation programs, and 84.2% lacked knowledge about proper medication disposal. Despite this, 71.4% believed that drug donation programs positively impact healthcare, and 87.9% saw them as reducing drug waste and environmental pollution. However, 48.1% expressed concerns about the potential misuse of donated medicines. Awareness and knowledge were significantly higher among participants aged 30 and above. Conclusions: The findings highlight the need for enhanced public awareness, clear medication disposal guidelines, and ethically governed donation practices in Saudi Arabia. These measures can improve healthcare outcomes, protect the environment, and support global health and sustainability goals.

Evaluating Blinatumomab Treatment Adoption in Varied Resource Settings Using the RE-AIM Framework

Background Blinatumomab is a targeted immunotherapy for B-ALL. Widespread adoption of this evidence-based intervention in varied resource settings has been limited due to cost, commercial access, and barriers including institutional capacity and medication complexity. We used implementation science frameworks to facilitate and study the translation of blinatumomab into hospitals in lower-resource settings in partnership with a drug-donation program. After 2 years of collaboration, we applied the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework to assess implementation processes and effectiveness outcomes in 2 pilot centers. Methods As a component of a larger hybrid effectiveness-implementation type 2 study, we applied RE-AIM methodology retrospectively to examine data for one hospital in India and one in Pakistan. Quantitative and qualitative data were abstracted from meeting notes, readiness assessments, a 54-question implementation survey based on validated measures, and clinical team observations. Local physicians overseeing the patient treatment with blinatumomab collected de-identified clinical data from routine care from 20 patients. Infusion and 6-month follow-up data were available for 18 and 16 patients, respectively. Patient characteristics were summarized using descriptive statistics. Clinical data were analyzed in aggregate to report real-world effectiveness, and other data were integrated to report on the five RE-AIM domains. Results Overall reach was determined by comparing proportion of annual patient requests, predicted number of eligible patients, and characteristics of patients who received blinatumomab. Reach varied by site from 48%-110%. Participants were representative with a median age of 8 years (IQR 6.23) and 55% were female. MRD-positive disease was the primary indication for receiving blinatumomab (60%, n=12). Regarding effectiveness, 73.3% of patients achieved remission after cycle 1, and 9 patients (60%) proceeded to hematopoietic stem cell transplant after receiving blinatumomab. At six months, 81.3% of patients were alive, 1 had died, and 2 were lost to follow-up. Adoption at the staff level was measured based on engagement of provider roles in training and feedback as measured by completion of a multidisciplinary implementation survey. While nursing was engaged in training at both sites, there was a notable lack of nursing-specific input to the implementation survey, identifying a key opportunity to improve engagement strategies. Early-indicator implementation outcomes were assessed by local multidisciplinary teams demonstrated high feasibility (aggregate mean 4.64/5, SD 0.35), acceptability (aggregate mean 4.71/5, SD 0.39), and appropriateness (aggregate mean 4.86/5, SD 0.24) of blinatumomab at their institution. Site-specific modifications to improve implementation included: modifications to the bag change schedule due to the lack of availability of medical supplies (bag sizes, pump cassette), and nursing ratios were temporarily reduced to provide closer monitoring for patients receiving blinatumomab. Thematic analysis revealed that maintenance is supported by the perceived relative advantage of blinatumomab vs. traditional chemotherapy, with physicians appreciating the opportunity for improved quality of life for patients and noting that also “the treating teams and the parents are happy,” highlighting a potentially positive impact on the physician and family wellbeing. One challenge for program maintenance is the cost of associated medical supplies such as medication infusion tubing and filters and the need for prolonged hospitalization due to barriers related to transportation and the availability of outpatient and emergency services. This will inform future strategies, such as implementation mapping, to determine how to address these site and resource-specific barriers. Conclusion Successful implementation and collaboration with local multidisciplinary teams is a critical predecessor to establishing effectiveness and improving future global access to complex, novel therapies such as blinatumomab. Systematic application of established implementation measures, such as RE-AIM, can improve reporting of rich implementation data and inform strategies to improve the long-term adoption and maintenance of these effective therapies in the real world.

Evaluating blinatumomab implementation in low- and middle-income countries: a study protocol

BackgroundThe recent implementation of novel therapies has accelerated progress in pediatric cancer care. Despite the significantly poorer survival of patients in low- and middle-income countries (LMICs), administation complexities and other significant resource barriers have limited the translation of these novel therapies in these regions. This study aims to develop a model that can be used to support the implementation of novel therapies, such as blinatumomab (bispecific antibody therapy for B-cell acute lymphoblastic leukemia [B-ALL]) in LMIC centers, with the long-term goal of developing an implementation framework for similar future efforts.MethodsIn this study, mixed methods will be applied to understand the key contextual considerations that can be accounted for through a training program and prospectively designed implementation activities. The Consolidated Framework for Implementation Research will guide the activities related to implementation evaluation in parallel with a drug donation program. A multidisciplinary research team comprising high- and low-middle income healthcare professionals, industry, and implementation scientists has been assembled with the common goal of improving safe access to blinatumomab. To assess the factors affecting blinatumomab administration, semi-structured interviews with diverse collaborators and quantitative assessments of organizational characteristics will be conducted, together with quantitative and qualitative assessments of feasibility, acceptability, appropriateness, and cost of blinatumomab implementation. A quantitative assessment of stakeholder perceptions of different implementation strategies used as part of the multifaceted approach will also be performed. Finally, we will examine the key domains and processes used and construct the implementation roadmap for translation of novel therapies.DiscussionThis study will rigorously develop an implementation roadmap for translation of novel therapies in low-resource settings. The knowledge gained in the formative assessment will reveal the priority areas and key implementation strategies. Thereby, the resultant roadmap will facilitate future scale-out strategies for novel therapies in LMICs, thus increasing access, building capacity for management, and ultimately improving the care for children in LMICs.

Review and assessment of drug disposal state statutes in the United States, 2022

BackgroundEnsuring opportunities exist to dispose of unused or unwanted drugs that are appropriate, accessible, and affordable is critical to avoid misuse and lasting harm to the environment. ObjectiveThe objectives of this study were to identify state statutes promulgated in all 50 states and the District of Columbia (DC) facilitating disposal of unused or unwanted drugs in the community setting and assess their characteristics. MethodsA retrospective review of state statutes in all 50 U.S. states and DC between October 2020 and May 2022 was conducted. Statutes using terms “drug and disposal or collection” and that were intended to facilitate disposal of unused or unwanted drugs were included. Drug donation programs or repositories, drug returns to the pharmacy, charitable clinics, and others not intended to dispose or unused or unwanted drugs were excluded. Publicly available resources and Westlaw, a legal resource, were used to identify state statutes. Descriptive statistics were used to describe the findings. ResultsOf the 50 U.S. states and DC, we found that most states enacted a statute pertaining to drug disposal (63%; n = 32) as of May 2022. Of states with a drug disposal statute, few had funding mechanisms or required pharmacy participation. Most statutes specified the type of product that may be accepted for disposal, what site may accept them, and who may dispose of the product. Few states specified which health care provider or other individual may accept the product(s) for disposal. ConclusionMost states have enacted statutes facilitating drug disposal, but their characteristics varied widely. Opportunities may exist at the state level to further incentivize proper drug disposal, and further research is needed to measure possible effects of these state statutes.

The NTD Supply Chain Forum-Strengthening the backbone of NTD programs.

Global programs targeting 5 preventive chemotherapy neglected tropical diseases (PC-NTDs) have scaled up rapidly in recent decades due, in large part, to the generous drug donations from 6 pharmaceutical companies—Eisai; Johnson & Johnson (J&J); GlaxoSmithKline (GSK); Merck & Co., Inc., Kenilworth, New Jersey, United States of America (MSD); Merck KgaA; and Pfizer. Today, the scale of the PC-NTD drug donation programs is staggering. Nearly 15 billion tablets have been manufactured, packaged, shipped, and distributed in order to reach the people in need. The supply chains established to support such massive operations are enormously complex. Here, we describe a unique public–private partnership that was formed to bring together supply chain expertise to overcome the critical challenges associated with such large-scale production and delivery of donated pharmaceutical products.

Overview of Pharmaceutical Disposal Methods: Addressed to the General Assembly of Illinois

Drug donation programs increase medication availability and encourage proper pharmaceutical disposal. Proper disposal decreases the potential human and environmental risk posed by the presence of pharmaceutical compounds in water bodies. Furthermore, the public health hazard of drug abuse is mitigated due to the decreased availability of drugs. The preferred pharmaceutical disposal method is through drug take-back programs, in which medications are returned to local pharmacies, law enforcement, or other responsible agencies. Take-back programs can also involve medication donation, and states such as Oklahoma and Iowa have programs to fill prescriptions for people who would otherwise have financial difficulty. Because the state of Illinois currently does not have an enacted law for the donation and reuse of medication, we propose that Illinois enact clearer laws regarding pharmaceutical disposal and take-back programs.

Progress Report on Neglected Tropical Disease Drug Donation Programs

PurposeNeglected tropical diseases (NTDs) impose a significant burden on public health, particularly in developing nations. Many can be treated cost-effectively with drugs donated or offered at or below marginal cost. In 2012, the World Health Organization published an NTD roadmap that outlined a strategy for the prevention, control, and eradication of 17 NTDs by 2020. Inspired by this roadmap, executives from 13 pharmaceutical companies, government agencies, and other interested parties signed the London Declaration on Neglected Tropical Diseases in January 2012. In this paper, we will assess progress in meeting commitments on drug donations laid out in the London Declaration. MethodsWe conducted Medline and LexisNexis searches of peer-reviewed publications and trade journals, as well as product development partnership and government reports. Subsequently, we designed a survey instrument and surveyed 10 company signatories (companies with drug donation programs) to the London Declaration to determine current donations and pledges. FindingsNine of 10 companies with donation programs responded to the survey. The respondents reported substantial progress in meeting the goals laid out in the London Declaration. Survey respondents maintained 17 drug donation programs across 10 disease categories. In 2014, companies donated >1 billion treatments, with a dollar value of nearly $1.5 billion. However, not all donated products were distributed to patients in need. In addition, 4 of the 17 programs were slated to end before 2020, three of the 17 programs did not report explicit program objectives, and 7 of 17 did not measure the impact of programs in terms of numbers of patients treated. None of our survey respondents reported on whether the programs were leading to a reduction in disease prevalence. ImplicationsDonations are a necessary but insufficient condition for patient access to neglected disease drugs. Additional resources must be allocated to ensure delivery of donated products to patients. In addition, drug donation programs should provide explicit descriptions of program objectives, measurements of the impacts of their programs, and extension of all donation commitments through 2020. To achieve this, multiple stakeholders with a vested interest in reducing the burden of neglected diseases must collaborate in a multipronged approach toward NTD elimination.

Assessing "First Mile" Supply Chain Factors Affecting Timeliness of School-Based Deworming Interventions: Supply and Logistics Performance Indicators.

BackgroundBetween 2007 and 2012, Children Without Worms (CWW) oversaw the Johnson & Johnson (J&J) donation of Vermox (mebendazole) for treatment of school-age children to control soil-transmitted helminthiasis (STH). To identify factors associated with on-time, delayed, or missed mass drug administration (MDA) interventions, and explore possible indicators for supply chain performance for drug donation programs, we reviewed program data for the 14 STH-endemic countries CWW supported during 2007–2012.MethodologyData from drug applications, shipping records, and annual treatment reports were tracked using Microsoft Excel. Qualitative data from interviews with key personnel were used to provide additional context on the causes of delayed or missed MDAs. Four possible contributory factors to delayed or missed MDAs were considered: production, shipping, customs clearance, and miscellaneous in-country issues. Coverage rates were calculated by dividing the number of treatments administered by the number of children targeted during the MDA.Principal FindingsOf the approved requests for 78 MDAs, 54 MDAs (69%) were successfully implemented during or before the scheduled month. Ten MDAs (13%) were classified as delayed; seven of these were delayed by one month or less. An additional 14 MDAs (18%) were classified as missed. For the 64 on-time or delayed MDAs, the mean coverage was approximately 88%.Conclusions and SignificanceTo continue to assess the supply chain processes and identify areas for improvement, we identified four indicators or metrics for supply chain performance that can be applied across all neglected tropical disease (NTD) drug donation programs: (1) donor having available inventory to satisfy the country request for donation; (2) donor shipping the approved number of doses; (3) shipment arriving at the Central Medical Stores one month in advance of the scheduled MDA date; and (4) country programs implementing the MDA as scheduled.

Novel Humanitarian Aid Program: The Glivec International Patient Assistance Program-Lessons Learned From Providing Access to Breakthrough Targeted Oncology Treatment in Low- and Middle-Income Countries.

Imatinib was the first targeted therapy approved for the treatment of cancer. With its approval, it was immediately clear to Novartis that this breakthrough therapy would require an innovative approach to worldwide access, with special consideration of low- and middle-income countries. Lack of government reimbursement, universal health care, or health insurance coverage, few trained specialty physicians or diagnostic services, and poor health care infrastructure were, and continue to be, contributing barriers to access to treatment in low- and middle-income countries. The Glivec International Patient Assistance Program (GIPAP) is an international drug donation program established by Novartis Pharma AG and implemented in partnership with The Max Foundation, a nonprofit, nongovernmental organization. GIPAP was established in 2001, essentially in parallel with the first approval of imatinib for chronic myeloid leukemia. Since 2001, GIPAP has made imatinib accessible to all medically and financially eligible patients within 80 countries on an ongoing basis as long as their physicians prescribe it and no other means of access exists. To date, more than 49,000 patients have benefited from GIPAP, and 2.3 million monthly doses of imatinib have been approved through the program. GIPAP represents an innovative drug donation model that has set the standard for access programs for other targeted or innovative therapies. The purpose of this article is to describe the structure of GIPAP, as well as important lessons that have contributed to the success of the program. This article may assist other companies with the development of successful and far-reaching patient assistance programs in the future.

From River Blindness to Neglected Tropical Diseases--Lessons Learned in Africa for Programme Implementation and Expansion by the Non-governmental Partners.

After more than 20 years of action against some of the most debilitating neglected tropical diseases (NTDs), lessons have been learned by the non-governmental development organisations (NGDOs) in the light of changes in programme strategies and partnerships. This article aims to summarise the development of the non-governmental networks supporting the NTD programmes, starting with the original 1992 model to combat onchocerciasis (river blindness), and will review the lessons learned that have equipped the NGDOs to step up their support to NTD control and elimination. At the beginning of the 1990s, a small group of seven NGDOs began to work together to support onchocerciasis control [1]. Today, more than 50 international and national NGDOs (of which 30 collaborate at the international level) work together to control or eliminate five priority NTDs affecting more than one billion of the poorest people [2]. This is a significant contribution to the objectives of World Health Assembly resolutions and the London Declaration on NTDs [3], as well as addressing Millennium Development Goal (MDG) 1, “Eradicate extreme poverty and hunger;” MDG 6 “Combat HIV/AIDS, malaria, and other diseases;” and MDG 8, “Develop a global partnership for development.” In 2013, the first annual report of the London Declaration on Neglected Tropical Diseases recorded increased treatments and funding and significant progress towards the World Health Organization (WHO)’s roadmap for implementation for control, elimination, or eradication by 2020. This achievement has been made possible by developing networks of NGDOs and partnerships with governments of the endemic countries, with international and bilateral agencies, with drug donation programmes for specific diseases, and with the communities affected by those diseases [4]. By 2011, NGDOs reported support in 125 countries to more than 330 million treatments for five priority diseases: onchocerciasis, trachoma, lymphatic filariasis (LF), schistosomiasis, and soil-transmitted helminthiasis (STH) [5]. These diseases have effective mass drug administration (MDA) strategies supported by donated or very-low-cost drugs available to control or eliminate them [6,7].

Development assistance for neglected tropical diseases: progress since 2009.

Neglected tropical diseases (NTDs) is an umbrella term for a diverse group of debilitating infections that represent the most common afflictions for 2.7 billion people living on less than US$2 per day. Major efforts have recently re-focused attention on NTDs, including structured advocacy by the Bill and Melinda Gates Foundation, technical and political support by WHO and large-scale drug donation programs by pharmaceutical companies. An analysis of the Official Development Assistance (ODA) for NTDs in 2009 showed that Development Assistance Committee members and multilateral donors had largely ignored funding NTD control projects. This study reviews the changes since 2009 and finds an increased engagement by pharmaceutical manufacturers through drug donation programs substantially increased by the 'London Declaration' in 2012, a focused effort of 77 public and private partners on control or elimination of the 10 most common NTDs, but no increase in ODA for NTDs between 2008 and 2012. The allocation of ODA still does not reflect the respective importance of these diseases.

Prevention of mother-to-child HIV transmission in resource-limited settings: assessment of 99 Viramune Donation Programmes in 34 countries, 2000-2011.

BackgroundTransmission of HIV from mother-to-child during pregnancy, labor, or breastfeeding is the primary cause of pediatric HIV infection in sub-Saharan Africa. A regimen of single-dose nevirapine administered to both HIV-positive pregnant women and their infants has been shown to lower the risk of mother-to-child transmission (MTCT) of HIV. In an effort to facilitate scale-up of PMTCT programs in low-income countries, Boehringer Ingelheim, the manufacturer of Viramune (branded nevirapine), initiated the Viramune Donation Programme (VDP) in 2000. The aim of this study was to evaluate the impact of the VDP on participating institutions.MethodsA total of 164 institutions in 60 countries were included in the VDP over its 11-year duration. An online quantitative and qualitative questionnaire was submitted to all program managers. The questionnaire collected data on the impact of the VDP on initiation and scale-up of PMTCT services, operational capacity, national PMTCT policies, access to funding, and national and international partnerships. Participants were asked for their opinion of how VDP was perceived by different stakeholders (medical community, patients, government authorities, communities).ResultsNinety-nine managers (60.4%) in 34 countries responded to the online questionnaire; 89 of institutions (89.9%) were located in Africa The most positive aspects of the VDP identified were: helped to expand PMTCT services (85.9% of program managers), reduced stigma against HIV-positive pregnant women, increased social support mechanisms (78.8%), fostered partnerships with national and international organizations (69.0%), and encouraged access to donor funding (63.0%). Implementation of the VDP triggered improvements in training hospitals and logistical capacity and was associated with changes in policy strategies at the national level.ConclusionA drug donation program such as the VDP can act as a catalyst for systemic changes at the institutional and national levels. The VDP provides a model for how private initiatives can have a significant impact on public health issues and foster diverse public-private partnerships among governments, commercial organizations, local institutions, and international NGOs.

SCIENTIFIC SOVEREIGNTY: How International Drug Donation Programs Reshape Health, Disease, and the State

This essay sketches two international, pharmaceutical company–sponsored drug donation programs and assesses this novel integration of corporations into global health. Based on ethnographic interviews with retired and current pharmaceutical executives and scientists, international humanitarian workers, and volunteers and drug recipients in the Morogoro region of Tanzania, this essay develops a concept of “scientific sovereignty,” a process through which corporate and biomedical logics supplant the state in the exercise of biopower. I assess these interventions’ impact on a local health system and the theoretical implications of the global health orthodoxies on which they rely.

Improving Access to Medicines for Neglected Tropical Diseases in Developing Countries: Lessons from Three Emerging Economies

Neglected tropical diseases (NTDs) are those largely ignored by medical science, partly because they do not represent a viable commercial market for private pharmaceutical companies. These diseases are endemic in developing countries and have a significant impact at both personal and national levels. Globally, NTDs affect an estimated 2.7 billion people living on less than US$2 per day [1] and potently reinforce the poverty cycle [2]. At present, the prevailing strategy for improving access to medicines for these NTDs is drug donation programmes, which, despite providing some of the highest economic returns of public health programmes at 15%–30% [2], [3], have uncertain sustainability. Countries in demographic and economic transition are uniquely poised to be leaders in a shift towards a more sustainable, affordable means of providing access to medicines for NTDs.

Collaborative Effort Targets 17 Tropical Diseases for Control, Elimination

IN AN EFFORT TO CONTROL OR ELIMInate17neglected tropicaldiseases, the World Health Organization (WHO) is bringing together national governments, more than a dozen pharmaceutical companies, and philanthropies such as the Bill & Melinda Gates Foundation in the largest coordinated effort to date to combat this group of illnesses. WHO estimates that neglected tropical diseases affect more than 1 billion people worldwide, mainly in poor rural areas. To guide the effort and set targets for whatshouldbeachievedbytheendofthe decade,WHOhaspublishedanewstrategy, Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases: A Roadmap for Implementation (http://tinyurl.com/79ytbns). The projectcomes inresponsetoWHO’s2010report,Working toOvercometheGlobal ImpactofNeglectedTropicalDiseases,which calledfornewresourcestoovercomesuch diseases (http://tinyurl.com/7oxg2ah). The diseases that are being targeted includedengue, rabies,blindingtrachoma, Buruli ulcer, endemic treponematoses (yaws), leprosy, Chagas disease, human African trypanosomiasis, visceral leishmaniasis, cysticercosis, dracunculiasis (guinea worm disease), echinococcosis, foodborne trematode infections, lymphatic filariasis, onchocerciasis, schistosomiasis,andsoil-transmittedhelminthiases (intestinal worms). “We have the tools, we know what to do, and this public-private partnership is unprecedented,” Margaret Chan, MD, WHO’s director general, said at a London press conference held in January to announce the effort. “The do-good spirit is giving me a lot of optimism.” Focusing on treatments for these diseases is generally not profitable for drug companies. But those involved in the initiative announced that they would sustain or expand existing drug donation programs to meet demand through 2020, share expertise and compounds to accelerate the development of new drugs, and provide more than $785 million to support research efforts and strengthen drug distribution and implementation programs. Additional money will come from groups such as the UK Department for International Development and the US Agency for International Development. Also, various governments, including those where neglected tropical diseases are endemic (such as Bangladesh, Brazil, Mozambique, and Tanzania), announced that they would devote resources to combat these diseases. “The drug suppliers are willing to be generous, but they need to know there’s a road map . . . they need to know that there’s delivery funding . . . and they need to know that the countries involved are going to orchestrate their health systems to make sure that all of the drugs really get to those people in need,” Bill Gates, cochair of the Bill & Melinda Gates Foundation, said at the press conference. “And what’s unique today is that all of those actors have stepped forward in a dramatic way.” The WHO roadmap recommends 5 strategies for the prevention, control, elimination, and eradication of neglected tropical diseases: preventive chemotherapy; intensified disease management; vector and intermediate host control; veterinary public health at the human-animal interface; and provision of safe water, sanitation, and hygiene. A scorecard will regularly and formally track participants’ progress, including whether they are meeting their supply, research, funding, and implementation commitments to work toward the effort’s goals. news@JAMA From JAMA’s Daily News Site

‘SINCE WE ARE TAKING THE DRUGS’:

This paper examines and compares conceptions of the place of labor, commodity, value, and gift in two pharmaceutical company-sponsored international drug donation programs. Drawing on ethnographic research done between 2006 and 2008, the paper tracks how medical-scientific architects of these donation programs (NGO and pharmaceutical executives, tropical medicine experts, Ministries of Health) understand the labor of the drug recipients, how they imagine community participation, and how they value their own participation in the program. The paper incorporates interviews with past and present pharmaceutical company employees, elaborating their understandings of the relationships and values created by the donations, and their obligations within the programs. Scientist-administrators involved with the program envision community participation as being joyful and self-interested, and they show great excitement and pride in the power of their donated drugs. In contrast, interviews with farmers and local health volunteers drawn from a research trip to the Morogoro region of Tanzania show the ambivalent, conflicted, and sometimes resentful understanding of labor involved with the drug donation programs, labor which arrives in the form of distribution tasks and hygienic strictures associated with free, powerful drugs. The local scene provides a critical counterpoint to positive imaginations of community ownership and participation in health interventions, and points to systemic misunderstandings within the reciprocal relationship between African drug recipients and the American and European scientist-administrators who design and direct these programs.

Fiscally challenged drug-donation program helps needy Wyoming residents

The ability to help patients who cannot afford their medications offsets some of the daily resource challenges at Wyoming’s pharmacist-run drug-donation program. The program was created through a 2005 state law, the Drug Donation Program Act, and began operating the next year, said Donna Artery,

Eliminating Lymphatic Filariasis

Among infections closely associated with poverty, lymphatic filariasis (LF) is a study in contrasts. It is both a consequence of and a contributor to poverty. Although rarely fatal, it is recognized as a leading global cause of lifelong disability as well as significant personal, social, and economic burdens coincident with disease. Infection is often considerably more prevalent in communities than the number of cases of overt pathology for which LF is best known (lymphedema, elephantiasis, and hydrocele). With an estimated 120 million to 130 million affected persons in 83 countries and 1.25 billion persons living in areas at risk, in some countries LF may be expanding its range, whereas in others, with economic development, it has disappeared with little if any targeted intervention. The transmission cycle is relatively inefficient, yet an association with pockets of deepest poverty remains tenacious. Thanks to scientific advances in diagnostic tools, and particularly in control strategies focused on large-scale drug donation and mass drug distribution programs, scientists and policy makers now consider LF eliminable. Together with new approaches for morbidity control, a hopeful tone surrounds a disease problem that as recently as two decades ago could easily have been categorized as among the most neglected of neglected diseases. Continued progress toward global LF elimination will require solutions to potential obstacles in the most challenging--that is, the poorest--endemic settings. This chapter reviews progress toward LF elimination and some of the remaining challenges from a perspective in Haiti, the only least developed country of the Americas.

Corporate social responsibility strategies aimed at the developing world: perspectives from bioscience companies in the industrialised world

Bioscience companies have started to implement Corporate Social Responsibility (CSR) mechanisms aimed at the developing world because many companies feel they have a moral responsibility to give back to society instead of only focusing on profits. This research team went to the source and interviewed over 100 managers and executives of bioscience companies to uncover what ethical issues they face and what mechanisms they are using to address these issues. This paper reports on six CSR mechanisms that the companies studied are using to address global health problems in the developing world: (1) Drug Donation Programmes, (2) Pricing Strategies, (3) Building Local Health Capacity, (4) Public–Private Partnerships (PPPs), (5) Benefit Sharing and (6) Charitable Foundations. Each mechanism is described in detail with examples from the companies studied followed by a preliminary analysis of some cautions that should be considered before each mechanism is implemented. These empirically based mechanisms offer ideas and models from which other companies can learn.

Benefit Cuts Force Many To Make Painful Choices

Benefit Cuts Force Many To Make Painful Choices