[EQ] Special Edition Of Social Medicine: Health Reform in Venezuela

 

Social Medicine/ Medicina Social [An international, open-access, peer-reviewed academic forum published online in English and Spanish.]

 

Currently available in English at  www.socialmedicine.info and in Spanish at www.medicinasocial.info . 

 

The theme for this special edition is:

Health for All: Alma Ata is Alive and Well in Venezuela

Vol 3, No 4 (2008)
Guest Editors: Joan E. Paluzzi & Fernando Arribas García

This issue includes an international group of physicians, public health specialists and other scholars, many of them directly involved in the design, implementation, and assessment of Venezuela’s new national health care system and the development of its concurrent educational infrastructure.
The articles on Venezuela include:

 

Table of Contents

Editorials

Health for All: Alma Ata is Alive and Well in Venezuela		PDF
Joan Elizabeth Paluzzi, Fernando Arribas García,
Venezuelan Health Reforms National Training Program for Comprehensive Community Physicians, Venezuela				Abstract PDF
Eugenio Radamés Borroto Cruz, Ramón Syr Salas Perea

 

Neoliberal Policies and their Impact on Public Health Education: Observations on the Venezuelan Experience	Abstract PDF
Oscar Feo

 

Venezuela's Barrio Adentro: participatory democracy, south-south cooperation and health care for all	Abstract PDF
Carles Muntaner, Francisco Armada, Haejoo Chung, Mata Rosicar, Leslie Williams-Brennan, Joan Benach

 

Venezuela’s Misión Barrio Adentro “Inside the Neighborhood”	Slideshow
Joan Elizabeth Paluzzi

 

Adentro Barrio Adentro: An American Medical Student in Venezuela	Abstract PDF
Rebecca Trotzky Sirr

Themes and Debates

Social Determinants of Health: Perspective of the ALAMES Social Determinants Working Group	Abstract PDF
Oliva López Arellano, José Carlos Escudero, Luz Dary Camona

 

From: Joan Paluzzi JEPALUZZ Assistant ProfessorDepartment of Anthropology University of North Carolina joan_paluzzi@uncg.edu

Editorial Offices: Department of Family and Social Medicine
Albert Einstein College of Medicine/Montefiore Medical Center Bronx, New York

 

 

 

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.  

[EQ] Medicine prices, availability, and affordability in 36 developing and middle-income countries

Essential medicines out of reach for most people

 

WHO World health Organization: http://www.who.int/mediacentre/news/releases/2008/pr45/en/index.html

HAI - Health Action International: http://www.haiweb.org/medicineprices/

Full article PDFat: http://www.haiweb.org/medicineprices/01122008/MedPrices%20-%20Word.pdf

“….1 December 2008 | WHO GENEVA -- An alarming lack of availability of essential medicines in the public sector drives patients to pay higher prices in the private sector or go without, according to a WHO study reported in today’s online edition of The Lancet. The results confirm that governments must do more to improve access to essential medicines as part of their efforts to make national health systems more efficient and equitable.

 

The study analysed data from surveys in 36 countries from all WHO geographical regions and World Bank income groups. Results show an average public-sector availability of only 38% across surveys. This forces patients to buy medicines from the private sector where treatments are more expensive and frequently unaffordable. In Africa, for example, the lowest-paid government worker needs to spend two days' salary each month to purchase diabetes treatment using the lowest-priced generic medicine. When the originator brand is used, costs escalate to over eight days' wages….”

 

Medicine prices, availability, and affordability in 36 developing and middle-income countries:
a secondary analysis

The Lancet, Early Online Publication, 1 December 2008 doi:10.1016/S0140-6736(08)61762-6

 

A Cameron MPH a   , M Ewen Dip Pharm b, D Ross-Degnan ScD c, D Ball PhD d, R Laing MD e
Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland (A Cameron MPH); Health Action International, Amsterdam, Netherlands (M Ewen Dip Pharm); Harvard Medical School and Harvard Pilgrim Health Care, Boston MA, USA (D Ross-Degnan ScD); Pharmaceutical consultant, Manila, Philippines (D Ball PhD); and Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland (R Laing MD)

Website:http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61762-6/fulltext
[Subscription required]

WHO and Health Action International (HAI) have developed a standardised method for surveying medicine prices, availability, affordability, and price components in low-income and middle-income countries. Here, we present a secondary analysis of medicine availability in 45 national and subnational surveys done using the WHO/HAI methodology

 

Methods

Data from 45 WHO/HAI surveys in 36 countries were adjusted for inflation or deflation and purchasing power parity. International reference prices from open international procurements for generic products were used as comparators. Results are presented for 15 medicines included in at least 80% of surveys and four individual medicines.

 

Findings

Average public sector availability of generic medicines ranged from 29•4% to 54•4% across WHO regions. Median government procurement prices for 15 generic medicines were 1•11 times corresponding international reference prices, although purchasing efficiency ranged from 0•09 to 5•37 times international reference prices. Low procurement prices did not always translate into low patient prices. Private sector patients paid 9—25 times international reference prices for lowest-priced generic products and over 20 times international reference prices for originator products across WHO regions. Treatments for acute and chronic illness were largely unaffordable in many countries. In the private sector, wholesale mark-ups ranged from 2% to 380%, whereas retail mark-ups ranged from 10% to 552%. In countries where value added tax was applied to medicines, the amount charged varied from 4% to 15%.

 

Interpretation

Overall, public and private sector prices for originator and generic medicines were substantially higher than would be expected if purchasing and distribution were efficient and mark-ups were reasonable. Policy options such as promoting generic medicines and alternative financing mechanisms are needed to increase availability, reduce prices, and improve affordability.

 

 

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

 

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.