Promotion of access to essential medicines for Non-Communicable Diseases: Practical implications of the UN Political Declaration

Access to medicines and vaccines to prevent and treat non-communicable diseases (NCDs) is unacceptably low worldwide. In the 2011 UN political declaration on the prevention and control of NCDs, heads of government made several commitments related to access to essential medicines, technologies, and vaccines for such diseases. 30 years of experience with policies for essential medicines and 10 years of scaling up of HIV treatment have provided the knowledge needed to address barriers to long-term effective treatment and prevention of NCDs. More medicines can be acquired within existing budgets with efficient selection, procurement, and use of generic medicines. Furthermore, low-income and middle-income countries need to increase mobilisation of domestic resources to cater for the many patients with NCDs who do not have access to treatment. Existing initiatives for HIV treatment offer useful lessons that can enhance access to pharmaceutical management of NCDs and improve adherence to long-term treatment of chronic illness; policy makers should also address unacceptable inequities in access to controlled opioid analgesics. In addition to off-patent medicines, governments can promote access to new and future on-patent medicinal products through coherent and equitable health and trade policies, particularly those for intellectual property. Frequent conflicts of interest need to be identified and managed, and indicators and targets for access to NCD medicines should be used to monitor progress. Only with these approaches can a difference be made to the lives of hundreds of millions of current and future patients with NCDs

Ethical rooms for maneuver and theirprospects vis á vis the current ethical food policies in Europe

In this paper I want to show that consumer concerns can be implemented in food chains by organizing ethical discussions of conflicting values that include them as participators. First, it is argued that there are several types of consumer concerns about food and agriculture that are multi-interpretable and often contradict each other or are at least difficult to reconcile without considerable loss. Second, these consumer concerns are inherently dynamic because they respond to difficult and complex societal and technological situations and developments. For example, because of the rising concern with global warming, carbon dioxide absorption of crops is now attracting public attention, which means that new requirements are being proposed for the environmentally friendly production of crops. Third, there are different types of consumers, and their choices between conflicting values differ accordingly. Consumers use different weighing models and various types of information in making their food choices. Changing food chains more in accordance with consumer concerns should at least take into account the multi-interpretable, dynamic, and pluralist features of consumer concerns, for example, in traceability schemes. In discussing usual approaches such as codes, stakeholder analysis, and assurance schemes, I conclude that these traditional approaches can be helpful. However, in cases of dynamic, pluralistic, and uncertain developments, maintaining some pre-existing evaluating scheme or some clear cut normative hierarchy, such as codes or assurance schemes, can be disastrous in undermining new ethical desirable initiatives. Instead of considering ethical standards and targets as fixed, which is done with codes and schemes, it is more fruitful to emphasize the structure of the processes in which ethical weighing of relevant consumer concerns get shaped. The concept of ¿Ethical Room for Maneuver¿ (ERM) is constructed to specify the ethical desirable conditions under which identification and weighing of paramount values and their dilemmas can be processed. The main aims of the ERM are making room in all the links of the food chain for regulating and implementing the relevant consumer concerns by (1) balancing and negotiating, (2) supporting information systems that are relevant and communicative for various consumer groups and (3) organizing consumer involvement in the links of the food chain. The social and political context of agriculture and food production, particularly in Europe, gives ample opportunity for implementing several types of Ethical Rooms for Maneuver. Finally, I discuss several types of Ethical Rooms for Manoeuvre in the food chains that can be communicated by means of specific traceability schemes to less involved stakeholders with the potential consequence that the stakeholders will be motivated to be more involve

Intelligent systems in manufacturing: current developments and future prospects

Global competition and rapidly changing customer requirements are demanding increasing changes in manufacturing environments. Enterprises are required to constantly redesign their products and continuously reconfigure their manufacturing systems. Traditional approaches to manufacturing systems do not fully satisfy this new situation. Many authors have proposed that artificial intelligence will bring the flexibility and efficiency needed by manufacturing systems. This paper is a review of artificial intelligence techniques used in manufacturing systems. The paper first defines the components of a simplified intelligent manufacturing systems (IMS), the different Artificial Intelligence (AI) techniques to be considered and then shows how these AI techniques are used for the components of IMS

Hospital management staffing and training issues

Hospitals dominate health care in most parts of the world and for a variety of reasons are likely to continue being a key factor in the overall performance of the health care system. Any efforts to improve this performance must therefore give greater hospital efficiency the highest priority. After discussing key issues of managerial, clinical, and production efficiency, this paper suggests an agenda for the most useful areas of research.Health Monitoring&Evaluation,Pharmaceuticals&Pharmacoeconomics,Housing&Human Habitats,Environmental Economics&Policies,Health Systems Development&Reform