Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines

Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action

Simple model for transport phenomena : Microscopic construction of Maxwell Demon like engine

We present a microscopic Hamiltonian framework to develop Maxwell demon like engine. Our model consists of a equilibrium thermal bath and a non-equilibrium bath; latter generated by driving with an external stationary, Gaussian noise. The engine we develop, can be considered as a device to extract work by modifying internal fluctuations. Our theoretical analysis focusses on finding the essential ingredients necessary for generating fluctuation induced transport under non-equilibrium condition. An important outcome of our model is that the net motion occurs when the non-linear bath is modulated by the external noise, creating the non-zero effective temperature even when the temperature of both the baths are same.Comment: 6 pages, RevTex

Transport and bistable kinetics of a Brownian particle in a nonequilibrium environment

A system reservoir model, where the associated reservoir is modulated by an external colored random force, is proposed to study the transport of an overdamped Brownian particle in a periodic potential. We then derive the analytical expression for the average velocity, mobility, and diffusion rate. The bistable kinetics and escape rate from a metastable state in the overdamped region are studied consequently. By numerical simulation we then demonstrate that our analytical escape rate is in good agreement with that of numerical result.Comment: 10 pages, 2 figures, RevTex4, minor correction

Generalization of escape rate from a metastable state driven by external cross-correlated noise processes

We propose generalization of escape rate from a metastable state for externally driven correlated noise processes in one dimension. In addition to the internal non-Markovian thermal fluctuations, the external correlated noise processes we consider are Gaussian, stationary in nature and are of Ornstein-Uhlenbeck type. Based on a Fokker-Planck description of the effective noise processes with finite memory we derive the generalized escape rate from a metastable state in the moderate to large damping limit and investigate the effect of degree of correlation on the resulting rate. Comparison of the theoretical expression with numerical simulation gives a satisfactory agreement and shows that by increasing the degree of external noise correlation one can enhance the escape rate through the dressed effective noise strength.Comment: 9 pages, 1 figur

Kramers turnover in class of thermodynamically open systems: Effect of interplay of nonlinearity and noises

A system-reservoir nonlinear coupling model has been proposed for a situation where the reservoir is nonlinearly driven by an external Gaussian stationary noise which exposes the system particles to a nonequilibrium environment. Apart from the internal thermal noise, the thermodynamically open system encounters two other noises that are multiplicative in nature. Langevin equation derived from the resulting composite system contains the essential features of the interplay between these noise processes. Based on the numerical simulation of the full model potential, we show that one can recover the turnover features of the Kramers dynamics even when the reservoir is modulated nonlinearly by an external noise.Comment: 7 pages, 2 figure

Oncology Drug Production in Sub-Saharan Africa: The Challenge and Opportunity, with Evidence from India

This chapter focuses on the scope for local production in East Africa of essential oncology medication, drawing on evidence of local clinical need; on Indian data on markets for generic oncology medication; and on industrial and regulatory experience. Import-dependence in oncology is almost complete across Sub-Saharan Africa, while India is a key exporter. The chapter documents competition failures in generic oncology markets and demonstrates the huge affordability impact of effective procurement of these medicines within India. Challenges for local oncology manufacturing are identified. The chapter argues that active health-industrial research linkages can build a local African oncology industry

Multiplicative cross-correlated noise induced escape rate from a metastable state

We present an analytical framework to study the escape rate from a metastable state under the influence of two external multiplicative cross-correlated noise processes. Starting from a phenomenological stationary Langevin description with multiplicative noise processes, we have investigated the Kramers' theory for activated rate processes in a nonequilibrium open system (one-dimensional in nature) driven by two external cross-correlated noise processes which are Gaussian, stationary and delta correlated. Based on the Fokker-Planck description in phase space, we then derive the escape rate from a metastable state in the moderate to large friction limit to study the effect of degree of correlation on the same. By employing numerical simulation in the presence of external cross-correlated additive and multiplicative noises we check the validity of our analytical formalism for constant dissipation, which shows a satisfactory agreement between both the approaches for the specific choice of noise processes. It is evident both from analytical development and the corresponding numerical simulation that the enhancement of rate is possible by increasing the degree of correlation of the external fluctuations.Comment: 9 pages, 1 figures, RevTex

Time dependent current in a nonstationary environment: A microscopic approach

Based on a microscopic system reservoir model,where the associated bath is not in thermal equilibrium, we simulate the nonstationary Langevin dynamics and obtained the generalized nonstationary fluctuation dissipation relation (FDR) which asymptotically reduces to the traditional form. Our Langevin dynamics incorporates non-Markovian process also, the origin of which lies on the decaying term of the nonstationary FDR. We then follow the stochastic dynamics of the Langevin particle based on the Fokker-Planck-Smoluchowski description, in ratchet potential to obtain the steady and time dependent current in an analytic form. We also examine the influence of initial excitation and subsequent relaxation of bath modes on the transport of the Langevin particle to show that the nonequilibrium nature of the bath leads to both strong non-exponential dynamics as well as nonstationary current.Comment: 10 pages, RevTex4, references updated, final version to appear in Journal of Mathematical Physic