20 research outputs found
La participation communautaire : une réponse à un double échec ? (Commentaire)
Kaddar Miloud. La participation communautaire : une réponse à un double échec ? (Commentaire). In: Sciences sociales et santé. Volume 13, n°2, 1995. pp. 61-64
Financement et dynamique des systèmes de santé au Maghreb : données et problèmes actuels
Kaddar Miloud. Financement et dynamique des systèmes de santé au Maghreb : données et problèmes actuels. In: Santé, médecine et société dans le monde arabe
Managing the effect of TRIPS on availability of priority vaccines
The stated purpose of intellectual property protection is to stimulate innovation. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) requires all Members of the World Trade Organization (WTO) to enact national laws conferring minimum standards of intellectual property protection by certain deadlines. Critics of the Agreement fear that such action is inconsistent with ensuring access to medicines in the developing world. A WHO convened meeting on intellectual property rights and vaccines in developing countries, on which this paper is based, found no evidence that TRIPS has stimulated innovation in developing market vaccine development (where markets are weak) or that protection of intellectual property rights has had a negative effect on access to vaccines. However, access to future vaccines in the developing world could be threatened by compliance with TRIPS. The management of such threats requires adherence of all countries to the Doha Declaration on TRIPS, and the protections guaranteed by the Agreement itself, vigilance on TRIPS-plus elements of free trade agreements, developing frameworks for licensing and technology transfer, and promoting innovative vaccine development in developing countries. The role of international organizations in defining best practices, dissemination of information, and monitoring TRIPS impact will be crucial to ensuring optimal access to priority new vaccines for the developing world
Le paiement des soins par les usagers dans les pays d'Afrique subsaharienne : rationalité économique et autres questions subséquentes.
JĂ©rĂ´me Dumoulin, Miloud Kaddar: Financing health care by patients in subsaharian countries: economie rationality and subsequent puzzles.
Financing health care by patients is an help to the failures of government financing. In a first part the neoliberal foundations of this policy is exposed; in a second part, the analysis of its implementation suggests a mitigated judgment. In a third part, three key issues are focused: health care quality, social solidarity in front of health hazards and decision decentralisation. These puzzles are underevaluated and misunderstood by neoliberal thinkers and ground experimenters.Résumé : Le paiement des soins par les usagers en Afrique subsaharienne vient au secours des défaillances du financement étatique. Cette question est analysée de deux points de vue : en premier lieu est exposée la logique rationalisatrice néolibérale selon laquelle le paiement par les usagers permettrait un progrès des services de santé ; en second lieu sont livrés les enseignements des expériences de terrain. Les auteurs en tirent un jugement mitigé. Dans une troisième partie, trois problèmes clés sont examinés : la qualité des soins, la solidarité face au risque de maladie, et la décentralisation des pouvoirs. Ces problèmes ne sont examinés suffisamment ni par les tenants de la logique rationalisatrice, ni par les praticiens de terrain.Jérôme Dumoulin, Miloud Kaddar : El pago de los servicios de salud en los paises de Africa subsahariana: racionalidad económica y otros interrogantes subsecuentes.
El pago de los servicios de salud por los utilizadores en Africa subsahariana se efectua en un momento en el que falla el financiamiento del Estado. Este problema se analiza desde dos puntos de vista: en primer lugar se expone la lĂłgica de la racionalizaciĂłn neoliberal segĂşn la cual el pago por los utilizadores de salud permitirfa un progreso de los servicios de salud; en segundo lugar se describen las ensenanzas de las experiancias de campo. Los autores hacen constar un resultado mitigado. En una tercera parte, se analizan très problemas claves: la calidad de los servicios mĂ©dicos, la solidaridad f rente al riesgo de la enfermedad, y la descentralizaciĂ´n de los poderes. Estos problemas no son analizados dĂ©bidamente ni por los defensores de la lĂ´gica racionalizadora ni por los que se dedican al trabajo de campo. segĂşn la cual el pago por los utilizadores de salud permitirĂa un progreso de los servicios de salud; en segundo lugar se describen las enseñanzas de las experiancias de campo. Los autores hacen constar un resultado mitigado. En una tercera parte, se analizan très problemas claves: la calidad de los servicios mĂ©dicos, la solidaridad f rente al riesgo de la enfermedad, y la descentralizaciĂłn de los poderes. Estos problemas no son analizados dĂ©bidamente ni por los defensores de la lĂłgica racionalizadora ni por los que se dedican al trabajo de campo.Dumoulin JĂ©rĂ´me, Kaddar Miloud. Le paiement des soins par les usagers dans les pays d'Afrique subsaharienne : rationalitĂ© Ă©conomique et autres questions subsĂ©quentes.. In: Sciences sociales et santĂ©. Volume 11, n°2, 1993. Aspects des systèmes de santĂ© dans les pays du Sud, sous la direction de Bernard Hours et JĂ©rĂ´me Dumoulin. pp. 81-119
Le prix des médicaments dans certains pays d'Afrique : comparaison avec les prix français
Jérôme Dumoulin, Miloud Kaddar: Drug prices in some african countries: comparison with drug priées in France.
A survey about retail prices of 47 drugs was carried out in Algeria, Tunisia, Senegal, Mali, Ivory Coast and Congo. These prices were compared to French retail prices. Prices in Algeria and Tunisia are far lower than those in France. There are higher in black Africa. Positive differences could be explained by national supplying policies and the negative deviations by higher distribution margins. Prices variations are very large amongst the 47 considered drugs. This probably could be explained by drug manufacturers' strategy facing a very competitive market.RĂ©sumĂ©. Une enquĂŞte sur les prix de vente de 47 mĂ©dicaments en officine a Ă©tĂ© rĂ©alisĂ©e en AlgĂ©rie, en Tunisie, au SĂ©nĂ©gal, au Mali, en CĂ´te-d'Ivoire et au Congo. Ces prix ont Ă©tĂ© comparĂ©s aux prix français. Les prix en AlgĂ©rie et en Tunisie sont nettement plus bas qu'en France ; ils sont plus Ă©levĂ©s en Afrique noire. La diffĂ©rence favorable s'explique par les politiques nationales d'approvisionnement, et les diffĂ©rences dĂ©favorables par les marges de distribution plus Ă©levĂ©es. Les variations sont très fortes selon les mĂ©dicaments considĂ©rĂ©s ; cela s'explique probablement par la politique des laboratoires face Ă la concurrence.JĂ©rĂ´me Dumoulin, Miloud Kaddar : El precio de algunos medicamentos en ciertos paises del Africa : comparacĂon con los presios franceses.
Se llevĂł a cabo un estudio sobre los precios de 47 medicamentos vendidos en farmacia en Argelia, TĂşnez, Senegal, Mali, Costa de Marfil asĂ como en el Congo. Estos precios fueron comparados con los precios franceses. Los precios en Argelia y en TĂşnez resultan ser netamente mas bajos que en Francia. Sin embargo, son mas elevados en el Africa negra. La diferencia favorable se explica por las polĂŻticas nacionalcs de abastecimiento, y las diferencias desfavorables por mârgenes de distribution mas elevados. Las variaciones son muy importantes segĂ»n el mĂ©dicamento que se tome en cuenta: es probable que este fenĂ´meno se explique por la polĂ®tica de los laboratorios frente a la competencia. dos en el Africa negra. La diferencia favorable se explica por las polĂticas nacionales de abastecimiento, y las diferencias desfavorables por márgenes de distribuciĂłn mas elevados. Las variaciones son muy importantes segĂşn el mĂ©dicamento que se tome en cuenta: es probable que este fenĂłmeno se explique por la polĂ®tica de los laboratorios frente a la competencia.Dumoulin JĂ©rĂ´me, Kaddar Miloud. Le prix des mĂ©dicaments dans certains pays d'Afrique : comparaison avec les prix français. In: Sciences sociales et santĂ©. Volume 8, n°1, 1990. pp. 51-71
The impact of the Global Polio Eradication Initiative on the financing of routine immunization: case studies in Bangladesh, CĂ´te d'Ivoire, and Morocco
To determine if the Global Polio Eradication Initiative (PEI) affected financing of routine immunization programmes, we compared sources and uses of funds for routine immunization programmes and PEI activities in Bangladesh, CĂ´te d'Ivoire, and Morocco for the years 1993-98. We also examined funding trends for these years in these countries and assessed the effect of the initiative on the availability of specific resources in national immunization programmes, such as cold-chain equipment and personnel time spent on activities related to national immunization days and surveillance of poliomyelitis and acute flaccid paralysis. We found that all three governments and the majority of donors and international organizations continued to fund routine immunization programmes at levels similar to those before the PEI. Trend analysis also indicated that financing for routine immunization in each of the countries continued to increase after the PEI was introduced. The results show that the PEI did not reduce funding for routine immunizations in these countries
Financial challenges of immunization: a look at GAVI.
Securing reliable and adequate public funding for prevention services, even those that are considered highly cost effective, often presents a challenge. This has certainly been the case with childhood immunizations in developing countries. Although the traditional childhood vaccines cost relatively little, funding in poor countries is often at risk and subject to the political whims of donors and national governments. With the introduction of newer and more costly vaccines made possible under the Global Alliance for Vaccines and Immunization (GAVI), the future financial challenges have become even greater. Experience so far suggests that choosing to introduce new combination vaccines can significantly increase the costs of national immunization programmes. With this experience comes a growing concern about their affordability in the medium term and long term and a realization that, for many countries, shared financial responsibility between national governments and international donors may initially be required. This article focuses on how GAVI is addressing the challenge of sustaining adequate and reliable funding for immunizations in the poorest countries