Access to Medicines: the Role of Intellectual property Law and Policy

Intellectual property (IP) policy is an important structural determinant of health. Patent policy influences the rate and direction of innovation for health, playing a positive or negative role depending on how it is shaped and implemented. Patent policy also has critical implications for access to existing medicines and medical technologies. This has been illustrated most dramatically in the context of the global Acquired immunodeficiency syndrome (AIDS)/ Human immunodeficiency virus (HIV) pandemic. Prices for a three-drug combination of anti-retroviral (ARV) HIV therapy in 2000 from patent-holding companies exceeded USD $10,000 per person per year, ensuring that treatment could not be extended to the vast majority of those living with HIV around the world. Generic competition led to precipitous price reductions, so that today treatment can be provided for less than USD$75 per person per year. This history has contributed to the growing recognition that strong patent law applied to pharmaceuticals in developing countries undermines access to medicines and compromises the human right to health. While the relationship between IP and innovation is covered in a separate paper, it is worth noting here that there is little reason to expect that stronger patent rights in developing countries will lead to any substantial offsetting gains in innovation for the affected countries. Developing countries represent a very small share of the world’s pharmaceutical market, meaning that the marginal added value of stronger patent protection will be small, and is unlikely to outweigh the costs to access

Comparison of the sofa and qsofa scores in predicting in-hospital mortality among adult critical care patients with suspected Infection.

Background: Sepsis is global health priority and the commonest cause of death in critical care. SEPSIS 3 criteria introduced in 2016 is the latest tool in diagnosing sepsis, uses qSOFA and SOFA scores in place of the SIRS based definition for better prediction of mortality in patients with suspected infections. Their performance in predicting mortality in critical care units outside high- income countries remains largely unknown. Objective: We compared the SOFA and qSOFA scores in predicting the hospital mortality of adult critical care patients admitted with suspected infection at the Aga Khan University Hospital Nairobi, Kenya. Methods: We did a retrospective review of all admissions to the critical care units from January 2017 to December 2017, enrolling eligible patients. We censored on hospital discharge or death. We electronically collected clinical, demographic and outcome data. AUROC with 95 per cent confidence intervals for SOFA and qSOFA compares the scores. Results: There were a total of 450 patients with a mean age of 56 years and 57.60% were male. There were 92 deaths (20.44%) and 284 (63.1%) patients experienced a prolonged ICU stay (≥3 days). Majority (371, 82.44%) manifested a SOFA score of two or more and 190 patients (42.22%) had a qSOFA score of two or more. SOFA score had a better ability in predicting in hospital mortality compared to qSOFA (AUROC of 0.799 (95% CI, 0.752 - 0.846) Vs AUROC of 0.694 (95% CI, 0.691 -0.748), P \u3c 0.001). Conclusion and recommendations: Among adult critical care patients with suspected infection at admission to critical care, a SOFA score of two or more was better than qSOFA score of two or more in predicting in-hospital mortality

What was the Social Revolution of 1946 in East Sumatra?

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