Submission to the United Nations Secretary General's High Level Panel on Access to Medicines

Much of the current debate on health care goals, medical innovation and trade rules focuses on the misalignment between the need to provide incentives to innovation – mainly through a tight intellectual property (IPR) regime – and the resulting negative consequences in terms of access to medicines. While this clash is certainly crucial, this contribution focuses on a different aspect of the misalignment between innovation and access, concerning essential drugs and generics rather than brand new, innovative drugs. This contribution argues that the promotion of domestic drug production and innovative capabilities in low and middle income countries, and notably on the Sub-Saharan African subcontinent, can may constitute an important step towards achieving significant improvements in public health – as a human right that includes access to essential medicines. We provide background and evidence for this argument. We then draw out policy implications, arguing that increased policy coherence between health policies for medicines access and public health, and industrial and trade policies for Africa-based pharmaceutical production and innovation, are both feasible and beneficial, generating synergies between improved medicines access and local industrial innovation

Pharmaceuticals in Kenya: The Evolution of Technological Capabilities

As Chapter 1 briefly outlined, Kenya has a strong and long-standing pharmaceutical industry. A 2015 Business Monitor report on pharmaceutical manufacturing in Kenya states that the country hosts the largest pharmaceutical industrial base in East Africa. The report also sees a bright future as a ‘potential base for export across East Africa’ (BMI Research, 2015). This chapter locates the Kenyan pharmaceutical industry within the country’s historical context of industrial development and growth

Prevention and early diagnosis of oral carcinoma in construction workers in Italy: a pilot project

Objectives: A research project on occupational exposure in relation to oral carcinoma was periodic compulsory check-ups, oral examinations were performed to detect pathologies and the prevalence of potentially neoplastic oral conditions and a selfassessment questionnaire was administered to all of the subjects. The questionnaire was structured to collect information regarding demographic and clinical characteristics, risk habits (tobacco and alcohol consumption) and oral health habits, and to allow an assessment of knowledge about oral cancer, related risk factors and early signs. Results: The study cohort included people with different ethnicities, and there were significant differences in clinical characteristics between Italians and other Europeans. The subjects showed a good knowledge about oral cancer and related risk factors (with correct answers provided to >50% of the questions) but insufficient knowledge about the early signs of oral carcinoma (correct-answer rates of 16–42%). There were high rates of habits that are potentially harmful to oral health, such as smoking (43.8%) and alcohol consumption (57%). The daily habit of brushing teeth was present in 92.6% of the subjects, but they had a low propensity to undergo regular dental examinations. The percentage of subjects with pathologies of the oral cavity was 18.6%. Conclusions: Despite the smallness of the sample, this pilot project could facilitate the acquisition of valid and cost-effective data for the primary prevention of oral cancer through information and educational campaigns on the related risk factors

Exploring the anti-biofilm activity of cinnamic acid derivatives in Candida albicans

Some compounds, characterized by phenylethenyl moiety, such as methyl cinnamate and caffeic acid phenethyl ester, are able to inhibit C. albicans biofilm formation. On these bases, and as a consequence of our previous work, we synthesized a series of cinnamoyl ester and amide derivatives in order to evaluate them for the activity against C. albicans biofilm and planktonically grown cells. The most active compounds 7 and 8 showed ⩾50% biofilm inhibition concentrations (BMIC50) of 2 μg/mL and 4 μg/mL respectively, against C. albicans biofilm formation; otherwise, 7 showed an interesting activity also against mature biofilm, with BMIC50 of 8 μg/m

Financialisation As An Enabler Or Inhibitor Of Innovation? The Case Of UK Biotech

This paper discusses the structural changes occurring in the Pharmaceutical and Biotechnology industries the basis for a case study to explore the existence of a relationship between financialisation and innovation. The paper specifically examines the extent to which structural change can be identified as an outcome of ‘financialisation’, and/or a test of the effectiveness of financialisation, especially in the UK and US. It focuses on the problem of financial resources transfer within the new industry structure, from large developers and marketers of drugs to small independent innovators. The industry’s structural change permits a exploration of two related hypotheses. First, that the old vertically integrated structure was due (at least in part) to financial market imperfections, which made it more efficient to transfer financial resources within one company structure than between companies via financial transactions. Second, that the industry’s vertical disintegration results (at least in part) from improvements in the efficiency of financial mediation, making market-based financial transfer more efficient than intra-firm transfer. However, in contrast to the theoretical expectations we find our case study of the biopharmaceutical industry highlights that the impact of financialisation has been to focus the transfer of financial resources towards opportunities with short-term near market opportunities, instead of focusing on long-term innovation projects

PERSISTENCE BY DIVISION: A STUDY OF HIV-1 RESERVOIR QUANTIFICATION AND ITS MAINTENANCE THROUGH ANTIGEN-DRIVEN T CELL PROLIFERATION

Antiretroviral therapy (ART) greatly reduces HIV-1 morbidity and mortality. However, it has no effect on the HIV-1 reservoir, a small pool of latently infected cells that rekindles infection upon treatment interruption. Due to the persistence of this reservoir, ART must be continued indefinitely, requiring public health systems to deliver medications to all 38 million people living with HIV-1 for life. In this dissertation we explore two outstanding challenges of our field: i) understanding the composition and magnitude of persistent HIV-1-infected cells, and ii) identifying the mechanisms that allow the maintenance of the reservoir through cell proliferation. The assays currently used to measure HIV-1 persistence present limitations. Culture-based approaches, considered the gold-standard in determining the size of the reservoir with inducible, replication competent proviruses, allow recovery of infectious virus. However, outgrowth assays are labor-intensive, require large numbers of cells, and rely on proviral reactivation from latency, which can lead to an underestimation of reservoir size. On the other hand, PCR-based assays can be easily implemented in most laboratories, but fail to distinguish intact from defective proviruses, the latter representing about 90% of the proviral landscape. Our group recently developed the Intact Proviral DNA Assay (IPDA), a method based on a duplexed droplet digital PCR that offers a paradigm shift in the quantification of HIV-1 DNA. The IPDA provides rapid and sensitive detection of HIV-1 DNA with two strategically designed sets of primers and probes that allow the parsing of intact proviruses from those with lethal mutations. In this dissertation, we demonstrate the scalability of this approach, studying a cohort of 400 individuals living with HIV-1 on ART. The reservoir is maintained by the long half-life and proliferation of infected cells. Through proliferation, cells infected before the introduction of ART give rise to clonal progeny harboring identical copies of HIV-1 DNA integrated into the cell genome. Despite its central role, the mechanisms of this persistence through division are not completely understood. Thus, if the cells that we aim to eliminate proliferate in infected individuals, we need to understand why and find a way to stop this phenomenon. There are three potential causes driving the expansion of infected cells: homeostatic proliferation, insertional mutagenesis due to HIV-1 integration in specific genes, and the interaction with cognate or cross-reacting antigens. In this dissertation, we investigated the role of chronic viral antigens, such as those from cytomegalovirus, in driving the expansion of HIV-1-infected clones in vivo. We demonstrated that antigen-driven clonal selection leads to large, infected clones that persist over time. Overall, the results from this thesis work suggest that antigen-driven clonal expansion, relative to homeostatic proliferation and HIV-1 integration, plays a major role in promoting HIV-1 persistence and that adaptive immune responses impose selective pressure on HIV-1-infected cells

La desestatización de la función jurisdiccional en los procesos concursales de las entidades de intermediación financiera y de valores.

Abstract. This paper deals with the changes introduced by Laws 18.401 and 18.627, which entrusted the bankruptcy proceedings of banks, stock exchanges and other related persons, to non-governmental entities. This is a violation of the Constitution, which specifies who are the subjects that may develop the Jurisdictional role, establishing it asan exclusive performance by the State, mainly by the Judiciary. These unconstitutional legislative innovations affect the procedural rights of debtors and creditors in bankruptcy, to the point of compromising the existence of the Due Process, which cannot be assured out of the State courts designated by the Constitution.Resumen. El presente trabajo trata sobre los cambios introducidos por las leyes 18401 y 18627, que confiaron los procesos concursales de bancos, bolsas de valores y otras personas afines a personas jurídicas que no integran el Estado. Esto supone una violación a la Constitución, que indica taxativamente qué sujetos pueden desarrollar la función jurisdiccional, y la establecen como un cometido exclusivo del Estado, a cargo, en principio, del Poder Judicial. Estas innovaciones legislativas inconstitucionales afectan los derechos procesales de deudores y acreedores concursales, al extremo de ver comprometida la existencia misma del debido proceso, el que no puede asegurarse fuera de los tribunales estatales designados por la Constitución

Turismo & qualidade: referenciais teóricos para uma prática

Discute os pontos teóricos básicos para adoção de um sistema de qualidade na área de turismo. Aborda o turismo como serviço; os princípios teóricos e considerações básicas sobre qualidade; a ISO 9000 e, em especial, a norma de prestação de serviços - ISO 9004-2 - e suas implicações para o setor de Turismo.Basic touristic theories were discussed for a quality system implementation in tourism area, tourism as a service quality: main theories and approaches, ISO 9000 family, customer service procedures - ISO 9004-2 and their implications in tourism area

O imaginário amazônico na poética do pintor Eli Bacelar

Essa dissertação tem como objetivo compreender o imaginário amazônico na poética visual do artista autodidata Eli Bacelar, que nasceu em Manaus - Amazonas em 1960 e aos 15 anos participou da primeira exposição. Ao longo de sua trajetória de 45 anos recebeu premiações e participou de diversas exposições regionais e nacionais. Desta forma, a escolha do artista se justifica por sua importância para a história da arte local e pela carência de informações, pois quando se busca, sobre sua produção, não se encontra muitas referências. Em relação a abordagem metodológica, quanto a natureza a pesquisa foi qualitativa e quantos aos meios foi bibliográfica e documental que foram utilizados como suporte na produção do referencial teórico. Quanto a análise dos documentos de processo como rascunhos e esboços, recorreuse à abordagem utilizada pela Crítica Genética. Na pesquisa de campo, foram realizadas diversas entrevistas com o artista e visitas os acervos públicos e colecionadores particulares. Como resultado, além de apresentar uma abordagem sobre os aspectos pertinente aos caminhos da sua vida pessoal e artística e o registro de 160 trabalhos entre pinturas, desenhos e esboços, a pesquisa debruçou-se na análise do processo criativo e poético de algumas obras à luz imaginário amazônico. Desta forma foi possível perceber o caminho percorrido na elaboração e amadurecimento de seu estilo e observar as relações construídas pelo artista, e os diversos aspectos da cultura amazônica e universal.This dissertation aims to understand the Amazonian imaginary in the visual poetics of the selftaught artist Eli Bacelar, who was born in Manaus - Amazonas in 1960 and at the age of 15 participated in the first exhibition. Throughout his 45-year history he has received awards and participated in several regional and national exhibitions. Of this firm, the choice of the artist is justified by its importance for the history of local art and the lack of information, because when searching, about its production, there are not many references. Regarding the methodological approach, how much the research was qualitative and how many to the means was bibliographic and documentary that were used as support in the production of the theoretical framework. After the analysis of process documents such as drafts and drafts, the approach used by Genetic Criticism was used. In the field research, several interviews were conducted with the artist and visits the public collections and private collectors. As a result, in addition to presenting an approach on the aspects pertinent to the paths of his personal and artistic life and the recording of 160 works among paintings, drawings and sketches, the research focused on the analysis of the creative and poetic process of some works in the Amazonian imaginary light. In this way it was possible to perceive the path taken in the elaboration and maturation of his style and observe the relationships constructed by the artist, and the various aspects of Amazonian and universal culture