Beyond patents: Scientific knowledge, and access to vaccine

Knowledge is a public good. Patents provide property rights in knowledge, which gives the patentee the right to exclude others from utilising the knowledge for the life of the patent. Patents in the field of pharmaceuticals are controversial because of the importance of the knowledge which they exclude others from using. Patents have come under significant criticism for this very reason – with some going as far as to claim that patent protection on pharmaceutical products as the cause of developing states having poor or limited access to life-saving pharmaceutical products. Most of the academic literature regarding access to medicines goes this same way. This paper challenges this viewpoint, and considers the barriers to generic access to medicines beyond patents. This paper looks beyond intellectual property rights to determine what other mechanisms exist that allow innovative vaccine manufacturers to control access to knowledge regarding their products which can act as a barrier to the utilisation of knowledge in the pharmaceutical industry, in a similar manner to intellectual property rights. This paper takes a case study approach considering non-patent-related barriers to access to medicines, focusing on pandemic influenza vaccines and the role of proprietary, non-patented knowledge. This paper concludes that manufacturers have an exclusive monopoly, not because of their intellectual property rights, but because the knowledge required to make the drug is not accessible to generic manufacturers, and highlights why this is the case. This paper argues that it is not the patent protection which is the barrier to introducing generic pandemic influenza vaccines, but rather it is the inaccessibility of knowledge which is not in the public domain, or the inability of manufacturers in developing states to utilise this knowledge, which is the true barrier in this field

The interplay between household food security and wellbeing among small-scale farmers in the context of rapid agrarian change in India

Abstract Background Small-scale agriculture, government entitlements, and livelihood opportunities offered by rapid economic growth shape the food security and wellbeing of people in rural India. This paper analyses this ongoing process of agrarian development from the perspective of three major approaches: the food availability approach, the entitlement and livelihood approach, and food sovereignty. We draw on quantitative and qualitative data collected from 68 households in rural Tamil Nadu on landholding and management, farm diversity, agricultural production, food availability, off-farm employment, rural out-migration, objective and subjective wellbeing, and socioeconomic and demographic profile of respondents. Results Rural households were classified in four categories, based on their engagement in agriculture and off-farm employment, to understand the interplay between food sufficiency and wellbeing. The households solely based on small-scale agriculture were found to have higher food sufficiency, landholding, and crop diversity, but lower monthly income and wellbeing. The households that were engaged in off-farm employment in addition to agriculture were found to have lower food sufficiency, landholding, and crop diversity, yet they exhibited better wellbeing and higher income. The landless households, which were primarily engaged in off-farm labour, work in distant markets had higher income than households solely engaged in farming. However, they had the lowest wellbeing index among all household types. The findings indicated that the impacts of women’s participation in local or distant employment schemes on household food security and wellbeing were complex and shaped by the household’s engagement in agriculture and their aspirations for a better quality of life. Conclusions None of the three food security approaches provides a fully satisfactory basis for interventions aimed at enhancing the capacity of small and marginal farmers to achieve food security and meet their aspirations for wellbeing in the research area, although the entitlements and livelihoods approach has had a significant impact on local possibilities for livelihoods diversification. The study demonstrates that the interaction between food security and the subjective wellbeing of farmers is complex and shaped by the productivity of small-scale agriculture and livelihood aspirations of farm households

Accessible Tourism and the Role of Public Transport Provision: Comparing the Access to Attractions for Tourists with and without Disabilities in Bangkok

Tourism is acknowledged as one of the world's most important economic sectors, responsible for a significant share of global GDP. Transport is a key element for this industry, as one of the factors that affects the attractiveness of a tourist destination. Worldwide, it is estimated that more than 130 million people have some sort of disability that requires the use of a wheelchair and that number will tend to increase, due to the rapidly aging population. The provision of wheelchair-friendly transportation, particularly in the public sphere, is essential to ensuring access to tourist attractions. In that context, in this paper we aim to assess how the absence of fully accessible public transportation affects the tourism of wheelchair users. To perform this study, the city of Bangkok was chosen, which ranked as number one in the list of most visited destinations in 2018. As the literature shows that tourists usually prefer to use railways rather than buses when they are traveling to unfamiliar places, this study considered only the urban rail systems in the analysis. In order to evaluate the influence that the provision of wheelchair-friendly transportation has on the access to tourism, the most visited tourist attractions, as well as their locations within the city's municipal area, were identified and sorted. Data on the number of lines and stations, accessibility status of each station, and its distance from the tourist destination were also collected. The geographic information system tool was then used to analyze the station coverage. The results showed that the lack of accessibility in some stations or their distance from the destinations can create inequality of access. Moreover, insufficient provision of accessibility is a critical issue that can inhibit the tourism of people in wheelchairs, which in turn can lead to a potential economic loss for the sector

Evidence and decision making: tobacco control policy and legislation in Vietnam

The Ministry of Health (MOH) in Vietnam is currently drafting the Tobacco Harm Prevention Law. The government requested the MOH to provide evidence on the strategies proposed in the draft law as part of its submission to the National Assembly. This study examines the availability and strength of evidence and its relationship to policy stakeholders' positions towards policy instruments proposed in the law. Several qualitative methods were employed including documentary analysis, key informant interviews, focus group discussion and a key stakeholders' survey. Contradictory findings were identified over the role of evidence. While there is high demand for local evidence, the availability and strength of evidence are not always aligned with stakeholders' positions with respect to different strategies. Stakeholders' positions are shaped by competing interests on the basis of their perceptions of the socioeconomic implications and health consequences of tobacco control. Claims of limited availability of evidence are often used to justify the maintenance of the status quo, a position that is seen to protect the state-owned tobacco industry and state revenue. Local evidence of the impact of tobacco on population health is argued to be 'one-sided' and evidence of selected interventions discounted. Compelling and comprehensive local evidence, including those addressing economic concerns, is acutely needed in order to proceed with the current legislation process. For evidence to play a critical role, it needs to engage those ministries responsible for the tobacco industry itself and the economic development

Assessment of the vaccine industry in Iran in context of accession to WTO: a survey study

<p>Abstract</p> <p>Background</p> <p>The vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO) because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations.</p> <p>Purpose of the study</p> <p>In this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO.</p> <p>Methods</p> <p>This is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry’s key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email.</p> <p>Results</p> <p>According to the interviewees, the country’s main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP) rules, not being recognized as pre-qualified by the World Health Organization (WHO), the use of old equipment, and a lack of cooperation with global vaccine companies.</p> <p>Major conclusions</p> <p>Iran’s local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP), a lack of adequate and meaningful investment in research and development (R&D), and limitations on private sector participation in the production of vaccines.</p> <p>Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions.</p