政治自由主义 = Political liberalism

http://depts.washington.edu/sphnet/wp-content/uploads/2013/01/Coovadia.pdf

The health and health system of South Africa: historical roots of current public health challenges

Biomedical engineers have traditionally developed technologies in response to the needs of the developed world's medical community. As a result, the diagnostic systems on which they have worked have met the requirements of well-funded laboratories in highly regulated and quality-assessed environments. However, such approaches do not address the needs of the majority of the world's people afflicted with infectious diseases, who have, at best, access to poorly resourced health care facilities with almost no supporting clinical laboratory infrastructure. A major challenge for the biomedical engineering community is to develop diagnostic tests to meet the needs of these people, the majority of whom are in the developing world. We here review the context in which the diagnostics must operate, some of the appropriate diagnostic technologies already in distribution, and some emerging technologies that promise to address this challenge. However, there is much room for innovation, adaptation, and cost reduction be...

https://www.annualreviews.org/doi/pdf/10.1146/annurev.bioeng.10.061807.160524

Point-of-care diagnostics for global health.

http://sa.indiaenvironmentportal.org.in/files/Multidrug-resistant.pdf

Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis

Although progress has been made to reduce global incidence of drug-susceptible tuberculosis, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis during the past decade threatens to undermine these advances. However, countries are responding far too slowly. Of the estimated 440 000 cases of MDR tuberculosis that occurred in 2008, only 7% were identifi ed and reported to WHO. Of these cases, only a fi fth were treated according to WHO standards. Although treatment of MDR and XDR tuberculosis is possible with currently available diagnostic techniques and drugs, the treatment course is substantially more costly and laborious than for drug-susceptible tuberculosis, with higher rates of treatment failure and mortality. Nonetheless, a few countries provide examples of how existing technologies can be used to reverse the epidemic of MDR tuberculosis within a decade. Major improvements in laboratory capacity, infection control, performance of tuberculosis control programmes, and treatment regimens for both drug-susceptible and drug-resistant disease will be needed, together with a massive scale-up in diagnosis and treatment of MDR and XDR tuberculosis to prevent drug-resistant strains from becoming the dominant form of tuberculosis. New diagnostic tests and drugs are likely to become available during the next few years and should accelerate control of MDR and XDR tuberculosis. Equally important, especially in the highest-burden countries of India, China, and Russia, will be a commitment to tuberculosis control including improvements in national policies and health systems that remove fi nancial barriers to treatment, encourage rational drug use, and create the infrastructure necessary to manage MDR tuberculosis on a national scale.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(10)60410-2.pdf

Tuberculosis 2 Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis

Guideline 11 of the 2002 version of the Council of International Organizations of Medical Sciences' International Ethical Guidelines for Biomedical Research Involving Human Subjects supports the use of placebo controls in clinical trials even when an established effective intervention exist. A note of clarification added to the new World Medical Association's Declaration of Helsinki goes in the same direction, even though this note clearly contradicts other provisions in the Declaration. The article highlights how this approach to placebo controlled trials constitutes an endorsement of the violation of well-established legal obligations, related to the primacy of the human subject and physicians' duty of care. The authors analyse the legal standards of four national jurisdictions to support this view. The CIOMS rule thus exposes researchers, research ethics committees and institutions to legal liability under national law. Surprisingly, nothing in the CIOMS guideline gives any indication of legal duties of researchers under national law. The authors call for an explicit recognition by CIOMS and the World Medical Association of the binding nature of national law. They invite national regulatory agencies and other legal scholars to clarify the legal standards in their jurisdiction and to improve awareness of the existence of legal obligations in the context of research.

CIOMS' Placebo Rule and the Promotion of Negligent Medical Practice

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As a growing number of vaccines for COVID-19 gain emergency use designation, including emergency use authorisation and conditional marketing authorisation under different jurisdictions, the WHO Strategic Advisory Group of Experts on Immunization (SAGE)1 has issued a number of …

https://gh.bmj.com/content/bmjgh/6/5/e005912.full.pdf

Jerome Amir Singh

Papers

CIOMS' Placebo Rule and the Promotion of Negligent Medical Practice

Ethical and policy considerations for COVID-19 vaccination modalities: delayed second dose, fractional dose, mixed vaccines.

COVID-19 vaccine trials: Duty of care and standard of prevention considerations.

Genocide: burden of proof and inaction is costing lives in Sudan.

The 20-year African biotech plan.