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

Is donor aid allocation to Iraq fair

The ethics of exclusion: why pregnant and lactating women must be front and centre of HIV research

John Coggon, Bill Madden, Tina Cockburn, Cameron Stewart, Jerome Amir Singh, Anant Bhan, Ross E. Upshur and Bernadette Richards

/pdf/organ-donation-discrimination-after-death-anti-vaccination-1y62m5pxbo.pdf

Organ Donation, Discrimination After Death, Anti-Vaccination Sentiments, and Tuberculosis Management

Security fears have led to violation of international law before. It must not happen again.

/pdf/work-on-non-lethal-weapons-should-be-limited-too-422zw1bsv5.pdf

Work on 'non-lethal' weapons should be limited too

The CAPRISA 004 trial, a phase 2b, double-blind, randomised, placebo-controlled trial, revolutionised the HIV prevention arena, particularly the microbicide field, by becoming the first study to demonstrate efficacy of a HIV microbicide product. The trial found that 1% tenofovir gel was 39 % efficacious in preventing vaginal HIV infection, and 51% efficacious in preventing herpes simplex virus type 2 (HSV-2) amongst women [1]. The study also found that women who adhered to the prescribed regimen of two doses of tenofovir gel for more than 80% of their sex acts had a 54% lower risk of HIV infection. Despite the trial’s success, as the CAPRISA 004 trial was a phase 2b trial, drug regulatory authorities—such as the United States Federal Drug Administration (FDA) and South Africa’s Medicine Control Council (MCC)—required additional confirmatory evidence from a phase 3 trial before registering and license the product as a HIV prevention agent for females. In the aftermath of the CAPRISA 004 trial, even if a follow-up phase 3 confirmatory trial yielded evidence in support of the CAPRISA 004 trial’s findings, it was realistic to expect that tenofovir gel would only obtain licensure 4–5 years after the conclusion of the CAPRISA 004 trial. Such a delay raised profound ethical, legal and human rights issues regarding CAPRISA 004 trial participants’ access to tenofovir gel during the period between the conclusion of the CAPRISA 004 trial and the results of the follow-up phase 3 confirmatory trial (the FACTS-001 trial [2]), and moreover, between the conclusion of the CAPRISA 004 trial and its potential licensure by regulatory authorities. How CAPRISA considered and realised its post-trial obligations towards relevant participants of the CAPRISA 004 trial may be instructive to others facing similar dilemmas.

Jerome Amir Singh

Papers

Is donor aid allocation to Iraq fair

The ethics of exclusion: why pregnant and lactating women must be front and centre of HIV research

Organ Donation, Discrimination After Death, Anti-Vaccination Sentiments, and Tuberculosis Management

Work on 'non-lethal' weapons should be limited too

Ethical and Legal Considerations for Realising Post-trial Access of Novel Experimental Interventions: Lessons from the CAPRISA 004 Trial