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Monthly Archives: February 2012

Are compulsory vaccinations being put into place as a means to maintain and increase standards of health among populations? Are compulsory vaccinations being put into place as what has become a simple means of accruing monetary gain? This week, both of my sisters became sick with the flu, and interestingly, this year was the first in many that both of my sisters received flu shots! They did as doctors and many others advised, vaccinated themselves to prevent illness, and now they are sick. I am currently on the hunt to understand the potential benefits, the possible harmful side effects, along with the skepticism’s and the concerns of vaccines; I would like to imagine that health professionals have been and are continuing to do the like.

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On Tuesday The Supreme Court heard opening arguments in a case that, at it’s resolution, will set a strong precedent regarding corporate liability for civil suits brought by foreign nationals for human rights violations committed abroad.

The case, Kiobel v. Royal Dutch Petroleum, involves a civil suit filed by 12 Nigerian Plaintiffs who allege that Royal Dutch Petroleum, a.k.a. Shell, “aided and abetted, and were otherwise complicit in, violations of international law;” specifically that the corporation “collaborated closely with Nigeria’s then-military government as it carried out a campaign of intimidation and violence” against the Ogoni people who opposed the development of their land for oil. At this stage the suit, filed under the umbrella of the Alien Tort Claims Act of 1789, is immediately concerned with whether foreign nationals have any right to try such claims through the United States Judicial System at all.

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An MSF physiotherapist providing medical assistance to a Libyan detainee in a detention center in Misrata.

Last month, Doctors Without Borders/Médecins Sans Frontières or MSF for short, decided to put an end to all efforts designed to provide medical care to Libyan detainees, according to MSF’s general director Christopher Stokes. The organization, which is globally recognized for its humanitarian relief in both war and natural disaster swept countries, believed that their services were not being employed for the common good.

Since August of 2011, MSF had been stationed in Misrata–Libya’s third largest city–providing medical relief to detainees who had been injured in the war. However, MSF soon began noticing a disturbing trend. A large majority of the wounds in which MSF was treating the Libyan detainees for were being obtained during torturous interrogation sessions by the National Army Security Service. And what was more disturbing was the fact that many of these same detainees that had been previously treated by MSF for torture wounds were being sent back to the organization for the treatment of additional torture wounds–which were being acquired during further interrogation sessions. In fact, on one occasion, MSF had been asked to actually provide medical aid to detainees after interrogation sessions. MSF, of course, did not carry out the request.

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Is it a violation of a human right not to be taught the accurate way to use a condom, when this basic health-related information could help prevent many STIs including HIV/AIDS?

Office of the United Nations High Commissioner for Human Rights writes in its report “The Right to Health,” that “the right to health contains entitlements. These entitlements include: The right to a system of health protection providing equality of opportunity for everyone to enjoy the highest attainable level of health; The right to prevention, treatment and control of diseases;  Access to essential medicines; Maternal, child and reproductive health; Equal and timely access to basic health services; The provision of health-related education and information; Participation of the population in health-related decision-making at the national and community levels.”

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Today, the American Academy of Pediatrics recommended that boys in the US be immunized against human papillomavirus (HPV) beginning at age 11-12, just as they had previously recommended for girls.  The recommendation is to use Gardasil, the vaccine produced by Merck.  It should cost about $360 per person for the 3-dose schedule, not including fees for clinic visits.

By protecting against infection with HPV types 16 and 18, which are associated with development of cervical, penile, and anal cancers (and have been reported in conjunction with some oral cancers), Gardasil is meant to be a cancer vaccine.

What does this mean for people in poor countries — where cervical and penile cancer are much more common than in the US, but the vaccine at American prices would be prohibitively expensive?  There are an estimated 500,000 new cases of cervical cancer worldwide, of which only about 12,000 (2.4%) are in the US.  Penile and oral cancer are even rarer here.

So is Merck using the world burden of cancer as an excuse to sell vaccine that the people who need it — primarily women in poor countries — won’t be able to afford?

Merck has begun an initiative to make Gardasil available in the rest of the world.  They say they will donate 3 million doses of the vaccine (enough to immunize a million people — about 2 years’ worth of new infections) over the next 5 years.  Some of this will be done through the Global Vaccine Initiative, GAVI.

How do we make sense of all this data? This is a link to an animation of the relationship between health and wealth: gapminder

There are numerous TED Talks by Hans Rosling, a Swedish public health professor who developed the gapminder program, these talks are interesting and informative. Rosling uses his software to create visual representation of data, which allow analysis of trends over time. This is an interesting, 20 minute, talk that he gave at the US State Department where he calls for a re-framing of the term “developing world”: Hans Rosling TED Talk. Part of the argument posed by Rosling is that there is a huge degree of disparity within geographical regions, and within nations themselves, and also similarities between “developing” and “developed” nations.

The term “Developing Countries” might have made sense once.

Today it’s impossible to make a clear distinction between “developing” and “developed” countries.

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The economics of supply and demand have allowed drug companies to reap exorbitant profit from the market, but what are the effects when the supply does not meet the demand? The United States is currently wheeling from a shortage of two drugs used to combat cancer, this shortage has prompted the FDA to seek drugs from foreign markets, such as India. The two drugs are Doxil and methotrexate, which is known by the trade names Rheumatrex and Trexall. Pharmaceutical companies have a market interest in providing their products to consumers. After the introduction of a product, should companies be mandated to ensure a consistent supply chain? As patients/consumers what assurance do we have that life saving drugs will be available if we need them? In some way I can see situations such as this manifesting a loosening of international trade agreements. If India did not have a readily available supply of a drug similar to Doxil this would have undoubtedly affected the lives of a larger number of people. The intellectual property rights of drug developers are protected through trade agreements, what is the impact of these protections in critical shortage situations? The loosening of patent restrictions may improve the health of consumers by ensuring access to needed drugs, while keeping costs lower.