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Objective To analyse sales of fixed-dose combination and single antibiotics In India In relation to World Health Organization (WHO) recommendations and national regulatory efforts to control antibiotic sales. Methods We extracted data on sales volumes of systemic antibiotics in India from a market research company sales database. We compared the market share of antibiotic sales in 2020 by WHO AWaRe (Access, Watch and Reserve) category and for those under additional national regulatory controls. We also analysed sales of fixed-dose combinations that were: formally approved for marketing or had a no-objection certificate; on the national essential medicines list; and on the WHO list of not-recommended antibiotics. Findings There were 78 single and 112 fixed-dose combination antibiotics marketed in India, accounting for 7.6 and 4.5 billion standard units of total sales, respectively. Access, Watch and Reserve antibiotics comprised 5.8, 5.6 and 0.1 billion standard units of total market sales, respectively. All additionally controlled antibiotics were Watch and Reserve antibiotics (23.6%; 2.9 billion standard units of total sales). Fixed-dose combinations on the WHO not-recommended list were marketed in 229 formulations, with 114 formulations (49.8%) having no record of formal approval or no-objection certificate. While there were no not-recommended fixed-dose combinations on the national list of essential medicines, 13 of the top-20 selling antibiotic fixed-dose combinations were WHO not-recommended. Conclusion The sale of Watch group drugs, and antibiotics banned or not approved, needs active investigation and enforcement in India. The evidence base underpinning formal approvals and no-objection certificates for not-recommended fixed-dose combinations should be audited. Objectif Analyser les ventes d'antibiotiques en association fixe et a dose unique en Inde, a la lumiere des recommandations de l'Organisation mondiale de la Sante (OMS) et des efforts de reglementation a l'echelle nationale visant a controler la vente d'antibiotiques. Methodes Nous avons preleve des donnees relatives aux volumes de vente d'antibiotiques systemiques en Inde dans la base de donnees commerciales d'une societe d'etudes de marche. Nous avons ensuite compare la part de marche qu'occupe, en 2020, la vente d'antibiotiques appartenant a chaque categorie AWaRe (Access, Watch and Reserve) etablie par l'OMS, mais aussi de ceux cibles par des mesures nationales de controle supplementaires. Enfin, nous avons examine les ventes d'associations fixes: dont la commercialisation a ete officiellement approuvee ou qui ont fait l'objet d'un certificat de non-objection; figurant sur la liste nationale de medicaments essentiels; et reprises dans la liste des antibiotiques non recommandes par l'OMS. Resultats Nous avons comptabilise 78 antibiotiques a dose unique et 112 antibiotiques en association fixe sur le marche indien, representant respectivement 7,6 et 4,5 milliards d'unites standard sur l'ensemble des ventes. Les antibiotiques des categories Access (dont l'accessibilite est essentielle), Watch (a utiliser selectivement) et Reserve (de reserve, non recommandes) equivalaient a 5,8 milliards, 5,6 milliards et 0,1 milliard d'unites standard sur le total des transactions. Tous les antibiotiques soumis a des controles supplementaires faisaient partie des categories Watch et Reserve (23,6%; 2,9 milliards d'unites standard sur l'ensemble des ventes). Des associations fixes deconseillees par l'OMS etaient commercialisees dans 229 formulations, dont 114 (49,8%) ne possedaient ni attestation d'approbation officielle, ni certificat de non-objection. Bien qu'aucune association fixe deconseillee ne soit mentionnee sur la liste nationale de medicaments essentiels, 13 des 20 antibiotiques en association fixe les plus vendus n'etaient pas recommandes par l'OMS. Conclusion Il est necessaire de mener une enquete approfondie en Inde sur la vente de medicaments appartenant a la categorie Watch et d'antibiotiques interdits ou non approuves, et de prendre des mesures concretes. Les preuves sur lesquelles reposent les autorisations officielles et les certificats de non-objection pour les associations fixes non recommandees doivent etre verifiees. Objetivo Analizar las ventas de los antibioticos combinados en dosis fijas y en dosis unicas en la India en relacion con las recomendaciones de la Organizacion Mundial de la Salud (OMS) y los esfuerzos nacionales de regulacion para controlar las ventas de los antibioticos. Metodos Se extrajeron datos sobre los volumenes de ventas de antibioticos sistemicos en la India de una base de datos de ventas de empresas de investigacion de mercado. Se comparo la cuota de mercado de las ventas de antibioticos en 2020 por categoria AWaRe (Access, Watch and Reserve) de la OMS y para los que estaban sometidos a controles regulatorios nacionales adicionales. Tambien se analizaron las ventas de combinaciones en dosis fijas que estaban: formalmente aprobadas para su comercializacion o tenian un certificado de no objecion; en la lista nacional de medicamentos esenciales; y en la lista de antibioticos no recomendados de la OMS. Resultados En la India se comercializaron 78 antibioticos en dosis unica y 112 antibioticos combinados en dosis fijas, que representaron 7,6 y 4,5 mil millones de unidades estandar de ventas totales, respectivamente. Los antibioticos de acceso, vigilancia y reserva supusieron 5,8, 5,6 y 0,1 mil millones de unidades estandar de las ventas totales del mercado, respectivamente. Todos los antibioticos controlados adicionalmente fueron antibioticos de vigilancia y reserva (23,6 %; 2,9 mil millones de unidades estandar de las ventas totales). Las combinaciones en dosis fijas incluidas en la lista no recomendada de la OMS se comercializaron en 229 formulaciones, de las que 114 (49,8 %) no tenian registro de aprobacion formal ni certificado de no objecion. Mientras que no habia combinaciones en dosis fijas no recomendadas en la lista nacional de medicamentos esenciales, 13 de las 20 combinaciones en dosis fijas de antibioticos mas vendidas no estaban recomendadas por la OMS. Conclusion Se debe investigar y controlar activamente la venta de medicamentos del grupo Watch y de antibioticos prohibidos o no aprobados en la India. Asimismo, se debe auditar la base de pruebas que sustenta las aprobaciones formales y los certificados de no objecion para las combinaciones en dosis fijas no recomendadas., Introduction The overuse and misuse of antibiotics contribute to the development of antimicrobial resistance, eroding the drugs' effectiveness. (1) Consequently, efforts continue to be made to improve antibiotic stewardship internationally [...]

Objectives: (a) To critically appraise the quality of data submitted by sub-Saharan African (SSA) cancer registries to GLOBOCAN 2020 and (b) compare the quality of data of the registries common to GLOBOCAN 2008 and 2020. Design: Critical appraisal of cancer registry data quality using the Parkin and Bray framework. Setting and Participants: GLOBOCAN 2020 cancer registry estimates for 46 countries in SSA. Forty-three registries in 31 (SSA) countries were identified from the GLOBCAN 2020 supplementary documents, of which data from 28 registries in 23 sub-Saharan African countries were publicly available. Main outcomes measures: Data quality for 15 variables in four domains (comparability, validity, timeliness and completeness) were appraised using the Parkin and Bray framework. Results from the appraisal of GLOBOCAN 2020 sources were compared with previous findings for GLOBOCAN 2008. Results: Compared with GLOBOCAN 2008, GLOBOCAN 2020 country coverage had increased from 21 to 31 countries with 15 countries having no established registries. Out of a total possible score of 15 for data quality, 18 of the 28 publicly available GLOBOCAN 2020 registries fulfilled a score of 5 or more compared with seven registries in GLOBOCAN 2008. Of the 17 registries common to GLOBOCAN 2008 and 2020, nine showed an improvement in data quality. Conclusion: Country coverage and data quality have improved since GLOBOCAN 2008, however, overall data quality and coverage remain poor. GLOBOCAN 2020 estimates should be used with caution when allocating resources. [ABSTRACT FROM AUTHOR]