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Background: Essential medicines (EMs) are those that satisfy the basic healthcare needs of the population. However, access to EMs remains a global health challenge. The World Health Organization (WHO) and the East African Community (EAC) manufacturing plan 2017–2027 support local production of EMs as a strategy to improve access to medicines. The aim of this study was to determine for each therapeutic class on the national essential medicine lists (NEMLs) of Kenya, Tanzania and Uganda, the number of EMs produced in each country. Methods: In 2018, we analysed NEMLs and national drug registers (NDRs) in each country to identify local manufacturers and local products by EM status. For each local manufacturer we determined the number of EM products and individual EMs, and analysed EMs in each therapeutic class by registration status and whether produced locally. Results: There were nine companies manufacturing locally in Kenya, four in Tanzania and six in Uganda. Most local medicine products were non-EM products. Of the 946 locally produced products in Kenya, 310 were EM products; of the 97 locally produced products in Tanzania, 39 were EM products; and of the 181 locally produced products in Uganda, 100 were EM products. Many local EM products were duplicate. Only a small proportion of EMs on each NEML were produced locally: 21% (92/430) in Kenya, 5% (24/510) in Tanzania, and 10% (55/526) in Uganda. Kenya, Tanzania and Uganda had no local EM products in 13/32, 17/28 and 15/32 therapeutic classes, respectively. The proportion of EMs that were registered varied across the countries from 327 (76%) in Kenya, 269 (53%) in Tanzania, and 319 (60%) in Uganda. Conclusions: This study highlights the importance of auditing NDRs and NEMLs for local production to inform regional and national local manufacturing strategies. EMs should be prioritized for local production and drug registration to ensure that production is aligned with local health needs. [ABSTRACT FROM AUTHOR]

The authors reflect on the effectiveness of independent treatment centers which have been developed by Great Britain's National Health Service. They suggest that there is no definitive evidence which supports the continued funding of the centers. They argue that concerns from patients, lawyers and healthcare professionals about the quality and safety of the centers are being ignored by the government.

Focuses on Great Britain's National Health Service (NHS) and the Health and Social Care Bill of 2003. Definition of foundation trusts; How the secretary of state is obligated to promote a comprehensive, free health service to improve the health of the people; Problems of the inequity increasing through local generation of income.

Trade ministries from the World Trade Organization's (WTO's) 144 member states are presently deciding which public services to open to foreign competition under the complex liberalisation rules of the general agreement on trade in services (GATS). A frequent criticism of the WTO system is that it reduces national autonomy over public policy. However, respect for national sovereignty is asserted in the GATS treaty. Here, we examine claims made by the WTO and others that GATS exempts public services and does not require their privatisation. We discuss trade treaty processes that can subject public services to commercial rules, the treaty's flexibility with respect to national autonomy, and the effect of GATS in situations in which national autonomy is not protected. We conclude that national autonomy over health policy is not preserved under GATS, and that accordingly, there is a role for international standards that protect public services from the adverse effect of trade and market forces. [ABSTRACT FROM AUTHOR]

Addresses concerns in the United Kingdom of whether primary care trusts leads to United States-style health care. Ability of a National Health Service (NHS) body to charge for personal care and hotel costs; How government guidance on intermediate care restricts entitlement to NHS care to six weeks except in exceptional circumstances; Details of the incentive structure of the new system, which will force care trusts to find ways of constraining expenditure through rationing, user charges, and commercial activities.

Assesses the challenges of devolution on public health Wales and Scotland. Structure of the assemblies and their powers; Inequalities in health and wealth in both countries; Overview of public health in both countries; Party policies on health services.

The article focuses on the UK Department of Health's "Best Research for Best Health," a report which sets up an organizational and funding framework for National Health Service and associated university medical schools in England. The report outlines the implementation of a National Institute for Health Research, which will centralize governance, staff, facilities and infrastructure needs of medical research.

Reports on the supposed resolution of the issue of giving poor countries access to essential medicines without breaching laws on intellectual property by the World Trade Organization (WTO). Past agreements; Allowance of drug companies to charge monopoly prices for essential drugs; Provisions for over-riding of patent protection for public health purposes; 2001 declaration stating the WTO's intention of finding an interpretation that squared the interest of pharmaceutical industries and poor countries; Description of the deal as a historical agreement by WTO director general Supachai Panitchpakdi; Grounds for scepticism; Basic problems with trade related aspects of intellectual property (TRIPS); Questions from the United Kingdom Commission on Intellectual Property Rights and Development Policy.

Discusses a decision by the United Kingdom's Competition Commission that could make all contracting out and commissioning of health care by N.H.S. and social services subject to European Union competition law, rather than a matter for national public health policy. Tensions between the European Union's economic constitution and national control over healthcare policy because of healthcare reforms; Judgment by the United Kingdom tribunal that shows how the courts are moving the dividing line between economic and social activities; Implications of the judgment.

Discusses the advantages and disadvantages of community oriented primary care as a method of teaching and applying public health skills in Great Britain. Description of King's Fund pilot project; Factors for needs assessment; Support for health authorities.

Background: Local pharmaceutical production has been endorsed by the WHO as a means of addressing health priorities of developing countries. However, local producers of essential medicines must comply with international pharmaceutical standards in order to be eligible to compete in donor tenders. These standards determine production rights for on-patent and off-patent medicines, and guide international procurement of medicines. We reviewed the literature on the impact of Good Manufacturing Practice (GMP) on local production; a gap analysis from the literature review indicated a need for further research. Over sixty interviews were conducted with people involved in the Nepali pharmaceutical production and distribution chain from 2006 to 2009 on the GMP areas of relevance: regulatory capacity, staffing, funding and training, resourcing of GMP, inspectors' interpretation of the rules and compliance. Results: Although Nepal producers have increased their overall share of the domestic market, only the public manufacturer, Royal Drugs, focuses on medicines for public health programmes; private producers engage mainly in brand competition for private markets, not essential medicines. Nepali regulators and producers state that implementation of GMP standards is hindered by low regulatory capacity, insufficient training of staff in the industry, financial constraints and lack of investment for upgrading capital. The transition period to mandatory compliance with WHO GMP rules is lengthy. Less than half of private producers had WHO GMP in 2013. Producers are not directly affected by international harmonisation of standards as they do not export medicines and the Nepali regulator does not enforce the WHO standards strictly. Without an international GMP certificate they cannot tender for donor dependent health programmes. Conclusions: In Nepal, local private manufacturers focus mainly on brand competition for private consumption not essential medicines, the government preferentially procures essential medicines from the only public producer while donor funded programmes rely on international manufacturers compliant with international GMP standards. We also found evidence of private hospitals bypassing national medicines approvals process. Policies in support of local pharmaceutical production in developing countries as a source of essential medicines need to examine carefully how GMP regulations impact on regulators, local industry and production of essential medicines in practice. [ABSTRACT FROM AUTHOR]

Presents a response to a letter to the editor regarding the role of industry and higher education in medical research conducted by the British National Health Service.