International journal of health policy and management
-
Int J Health Policy Manag · Sep 2020
Public Risk-Taking and Rewards During the COVID-19 Pandemic - A Case Study of Remdesivir in the Context of Global Health Equity.
Public investment, through both research grants and university funding, plays a crucial role in the research and development (R&D) of novel health technologies, including diagnostics, therapies, and vaccines, to address the coronavirus disease 2019 (COVID-19) pandemic. Using the example of remdesivir, one of the most promising COVID-19 treatments, this paper traces back public contributions to different stages of the innovation process. Applying the Risk-Reward Nexus framework to the R&D of remdesivir, we analyse the role of the public in risk-taking and reward and address inequities in the biomedical innovation system. ⋯ Despite the significant public transnational contributions to the R&D of remdesivir, the rewards are extracted by few actors and the return to the public in the form of equitable access and affordable pricing is limited. Beyond the necessity to treat remdesivir as a global public good, we argue that biomedical innovation needs to be viewed in the broader concept of public value to prevent the same equity issues currently seen in the COVID-19 pandemic. This requires the state to take a market-shaping rather than market-fixing role, thereby steering innovation, ensuring that patents do not hinder global equitable access and affordable pricing and safeguarding a global medicines supply.
-
Int J Health Policy Manag · Aug 2020
Drastic Reduction Inpatient Visits to the Emergency Department in a Hospital in Israel During the COVID-19 Outbreak, Compared to the H1N1 2009.
On February 26, 2020, the first case of coronavirus disease 2019 (COVID-19) was detected in Israel. The Ministry of Health (MoH) instructed people to take isolation measures and restrict their movement. Similarly, there was a gradual decrease in the number of visits to our emergency department (ED). ⋯ The behavior of people during the COVID-19 pandemic was different from their behavior during the H1N1 pandemic. People seemed to avoid visiting the ED. The boundary between precaution and panic in the generation of the media could be very thin. Decision-makers must take this into account.
-
Int J Health Policy Manag · Aug 2020
Estimating COVID-19-Related Infections, Deaths, and Hospitalizations in Iran Under Different Physical Distancing and Isolation Scenarios.
Iran is one of the first few countries that was hit hard with the coronavirus disease 2019 (COVID-19) pandemic. We aimed to estimate the total number of COVID-19 related infections, deaths, and hospitalizations in Iran under different physical distancing and isolation scenarios. ⋯ With no approved vaccination or therapy available, we found physical distancing and isolation that include public awareness and case-finding and isolation of 40% of infected people could reduce the burden of COVID-19 in Iran by 90% by mid-June.
-
Int J Health Policy Manag · Jul 2020
Exploring the Impact of COVID-19 on the Sustainability of Health Critical Care Systems in South America.
The coronavirus disease 2019 (COVID-19) pandemic has created strong pressure on national health critical care systems. After its initial impact in Asia, the highest case growth is now in the Americas. The South American countries face a strong challenge due to the vulnerabilities of their health systems and the fragile socio-economic conditions of their population. ⋯ In particular, Bolivia will need to increase the number of ICU beds 60-fold while Brazil will need to grow 12-fold to meet the growth rates of COVID-19 by the end of July 2020. In this sense, it is argued that national and transnational measures should be taken urgently to face this challenge. Furthermore, it is necessary to perform tests to detect COVID-19 cases earlier to alleviate the need for internment in ICUs.
-
Int J Health Policy Manag · Jun 2020
Using Open Public Meetings and Elections to Promote Inward Transparency and Accountability: Lessons From Zambia.
Community-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members. ⋯ While open meetings and elections have potential to enhance good governance at the community level, continuous training and mentoring are needed to build capacity and enhance sustainability.