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ETMM > CHAPTER 5 CHALLENGES IN PDW > Flashcards

CHAPTER 5 CHALLENGES IN PDW Flashcards

1
Q

Give 3 examples of public-private partnership

A

Medicine for Malaria venture (MMV)
Global alliance for TB drug development.
Gavi

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2
Q

Briefly the explain the mission of Medicine for Malaria Venture.

A

MMV is a not-for-profit product development partnership devoted to developing and facilitating access to lifesaving antimalarials.

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3
Q

Which Pharma companies are collaborating with Medicine for Malaria Venture.

A

GSK
Takeda
Novartis

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4
Q

How much did Bill and Melinda Gates fund Medicine for Malaria Venture.

A

To find new antimalarial drugs: 168 million
Continue research for newly found agents: 208 million

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5
Q

What are the screening the strategies are done in Medicine for Malaria Venture.

A

HTS: One mechanism for developing antimalarial target through understanding the drug target. Global phenotype screening.

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6
Q

What drug properties does MMV want for new antimalarial drug.

A

Must be cheap to produce $1, and short course (<3 days) to be accessible to low-income countries that are targeted.

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7
Q

What new target has been identified by MMV

A

In cytosol: glycolysis pathway (e.g. lactate dehydrogenase) has been targeted.

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8
Q

How many compounds are in the open source for MMV

A

5,000,000 compounds are in the MMV medicine box.

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9
Q

Name a recent success by MMV

A

450 million Coartem Dispersible (artemethur-lumefantrine) paediatric treatment has been distributed to over 50 countries since 2009, saving more than 960,000 children’s lives.

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10
Q

How many countries received Coartem Dispersible paediatric treatment.
(a) 50 countries
(b) 60 countries
(c) 28 countries
(d) 40 countries

A

(a) 50 countries. [ since 2009]

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11
Q

How many children lives have been saved by Coartem dispersible paediatric.
(a) 400,000
(b) 500,000
(c) 525,000
(d) 960,000

A

(d) 960,000

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12
Q

Give example of new target found by Global alliance for TB development.

A

Novel InhA inhibitor which can deal with resistance mycobacterium tuberculosis by targeting inna gene.

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13
Q

How has pharmaceutical companies contributed to developing words.

A
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14
Q

What was GSK access to medicine index value. How many of their projects incorporated an access place.

A

GSK was ranked 1 in 2021 Access to medicine index with 80% of their relevant projects having an access plan.

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15
Q

Why did Novartis beat GSK in the product delivery.

A

Novartis is the only company to apply equitable pricing strategies in at least one low income country for all products assessed. They consider they patient population across the income pyramid.

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16
Q

Give example of product HIV medicine granted voluntary licensing.

A

GSK access plans for dolutegravir paediatric project by Viiv healthcare includes registration commitments and 15 non-exclusive royalty-free voluntary licensing.

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17
Q

What does the Live Well initiative combat.

A

It address supply chain constraints in Zambia (social enterprise).

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18
Q

How many Gavi- eligible countries has Rotarix vaccine reached.
(a) 34
(b) 23
(c) 32
(d)36

A

(C)

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19
Q

What is a key target held by Reckitt when delivering ORT. ( think Sara)

A

To reduce 50% in diarrhoea incidences.

20
Q

What is the % of infants (under age of X) who did not receive any vaccines in (X) year.
(a) 19% under one years
(b) 20% under one years
(c) 17% under two years
(d) 17% under one years

A

(d) 17% of infants under age of one did not receive any vaccine in 2019.

21
Q

One of the main reasons why there is a lack of access to treatment is due to the viscous cycle between (a) and (b). (b) leads to deprivation, (c) living conditions, lack of basic (d) medicines that predisposes a population to (a).

A

(a) Disease
(b) Poverty.
(b) Poverty
(c) poor
(d) essential
(a) disease.

22
Q

What are the challenges faced when getting medicines to the developing world.
Describe each factor (1,2,3: 3 As).

A

Availability:
Is the treatment available? Is it available in formulation that can withstand high temperatures (without refrigerator)/appropriate for patient group (e.g. paediatric population). Heat stable injectables?

Accessibility:WHO model list of essential medicine off patent are not reached in almost 1/3rd of the world’s population in low and middle income countries. Rural areas?

Affordability: Who will pay for the treatment? 50%-90% medicines in low- and middle-income countries are paid by the patients themselves.

23
Q

Vaccine produced by start up company requires to be kept in temperatures between -2-+2°C. What factor is affecting this vaccines reach to the developing world (give brief reason why).

(a) Availability
(b) Accessibility
(c) Affordability

A

(a) Availability. If there is no available vaccine formulation that is heat stable injectable not requiring refrigeration then the formulation is not stable to be distributed to Africa.

24
Q

Patent drugs are affecting the accessibility of medicines to the low-and middle income countries.
(A) True
(B) False

A

False patents are not blocking the access to essential medicines in poor countries.

25
Q

What is the % of drugs on WHO essential medicine list that are off-patent.

A

95%.

26
Q

F.O.B stands for.

A

Free on board which are international shipping agreement fees used in transportations of good between buyer and sellers.

27
Q

What are the principle factors affecting Access to medicines in the Developing World. For each point explain briefly (look at empty mind map).

A
28
Q

For both generic and patented essential medicines in developing countries what is the final price compared to the producer or importer. What does this final price reflect.

A
29
Q

What is the % taxation in some of the developing worlds.

A

Over 20% in some countries.

30
Q

How would you overcome the issue of price, taxes and tariffs. (+bonus: why would you do that intervention).

A

Reduction or elimination of duties, taxes and tariffs for generic and patented drugs on WHO essential list because taxes and tariffs on medicine are a form of regressive taxation since targets the poor and sick who cannot afford it.

Awareness and cultural perception change on medicines: Developing world Governments need to be aware of their own corruption and choose healthcare as one of their priorities for their country.

31
Q

Define counterfeit medicine

A

Deliberately and fraudulently mislabeled with respect to identity and/or source.

32
Q

Define substandard medicine.

A

Genuine drug products which don’t meet the quality specifications set for them.

33
Q

What is the proportion of antimalarial drugs that are counterfeit in X region.

A

1/3rd antimalarial drugs are counterfeit in Sub-Saharan Africa.

34
Q

How would you overcome the issue of counterfeit/substandard medicines.

A

In Europe to counteract falsified medicine, unique identifier must be carried in a 2D data matrix code.
Government should actively intervene to close down manufacturing sites that are non-GMP and individuals caught should be convicted of their crimes. Having activist such as Dora Akunyili fighting the good fight.
Having collaborative efforts: King’s college London is involved in the fight the fakes.

35
Q

What is the name of the Nigerian pharmacist who fought against counterfeit medicine.

A

Dora Akunyili.

36
Q

What are the clinical consequences of substandard medicines being distributed in Developing World.

A

Clinical consequences: resistance (already seen with artemesinin monotherapy), poor prognosis, prolonged duration of ailment and poor bioavailability.

37
Q

What are formulation consequences associated with substandard medicines.

A

Formulation consequences: Variable bioavailability, stability issues, degradants may be in the formulation affecting the potency, incorrect drug may be given due to API not be known.

38
Q

Give an example of where counterfeit medicine had deleterious effect in the developing world.

A

In teaching hospital, located in Enugu, four children died due to counterfeit adrenaline which was actually filled with water.

39
Q

In the medicine chain where can corruption take place.

A

At procurement import and distribution step: corruption in the form of counterfeit/substandard medicine, tax evasion, collusion, falsification safety/efficacy data.

At prescription level: Theft, bribery, over-invoicing can take place.

40
Q

What have bed nets in Africa been used for (think children in the pool).

A

Fishing/Wedding dress.

41
Q

How can in proper dispensing and in proper selection of treatment be overcome in the developing world.

A

Having specialised medical centers like India dealing with certain diseases plagued by the community e.g. malarial centres with trained specialist. DDQC: Correct diagnosis, Correct dosing , Quality drugs, appropriate monitoring on Compliance.

42
Q

How is accessibility in the Zambia overcome.

A

Zambikes which are bikes with stretchers attached that transport patients to local clinical if they were malaria symptomatic.

43
Q

What was the name of the president that denied the presence of AIDs in SA.

A

Thabo Mbeki.

44
Q

What are the five solutions that can combat the problems affecting the accessibility to medicine.

A
45
Q
A
46
Q

How many deaths did Thabo Mbeki denial cause

A

300,000

47
Q

Describe the graph and how it links to political issues affecting access to medicines.

A

Sleeping sickness cases were high when political priorities changed for example when Congo was in crisis and the Belgium withdrew themselves and there was withdrawal in AID international sanctions there was increase in sleeping sickness cases. Then when WHO introduced Next there was decrease in sleeping sickness cases and it has been sustained low number of cases since.

ETMM (13 decks)

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