Presentation on theme: "Health justice – worldwide! Perspective from South Dr. Narendra Gupta National Jt. Convener Peoples Health Movement India Coordinator, Prayas Centre for."— Presentation transcript:
Health justice – worldwide! Perspective from South Dr. Narendra Gupta National Jt. Convener Peoples Health Movement India Coordinator, Prayas Centre for Health Equity Rajasthan India Berlin, Germany SEPTEMBER 2010
Gandhiji's Mantra "I will give you a talisman. Whenever you are in doubt, or when the self becomes too much with you, apply the following test. Recall the face of the poorest and the weakest man whom you may have seen, and ask yourself, if the step you contemplate is going to be of any use to him. Will he gain anything by it? Will it restore him to a control over his own life and destiny? …………..for the hungry and spiritually starving millions? Then you will find your doubts and your self melt away."
The role of the health care provider for justice Rudolph Virchow: –Health care providers are natural attorneys for the poor … If medicine is to really accomplish its great task, it must intervene in political and social life…
Global Health Crisis Growing inequalities across and within countries. Health status of countries in south has not improved. Neo-liberal forces of market led globalisation cause for accelerating inequities in health.
A large proportion of the worlds population lacks access to food, education, safe drinking water, sanitation, shelter, land and its resources, employment and health care services.
Public services are not fulfilling peoples needs because they have deteriorated as a result of cuts in governments social budgets. Health services have become less accessible, more unevenly distributed and more inappropriate.
Current Global Health Spending
Basic Facts about South 96 Lower & middle income countries Mainly in –Africa. –Asia and the Pacific Region Some are in –in Western Asia –in the Caribbean Many are landlocked Few are small islands
Some more facts….. Total LDC Population – 750 million (2005) Projected Population – 950 million (2015) Projected number of people living in extreme poverty – 470 million by 2015
Health Indicators in different regions Life Expectancy Neonatal Mortality Rate (2008) IMR (2008) U-5 MR (2008) MMR (2005) African Region America Region South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region GLOBAL
Mortality (Income group wise) Life Expectancy Neonatal Mortality Rate (2008) IMR (2008) U-5 MR (2008) MMR (2005) Low Income Lower Middle Income Upper Middle Income High Income GLOBAL
Cause Specific Mortality Rate (Per population) (Income group wise) HIV/AIDS (2007) Malaria (2006) TB among HIV- negative people (2008) Low Income Lower Middle Income Upper Middle Income High Income4-1 GLOBAL301721
Cause Specific Mortality Rate (Per population) (region wise) HIV/AIDS (2007) Malaria (2006) TB among HIV- negative people (2008) African Region America Region South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region GLOBAL301721
Percentage annual rate decline of under 5 mortality
Mortality rate in children U-5 years
Global Trends in Maternal Mortality Maternal mortality in the LDCs remains the highest. 890 deaths per 100,000 live births in the world. Under five mortality rate is 160 deaths per 1,000 live births compared to 86 in the rest of the world.
Birth attended by skilled birth attendants
T.B., Malaria & HIV/AIDS 2.1 million new TB cases were reported in 2004 mainly as a result of HIV/AIDS. Rate of new HIV/AIDS cases (3.2%) in LDCs remains the highest in the world. Malaria Reduction in malaria prevalence in 15 LDCs but deterioration in 13 among 30 LDCs with trend data.
Access to Water & Housing Water Only 58 % of the population in LDCs has access to improved water. Slums Nearly 140 million people in LDCs live in poor housing conditions.
Income categories Poverty Almost 50% of the population in LDCs lives on less than $1 a day. Rates of undernourishment over 40% reported in 10 LDCs.
Some more facts….. One billion people lack clean drinking water and 3 billion lack sanitation –13,000-15,000 deaths per day worldwide from water-related diseases Hunger kills as many individuals in two days as died during the atomic bombing of Hiroshima
Population using improved sanitation facilities
Access to Essential medicines 55 % of worlds citizens lack essential health care because of very high costs of medicines. (WHO) Out of pocket healthcare expenditure is the second greatest cause of rural indebtedness in India today. Out of it 79% is on medicines.
In India Between , 32.5 million patients fell below the poverty line just after a single hospitalization. 40% of those hospitalized were forced to borrow money or sell assets to meet costs, and 23% of ill patients simply never seek treatment because of their inability to pay.
WHO estimates that 65% of Indias population lacks regular access to essential medicines. This is when INDIA IS THIRD LARGEST PRODUCER OF MEDICINES IN THE WORLD. DRUG PRICING AND PRESCRIPTION OF UNNECESSARY DRUGS MAIN CAUSE
Procurement through OPEN TENDER by GENERIC NAME reveals the actual costs… Generic Name of DrugChittorgarh Tender Rate* (Rs.) UnitMRP Printed on pack / strip (Rs.) Albendazole Tab IP 400 mg tablets Alprazolam Tab IP 0.5 mg tablets Arteether 2 ml Inj Injection Amlodipine Tab 5 mg tablets Cetrizine 10 mg tablets Ceftazidime 1000 mg Injection Atorvastatin Tab 20 mg tablets Diclofenac Tab IP 50mg tablets Diazepam Tab IP 5 mg tablets Amikacin 500 mg Injection Large gap between manufacturing price & MRP !!!!!! Huge profits - at the cost of the poor.
Who is more important ? Drug manufacturers or our poor countrymen
40.50/ mgNIMESULIDENISE 25/ mgNIMESULIDENICIP 29/ mgNIMESULIDENIMULID 20/ mgNIMESULIDENIMLIN Printed Max. Retail No. of Tablets PotencySalt name of medicine (Generic Name) Name given by drug company (Brand Name) THE PROBLEM : SAME MEDICINE : DIFFERENT PRICES However, the stockist price of NICIP manufactured by Cipla is only Rs. 1.88/-
Antibiotic Injection Drug manufacturi ng company Name given by company (Brand Name) Salt name of medicine (Generic Name) Rate at which drug is purchased by the chemist (Stockiest price) ONE INJECTION Rate at which drug is sold to the customer (Printed MRP) CadilaAmistar 500Amikacin 500 mg 8.00/-70/- German Remedies Amee 500Amikacin 500 mg 8.00/-70/- WockhardtZekacin 500Amikacin 500 mg 9.90/-70/- AlembicAmikanex 500Amikacin 500 mg 8.22/-64.25/- IntasKami 500Amikacin 500 mg 8.13/-60/- UnichemUnimika 500Amikacin 500 mg 7.80/-72/- RanbaxyAlfakim 500Amikacin 500 mg 8.50/-70/- CiplaAmicip 500Amikacin 500 mg 7.42/-72/-
The price of generic medicine is : Rs Ciplas 10 mg Cetrizine Ciplas Cetrizine 10 mg Brand Alerid MRP Ciplas Cetrizine 10 mg Brand Cetcip MRP Ciplas Cetrizine 10 mg Brand Okacet MRP 27.50
IF SOMEBODY IN YOUR FAMILY SUFFERS FROM BLOOD CANCER There Are Three Options With The Doctor
GENERIC NAME BRAND NAME NAME OF COMPANY NO. OF CAPSULES PRICE (Rs.) M.R.P. IMATINIBCap. GLIVECNOVARTIS1201,14,400/- IMATINIBCap. VEENATNATCO12010,800/- IMATINIBCap. BUT, DO THE PATIENTS HAVE ANY OPTION... ? ? ? Cipla supplies the generic version at just Rs. 6,500/- to Railway Hospitals
Promotion of Hazardous, Banned and Bannable Drugs
Contemporary Issues in Health & Justice 90% of research dollars spent on diseases affecting 10% of the worlds population Research on special populations (cultural minorities, prisoners, developing world, etc.) non existent. Role of institutional and for-profit IRBs Use of placebo controls
The cost of medicines is one of the largest factors contributing to this breach of human dignity.
Status of women Women do 67% of the worlds work receive 10% of global income own 1% of all property
Worldwide, every minute 380 women become pregnant (190 unplanned or unwanted) 110 women experience pregnancy-related complications 40 women have unsafe abortions 1 woman dies from childbirth or unsafe abortion Reason: Lack of access to reproductive health services
Establish Health as basic right by By global equitable distribution of resources. Transfer of technology Stopping migration of skilled health personnel from south to northern countries Abolition of international covenants and instrument which discriminate against southern countries.
Asian Social Forum
The human right to health and health care must take precedence over the profits of corporations, especially the profiteering of pharmaceutical companies. The Cuenca Declaration 2005 PHM GlobalGlobal Action
A global mobilisation only can ensure to bring about this Change. Join PEOPLEs HEALTH MOVEMENT
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