Why the MDGs need good governance in pharmaceutical systems to promote global health
Why the MDGs need good governance in pharmaceutical systems to promote global health
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DOI：
10.1186/1471-2458-14-63
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发表时间：
2014-01-21
影响因子：
4.5
通讯作者：
Ovtcharenko, Natalia
中科院分区：
文献类型：
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作者：
Kohler, Jillian Clare;Mackey, Tim Ken;Ovtcharenko, Natalia
背景：卫生部门的腐败可能损害健康成果。改善善治反过来又有助于预防与卫生有关的腐败。我们认为，善治具有以下特点：以共识为导向、问责、透明、反应迅速、公平包容、有效高效、遵循法治、具有参与性，理论上不容易受到腐败的影响。通过关注制药系统，我们探讨了从现有善治举措中吸取的一些关键经验教训。随着发展界开始确定2015年后千年发展目标的具体目标，有必要对善治方案进行评估，以便在这些成果的基础上建立可持续战略。本文对制药系统的讨论说明了其中的原因。讨论：考虑到诸如世界银行、世界卫生组织和全球基金发起的药品治理倡议，我们认为，善治倡议的国家所有权至关重要，但任何倡议都必须包括公正利益攸关方的参与。了解任何倡议的政治背景也至关重要，这样才能确定潜在的障碍，并使任何倡议的设计足够灵活，以便根据需要对方案拟订作出调整。最后，所有计划面临的内在挑战是充分衡量任何努力的结果。然而，公平地说，确定善治与卫生结果之间的确切关系很少是直截了当的。摘要：药品治理倡议中确定的挑战根据倡议的性质和结构以不同的形式表现出来，但这些挑战的经常性发生和对人口健康的影响表明，将药品治理作为2015年后千年发展目标的一个关键组成部分越来越重要。具体而言，需要承认这些挑战，并通过全球合作和创新来应对这些挑战，以建立地方化的循证善治指标，促进全球药品安全。
Background: Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key lessons learned from existing initiatives in good governance. As the development community begins to identify post-2015 Millennium Development Goals targets, it is essential to evaluate programs in good governance in order to build on these results and establish sustainable strategies. This discussion on the pharmaceutical system illuminates why.Discussion: Considering pharmaceutical governance initiatives such as those launched by the World Bank, World Health Organization, and the Global Fund, we argue that country ownership of good governance initiatives is essential but also any initiative must include the participation of impartial stakeholders. Understanding the political context of any initiative is also vital so that potential obstacles are identified and the design of any initiative is flexible enough to make adjustments in programming as needed. Finally, the inherent challenge which all initiatives face is adequately measuring outcomes from any effort. However in fairness, determining the precise relationship between good governance and health outcomes is rarely straightforward.Summary: Challenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals. Specifically, these challenges need to be acknowledged and responded to with global cooperation and innovation to establish localized and evidence-based metrics for good governance to promote global pharmaceutical safety.