Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines.
Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines.
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DOI：
10.1186/1744-8603-7-4
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发表时间：
2011-02-28
影响因子：
10.8
通讯作者：
Mujinja PG
中科院分区：
文献类型：
--
作者：
Mackintosh M;Chaudhuri S;Mujinja PG
高收入国家的公民依赖于高度监管的药品市场。然而，低收入国家的贫困人口通常在监管不力的市场上自费购买基本药物，从而难以获得基本药物;结果包括健康状况不佳、耐药性和进一步恶化。虽然非政府组织在低收入国家拥有的卫生设施的作用是有据可查的，但非政府组织在国内和国际上批发基本药物的情况基本上没有得到研究。本文描述和评估了非政府组织和社会企业在基本药物批发方面的活动。这篇文章是基于2006年至2008年对在欧洲、印度和坦桑尼亚经营的贸易非政府组织和社会企业进行的一系列采访。该分析适用于社会企业和市场监管的社会法律和经济视角。从事贸易的非政府组织可以抵制药品批发中固有的不正当激励措施，并改善基本药品的获得;它们还可以在可确定的情况下，通过影响竞争者的行为，对其市场施加更广泛的监管影响。我们探讨了社会企业在基本药物批发中成功和失败的原因，包括商业制造商的市场反应;社会企业贸易商自己的市场策略;以及市场优势，市场细分和捐赠者产生的补贴模式。我们的结论是，在缺乏有效的政府活动和监管的情况下，社会企业批发可以改善获得优质基本药物的机会。在国际卫生政策的设计中应重视并酌情支持这一作用。非政府组织的监管影响可以补充但不应取代国家行动。
Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action.
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影响因子：
1.6
作者：
Mackintosh, Maureen;Mujinja, Phares G. M.
通讯作者：
Mujinja, Phares G. M.
影响因子：
3.5
作者：
Grabowski, DC;Hirth, RA
通讯作者：
Hirth, RA
影响因子：
2.5
作者：
Chaudhuri, Sudip;Mackintosh, Maureen;Mujinja, Phares G. M.
通讯作者：
Mujinja, Phares G. M.
影响因子：
1.1
作者：
Leonard, KL
通讯作者：
Leonard, KL
影响因子：
2
作者：
Deakin, S;Michie, J
通讯作者：
Michie, J