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Book part
Publication date: 16 September 2022

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Counterfeiting and Fraud in Supply Chains
Type: Book
ISBN: 978-1-80117-574-6

Article
Publication date: 4 March 2021

Sofie Stulens, Kim De Boeck and Nico Vandaele

Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and…

Abstract

Purpose

Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and middle-income countries. The effective and efficient operation of HIV supply chains is critical to tackle this problem. The purpose of this paper is to give an introduction to HIV supply chains in low- and middle-income countries and identify research opportunities for the operations research/operations management (OR/OM) community.

Design/methodology/approach

First, the authors review a combination of the scientific and grey literature, including both qualitative and quantitative papers, to give an overview of HIV supply chain operations in low- and middle-income countries and the challenges that are faced by organizing such supply chains. The authors then classify and discuss the relevant OR/OM literature based on seven classification criteria: decision level, methodology, type of HIV service modeled, challenges, performance measures, real-life applicability and countries covered. Because research on HIV supply chains in low- and middle-income countries is limited in the OR/OM field, this part also includes papers focusing on HIV supply chain modeling in high-income countries.

Findings

The authors conclude this study by identifying several tendencies and gaps and by proposing future research directions for OR/OM research.

Originality/value

To the best of the authors’ knowledge, this paper is the first literature review addressing this specific topic from an OR/OM perspective.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 11 no. 3
Type: Research Article
ISSN: 2042-6747

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Book part
Publication date: 9 November 2006

Angela Wasunna and Daniel W. Fitzgerald

No other region of the world has suffered from such devastating epidemics in the recent past than sub-Saharan Africa. HIV/AIDS poses the worst single health threat on the…

Abstract

No other region of the world has suffered from such devastating epidemics in the recent past than sub-Saharan Africa. HIV/AIDS poses the worst single health threat on the continent and approximately 28.5 million of people infected with HIV/AIDS are in sub-Saharan Africa, yet, less than 8% have access to treatment. As African countries start or continue to expand their HIV/AIDS treatment programs with the assistance of international donors, they are facing several ethical and health policy challenges, including difficult decisions on how to ration available treatment, the high cost of drugs, the complexity of treatment regimens, the inadequacy of health and delivery systems, the lack of knowledge about treatment, and the threat of drug resistance.

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Ethics and Epidemics
Type: Book
ISBN: 978-1-84950-412-6

Open Access
Article
Publication date: 10 April 2017

Shyama V. Ramani, Ajay Thutupalli and Eduardo Urias

This paper aims to study how multinational enterprises (MNEs) can best integrate legitimacy concerns into their new product-launching strategy to successfully introduce high-value…

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Abstract

Purpose

This paper aims to study how multinational enterprises (MNEs) can best integrate legitimacy concerns into their new product-launching strategy to successfully introduce high-value hi-tech innovations in emerging countries.

Design/methodology/approach

Theoretical constructs on the role and process of legitimacy construction for the introduction of a new product are built upon the existing literature. Then they are validated and refined through the formulation and analysis of case studies of the launch of genetically modified cotton seeds by Monsanto in India and a HIV/AIDS drug cocktail by Merck in Brazil.

Findings

Legitimacy construction can serve MNEs to face challenges successfully while launching high-value hi-tech products in emerging countries. Challenges to MNEs are likely to be founded on a combination of four types of uncertainties: technological, commercial, organizational and societal. Expected challengers are public agencies and actors representing civil society. An MNE can prepare itself through legitimacy construction along three dimensions: redesign of technology, revision of marketing strategy and non-market investments. To implement the aforesaid, MNEs can engage in outreach in the form of strategic patience, market transaction, business collaboration, compromise and/or confrontation with diverse carefully chosen stakeholders.

Research limitations/implications

The authors limited ourselves to tracing only the formal interactions of MNEs, while it is well-known that many informal and backdoor activities can also accompany their growth in emerging economies.

Practical implications

Legitimacy construction can help MNEs face challenges successfully while launching high-value hi-tech products in emerging countries. This calls for an evaluation of the systemic uncertainties followed by the formulation of a strategy for legitimacy construction and implementation through outreach to diverse systemic actors. Strategic patience can yield positive returns. Market transactions can serve as economic anchors. Collaboration can be pursued with parties who can share the costs of legitimization construction and/or reduce technological and marketing uncertainties. Confrontation should be the last choice. Compromise is the most probable but not the only outreach strategy possible after a confrontation.

Social implications

Legitimacy implies product acceptance not only from the targeted consumer but also other societal stakeholders concerned with the safety and equity of the consumption in the emerging country, especially when regulations are not well-defined and/or implemented. The two kinds of societal stakeholders which are likely to monitor MNEs are public agencies and civil society groups. Public agencies will be concerned about the quantity, quality, technology or price of the innovation to be introduced. Civil society and NGOs may help the MNE act as citizen watchdogs for the environment and vulnerable communities.

Originality/value

Theoretical constructs have been developed in this paper on the sources of challenges in new product introduction, the types of challengers and the components of the firm’s legitimacy construction strategy and its implementation through an outreach strategy.

Details

Qualitative Market Research: An International Journal, vol. 20 no. 2
Type: Research Article
ISSN: 1352-2752

Keywords

Article
Publication date: 3 August 2015

Maria Nnyepi, Maurice R. Bennink, Jose Jackson-Malete, Sumathi Venkatesh, Leapetswe Malete, Lucky Mokgatlhe, Philemon Lyoka, Gabriel M. Anabwani, Jerry Makhanda and Lorraine J. Weatherspoon

Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the…

Abstract

Purpose

Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the benefits of integrating nutrition (assessment and culturally acceptable food supplement intervention) in the treatment strategy for this target group.

Design/methodology/approach

The authors conducted a randomized, double blind pre-/post-intervention trial with 201 HIV-positive children (six to 15 years) in Botswana. Eligibility included CD4 cell counts < 700/mm3 (a marker for the severity of HIV infection), documented treatment with antiretroviral (ARV) drugs, and no reported evidence of taking supplemental food products with one or more added nutrients in the six-month period prior to the study. The intervention (12 months) consisted of two food supplements for ethical reason, one with a higher protein content, bean (bean-sorghum based) group (n=97) and a cereal (sorghum) group (n=104) both of which contained added energy- and micro- nutrients. Anthropometric and biochemical nutritional status indicators (stunting, wasting, underweight, skinfolds for fat and muscle protein reserves, and hemoglobin levels) were compared within and between the bean and the cereal groups pre- and post-intervention separately for children six to nine years and ten to 15 years.

Findings

Older children (ten to 15 years) fared worse overall compared to those who were younger (six to nine years) children in anthropometric and protein status indicators both at baseline and post-intervention. Among children six to nine years, the mid arm circumference and blood hemoglobin levels improved significantly in both the bean and cereal groups (p < 0.01 and p < 0.05, respectively). Although the BMI for age z-score and the triceps skinfold decreased significantly in the bean group, the post-intervention subscapular skinfold (fat stores) was significantly higher for the bean group compared to the cereal group (p < 0.05). Among children ten to 15 years, both the bean and the cereal groups also showed improvement in mid arm circumference (p < 0.001), but only those in the bean group showed improvement in hemoglobin (p < 0.01) post-intervention.

Originality/value

Similar significant nutritional status findings and trends were found for both food interventions and age within group pre- vs post-comparisons, except hemoglobin in the older children. Post-intervention hemoglobin levels for the type food supplement was higher for the “bean” vs the “cereal” food in the younger age group. The fact that all children, but especially those who were older were in poor nutritional status supports the need for nutrition intervention in conjunction with ARV treatment in children with HIV/AIDS, perhaps using a scaled up future approach to enhance desired outcomes.

Details

Health Education, vol. 115 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Book part
Publication date: 11 November 2015

Matthew B. Flynn

Understanding of the factors that contribute to policies diverging from neoliberal norms and accounting for situations when social movement activists prevail over the interests of…

Abstract

Purpose

Understanding of the factors that contribute to policies diverging from neoliberal norms and accounting for situations when social movement activists prevail over the interests of more powerful opponents requires an analytical framework specifying the dimensions of interest. The case of Brazil’s pharmaceutical policies, especially those dealing with HIV/AIDS, is considered.

Methodology/approach

To understand the space and limits for progressive agency amidst contemporary globalization, previous articulations of dependent development and global capitalism require conceptual space with insights from social movement theory and normative framing.

Findings

Control over technology, political alliances, and normative appeals have changed since the concept of dependent development to today’s contemporary neoliberal globalization for understanding cases of progressive agency. Technology is based more on intangible knowledge, activism across the state-society boundary is more likely, and human rights has become the dominant idiom for naming and shaming more powerful opponents.

Research limitations/implications

The analytic framework developed informs our understanding of pharmaceutical autonomy – the ability of a country to provide for the prescription drug needs of its population – in the case of Brazil. Further research of other situations requires the application of the framework to determine its merits.

Originality/value

A focus on technology, alliances, and norms provides a useful starting point for exploring situations of development autonomy that prevails over the interests of corporate power.

Details

States and Citizens: Accommodation, Facilitation and Resistance to Globalization
Type: Book
ISBN: 978-1-78560-180-4

Keywords

Article
Publication date: 9 October 2009

Anil Hira

The majority of the world's population has limited access to needed medicines. The purpose of this paper is to explain why certain characteristics of the global pharmaceutical…

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Abstract

Purpose

The majority of the world's population has limited access to needed medicines. The purpose of this paper is to explain why certain characteristics of the global pharmaceutical market have not served a large majority of potential consumers in the developing world.

Design/methodology/approach

Through a political economy analysis of evolutionary and regulatory aspects of both supply and demand conditions for global pharmaceuticals, it can be understood why most of the world's poor have limited access to basic medicines. The paper then turns to what avenues are available for improving access to medicines. An analysis of the chief proposed solutions, namely: pooled demand and relaxation of intellectual property rights, reveals their inadequacies. A third emerging avenue, the growing production of pharmaceuticals in the south, is examined through case studies of leading producers including India, China, and South America.

Findings

While each of the three options offers potential benefits, none is adequate to solve the problem – a new, perhaps combinatorial, approach will be needed to ensure that a wider global market for pharmaceuticals can be created.

Originality/value

The paper offers insights into the political economy of the global pharmaceutical industry.

Details

International Journal of Development Issues, vol. 8 no. 2
Type: Research Article
ISSN: 1446-8956

Keywords

Article
Publication date: 14 June 2013

Venkatesan Chakrapani, Ram Kamei, Hoineilam Kipgen and Jayanta Kumar Kh

The authors aimed to examine the incarceration experiences of injecting drug users in accessing harm reduction, and HIV‐related services inside prisons in India.

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Abstract

Purpose

The authors aimed to examine the incarceration experiences of injecting drug users in accessing harm reduction, and HIV‐related services inside prisons in India.

Design/methodology/approach

The authors conducted three focus groups with a purposive sample of 23 formerly incarcerated male IDUs and four key informant interviews with a former police official, a drug dealer and service providers. Data were analyzed using a constant comparative method.

Findings

Participants reported availability of alcohol and injectable or oral drugs such as heroin, dextropropoxyphene, and marijuana inside prisons. Inmates obtained drugs and clean syringes (one syringe bought for 2.5‐4 USD) through prison staff, and collected used syringes and needles from the dustbins in prison sickrooms. Needles and syringes were reused and shared. Prisons did not have needle and syringe programmes, detoxification, overdose management or opioid substitution treatment. Drug‐using prison inmates faced several challenges in accessing antiretroviral treatment and HIV testing.

Practical implications

The authors' findings emphasize the need to protect the health of injection drug‐using inmates by introducing harm reduction programmes and removing barriers to HIV testing and antiretroviral treatment.

Originality/value

This study illustrates, for the first time, the contexts behind high risk injecting drug use behaviours among prison inmates in India. It also highlights the lack of availability of harm reduction services such as needle and syringe programmes, drug detoxification and opioid substitution treatment inside prisons. Further, it demonstrates the difficulties faced by HIV‐positive prison inmates in getting timely and uninterrupted antiretroviral treatment.

Details

International Journal of Prisoner Health, vol. 9 no. 2
Type: Research Article
ISSN: 1744-9200

Keywords

Content available
Article
Publication date: 6 February 2009

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Abstract

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 1
Type: Research Article
ISSN: 0952-6862

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Book part
Publication date: 25 September 2017

Eduardo Urias

There is sufficient evidence to prove that the improved health status of a nation’s citizens results in economic growth and development via improved functionality and productivity…

Abstract

There is sufficient evidence to prove that the improved health status of a nation’s citizens results in economic growth and development via improved functionality and productivity of labor. It is also commonly accepted that healthcare expenditure significantly influences health status through, for instance, improving life expectancy at birth and reducing morbidity, death, and infant mortality rates. Within healthcare, medicines account for a considerable share of health-related expenditure in both developed and developing countries. Therefore, it seems reasonable to assume that improved access to medicines is likely to contribute not only to the well-being of families and individuals but also to the economic growth and development in all societies. It has been widely advocated that pharmaceutical multinational enterprises (MNEs) can play an important role to address this problem, as they develop and supply a significant proportion of the drugs imported by low- and middle-income countries. This chapter is dedicated to a systematic review of literature in order to identify the strategies implemented by pharmaceutical MNEs to improve access to medicines in the low- and middle-income countries. A total of 76 research articles have been identified, and we have found that the main strategies of pharmaceutical MNEs are related to improving health outcomes through R&D, establishing partnerships for product development, pricing strategies to improve access to medicines, technology transfer, licensing agreements, and nonmarket efforts to improve access to medicines, among other strategies to overcome barriers imposed by intellectual property rights. We have also found that pharmaceutical MNEs’ strategies take place within a complex system and often involve interactions with a wide range of actors, such as international organizations, governments, private not-for-profit sector, universities and research institutes, and generic manufacturers. However, there is still a need for major progress in the field of access to medicines, and pharmaceutical MNEs should be more active in this field in order to avoid potential negative consequences, such as loss of legitimacy and compulsory licensing of their patented medicines.

Details

International Business & Management
Type: Book
ISBN: 978-1-78743-163-8

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