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Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

A key feature of human rights in health is access to safe, effective and affordable medicines. Pharmacovigilance is advocated for monitoring intended/unintended effects of medicines to assure their safety. The purpose of this paper is to synthesize knowledge about supply chain impediments to safe medicines in developing nations and contribute to future development of research in this field.

This paper conducts a structured literature review based on Preferred Reporting Items for the Systematic Reviews and Meta-Analyses guidelines. It aims at profiling supply chain impediments to safe medicines in developing nations by reviewing 46 recent pharmacovigilance-specific papers published between 2005 and 2020.

Analysis of reviewed articles identified criticality of supply chain impediments that affect constituents across pharmaceutical in developing nations, which still struggle to maintain robust national pharmacovigilance systems due to lack of awareness, policy and practices.

Research results can be applied by pharmaceutical industry decision-makers and drug safety professionals in developing nations. Because the review is qualitative in nature, its implication ought to be tested after actual implementation.

This review can help identify underinvestigated impediments and methods to aid in developing new pharmacovigilance knowledge areas in developing nation context.

The review uncovers gaps in global health equity dialogue in developing nations. It also recognizes that macrolevel supply chain impediments exist due to unfair disease burden and health inequities in developing nations.

The paper examines supply chain impediments to safe medicines in developing nations with insights for future pharmacovigilance research. Identifying and classifying supply chain impediments through this review is the first step toward creating effective interventions for these impediments to safe medicines.

Medicine shortages have a detrimental impact on stakeholders in the pharmaceutical supply chain (PSC). Existing studies suggest that building resilience strategies can mitigate the effects of these shortages. As such, this research aims to examine whether resilience strategies can reduce the impact of medicine shortages in the United Kingdom's (UK) PSC.

A sequential mixed-methods approach that involved qualitative and quantitative research enquiry was employed in this study. The data were collected using semi-structured interviews with 23 key UK PSC actors at the qualitative stage. During the quantitative phase, 106 respondents completed the survey questionnaires. The data were analysed using partial least square-structural equation modelling (PLS-SEM).

The results revealed that reactive and proactive elements of resilience strategies helped tackle medicine shortages. Reactive strategies increased relational issues such as behavioural uncertainty, whilst proactive strategies mitigated them.

The findings suggest that PSC managers and decision-makers can benefit from adopting structural flexibility and proactive strategies, which are cost-effective measures to tackle medicine shortages. Also engaging in strategic alliances as a proactive strategy mitigates relational issues that may arise in a complex supply chain (SC).

This study is the first to provide empirical evidence of the impact of resilience strategies in mitigating medicine shortages in the UK's PSC.

This paper aims to introduce an under-researched concept, travel medicine, to the hospitality field and proposes future research directions. This paper also highlights the need to acknowledge the missing link between hospitality and medical science and encourages research on the health of hotel guests, especially those with mental disorders.

By synthesizing relevant literature, this study proposes a conceptual framework focused on identifying and filling knowledge gaps between hospitality and medical science. Pathways for empirical research on hotel guests’ travel health are suggested accordingly.

This paper reveals that the topic of travel medicine has been neglected in hospitality, especially in relation to vulnerable hotel guests. Additionally, this study suggests that researchers should move beyond the confines of social science and conduct interdisciplinary hospitality studies. In-depth analyses of hotel guests’ health and safety are also recommended.

This conceptual piece serves as a “provocation” that is exploratory, thus laying a foundation for future interdisciplinary studies bridging hospitality and medical science. This paper offers practical significance for hospitality stakeholders (i.e. academics, practitioners, hotel guests and society) and also provides guidelines on how to create vulnerability-friendly hospitality environments.

To the best of the authors’ knowledge, this study takes an important step toward interdisciplinary research between hospitality and medical science through the lens of travel medicine. This paper offers insight to bridge these disciplines and extend hospitality research into medical science. This paper further identifies an under-investigated topic and feasible research avenues that can offer timely solutions for hospitality academics and practitioners.

This study aims to determine the factors and dynamic systems behaviour of essential medicine stockout in public health-care supply chains. The authors examine the constraints and effects of mental models on medicine stockout to develop a dynamic theory of medicine availability towards saving patients’ lives.

This study uses a mixed-method approach. Starting with a survey method, followed by in-depth interviews with stakeholders within five health-care supply chains to determine the dynamic feedback leading to stockout and conclude by developing a network mental model for medicines availability.

The authors identified five constraints and developed five case mental models. The authors develop a dynamic theory of medicine availability across cases and identify feedback loops and variables leading to medicine availability.

The need to include mental models of stakeholders like manufacturers and distributors of medicines to understand the system completely. Group surveys are prone to power dynamics and bias from group thinking. This survey’s quantitative output could minimize the bias.

This study uniquely uses a mixed-method of survey method and in-depth interviews of experts to assess the essential medicine stockout in Nigeria. To improve medicine availability, the authors develop a dynamic network mental model to understand the system structure, feedback and behaviour driving stockouts. This research will benefit public policymakers and hospital managers in designing policies that reduce medicine stockout.

This study investigated how consumers' confidence in medicine and health information seeking and usage could be related to purchase intentions and satisfaction.

A panel of 18 food supplements consumers were interviewed using soft laddering. Qualitative data were coded and used to develop a structured survey. Participants (N = 363) were recruited on a voluntary basis among the customers of an Italian company in this sector. Hypotheses were tested by linear regressions and generalized models.

Results showed that consumers' confidence in medicine interacted with health information seeking and usage influencing both purchase intention and satisfaction. Consumers with high confidence behave differently from those with low confidence.

The authors used a sample based on one company's customer base.

Companies should segment their customers based on their level of confidence in medicine and adopt different marketing strategies for different segments.

A broader knowledge of consumers' attitudes towards food supplements and medicines can improve the public policies aimed at increasing quality of life.

From a theoretical viewpoint, findings suggest to consider consumers' confidence in medicine along with other subjective and contextual variables in socio-cognitive models aimed at explaining food supplements' consumer behavior. From a marketing viewpoint, results suggest to consider confidence in medicine as a precious variable in segmentation strategies. While some communication strategies are valid for all customers (i.e. using experts as advisors, using scientific contents in ads), others (i.e. relying on the advice of trustworthy people, explaining the consequences of consumption) were proved to have different impact on consumers depending on their degree of confidence in medicine.

This paper aims to determine the knowledge and attitudes of the physicians regarding human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), to emphasize that these patients exist and they will exist in the future and to raise awareness so as to prevent that their rights to treatment are revoked.

The survey was conducted via a link sent through an online system. Random physicians from 81 cities of the country were invited to the survey. The survey has 41 questions regarding knowledge and attitudes in total, including epidemiological information such as age, gender and title.

A total of 3,107 physicians has voluntarily participated in the study. In total, 2,195 (70.7%) are internal physicians and 912 (29.3%) are surgical physicians among the participant physicians. In total, 1,452 (46.7%) of the participants are specialist physicians, 608 (19.6%) of the participants are practising physician and the rest of it is physician assistants, academicians and dentists, respectively.

In this study, it has been found out that the physicians have a lack of knowledge on HIV/AIDS and they adopt a discriminatory attitude towards HIV-positive persons. HIV-positive patients who are exposed to discrimination and scared of being uncovered refrain from applying to hospitals for treatment, which puts public health into jeopardy due to the high viral load and these patients are faced with difficulties in coping with both medical and emotional load of the disease.

The COVID-19 pandemic imposed movement restrictions and limited access to modern medical services, prompting the search for alternative solutions, such as indigenous herbal medicines. In Southwest Nigeria, female herbal producers, often with limited economic resources, play a significant role in herbal medicine production. Despite facing multiple challenges, these producers have demonstrated remarkable creativity in navigating the barriers. However, without deliberate efforts to preserve their creative values, indigenous herbal businesses face the threat of extinction. This chapter investigates the resourcefulness of female herbal producers during the COVID-19 pandemic in Southwest Nigeria and proposes strategies for sustaining their trade. Qualitative data were collected to identify the treatment patterns and trade dynamics among female herbal producers in the region. The findings indicate that movement restrictions during the pandemic disrupted herbal producers' access to treatment materials, yet they managed to meet their communities' health needs. These women often serve as first responders and primary healthcare providers in many local communities in Southwest Nigeria, and collaboration with the government will further enhance their effectiveness. The sustainability of indigenous herbal medicine production and trade by women can become a pathway to promote women's economic empowerment in Nigeria if given the necessary support. The chapter concludes with policy recommendations for sustaining the ingenuity of female herbal producers in Nigeria.

In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

This study aims to analyze the pattern of deaths in detention in Northern Tunisia as well as the causes of death.

The authors conducted a cross-sectional retrospective study including all the casualties of death in detention examined in the legal medicine Department in the main teaching hospital from 2005 to 2019. The department covers 10 out of the 11 governorates of Northern Tunisia and 13 prisons.

Of a total of 197 casualties, only 2 were females. The mean age was 45.39 ± 14.43 years. A known medical history was reported in 63.5%, mainly cardiovascular disease, mental health disorders and diabetes. Half of the deaths occurred at the hospital. A total of 53 victims spent less than one year in custody before their death. Most deaths occurred due to disease-related causes (78.7%; n = 155); among these, 69 victims died from cardiovascular disease. Suicide accounted for 3.6% of the casualties and homicides for four cases.

Several missing data regarding the details of the detention circumstances as well as the absence in some cases of the toxicological and histopathology analysis results, which could bias the study findings.

Death in detention in Northern Tunisia involved mainly males between their 30s and their 50s who died mainly from cardiovascular or pulmonary disease. These results underscore the importance of empowering the penitentiary health system.

To the best of the authors’ knowledge, this study is one of largest studies with regard to the number of decedents and the number of prisons from the Arab countries allowing to draw a pattern of casualties of death in prison.