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Trust and the regulation of pharmaceuticals South Asia in a globalised world 英文参考文献.doc

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Trust and the regulation of pharmaceuticals South Asia in a globalised world 英文参考文献

Brhlikovaetal.GlobalizationandHealth2011,7:10 /content/7/1/10 RESEARCH OpenAccess Trustandtheregulationofpharmaceuticals: SouthAsiainaglobalisedworld PetraBrhlikova1?,IanHarper1?,RogerJeffery1*?,NabinRawal2,MadhusudhanSubedi2andMRSanthosh3 Abstract Background:Buildingappropriatelevelsoftrustinpharmaceuticalsisapainstakingandchallengingtask,involving participantsfromdifferentspheresoflife,includingproducers,distributors,retailers,prescribers,patientsandthe massmedia.Increasingly,however,trustisnotjustanationalmatter,butinvolvescross-borderflowsofknowledge, threatsandpromises. Methods:Dataforthispapercomesfromtheproject‘TracingPharmaceuticalsinSouthAsia’,whichused ethnographicfieldworkandqualitativeinterviewstocomparedthetrajectoriesofthreepharmaceuticals (Rifampicin,OxytocinandFluoxetine)fromproducertopatientinthreesites(northIndia,WestBengalandNepal) between2005-08. Results:Wearguethatissuesoftrustarecrucialinreducingthelikelihoodofappropriateuseofmedicines.Unlike earlierdiscussionsoftrust,wesuggestthattrustcontextsbeyondthepatient-practitionerrelationshipare important.Weillustratetheseargumentsthroughthreecasestudies:(i)aconflictoverethicsinNepal,involvinga suggestedrevisedethicalcodeforretailers,medicalrepresentatives,producersandprescribers;(ii)disputesover counterfeit,fake,substandardandspuriousmedicines,andqualitystandardsinIndiangenericcompanies,looking particularlyattheroleplayedbytheUSFDA;and(iii)theimplicationsoflackoftrustintheDOTSprogrammesin IndiaandNepalfortherelationshipsamongpatients,governmentandtheprivatesector. Conclusions:Weconcludethatthebuildingoftrustisanecessarybutalwaysvulnerableandcontingentprocess. Whileitmightbedesirabletooutlinestepsthatcanbetakentobuildtrust,therangeofconflictinginterestsin thepharmaceuticalfieldmakefeasiblesolutionshardtoimplement. Background thatanotherpersonwillprotecthisorherinterests’[[1]: In conducting our research tracing three pharmaceuti- 1133].Mostanalysesoftrustinthehealthspherefocus cals(Rifampicin,Fluoxet