The study of isiZulu medicine names as reflected in indigenous healing system. This research focuses on the meaning of names of nsatural herbs in isiZulu language which form part of traditional medicine within the Zulu society. It plays an important role in the manifestation of a composite picture of Zulu society. This research also proposes to investigate isiZulu medicine as reflected in indigenous healing systems within th Zulu society which forms what is known as Zulu cosmoloy. the primary objective of this research is to contribute to an understanding of the ways in which humans use natural herbs and animal parts in constructing healthy life as part of healing practice. / African Languages / M.A. (African Languages)

The objective of this study was to evaluate the status of the counterfeit pharmaceuticals in Jordan. Four types of pharmaceuticals Lipitor (Atorvastatin-calcium), Concor (bisoprolol fumarate), Co-Diovan (Valsartan, hydrochlorothiazide) and Plavix (clopidogrel) were subjected to physical and chemical analysis. 173 samples of these four medicines were collected from the three most populated cities in the country, namely Amman, the capital of Jordan, Zarqa and Irbid. A sample of confiscated counterfeited medicines was obtained from the health authorities and tested utilising the HPLC and dissolution testing, in order to validate the reliability of the testing procedures. Samples were then tested using High Performance Liquid Chromatography (HPLC) and dissolution tests in order to assess the quality of these samples. Results of both chemical and physical analyses revealed that all samples were found to fall within the specification limits of United States Pharmacopoeia (USP) and no evidence was found of any counterfeit drug products in the samples examined. Since this study found no indication of a drug counterfeiting problem in Jordan, the researcher has concluded that there seemed to be two contributing factors to this result: first, the very effective legislative campaigns conducted by the health authorities’ in Jordan against counterfeit trade through new public health and pharmacy law which has been launched in 2008. Second, the rigorous tough enforcement measures conducted by health and law enforcement agencies in the country.

Η φαρμακευτική αγορά αποτελεί έναν κρίσιμο τομέα της οικονομίας και της κοινωνίας εν γένει, αφού το συναλλακτικό προϊόν της το φάρμακο, αποτελεί κοινωνικό αγαθό. Σχεδόν εδώ και έναν αιώνα η κύρια πηγή ενημέρωσης των γιατρών για τα φάρμακα ήταν και είναι οι ιατρικοί επισκέπτες. Η σχέση μεταξύ γιατρού και ιατρικού επισκέπτη είναι ιδιαίτερα πολύπλοκη και δεν περιορίζεται ως αυστηρά επαγγελματική, αλλά έχει και κοινωνικές προεκτάσεις. Βέβαια ο γιατρός έχει την επιρροή (δύναμη στη λήψη αποφάσεων), η οποία βασίζεται στην θέση και την επιστημονική του αυθεντία (κανονιστική δύναμη-normative power). Σε ένα τέτοιο πλαίσιο λήψεως αποφάσεων, οι σχέσεις ιατρών-φαρμακευτικής βιομηχανίας θα περιμέναμε να είναι μάλλον ασύμμετρες, ή μη ισορροπημένες. Με αυτή την έννοια, κάποιος θα περίμενε ότι οι σχέσεις γιατρών και ιατρικών επισκεπτών θα ήσαν περισσότερο διακριτές, χωρίς έρεισμα για ανάπτυξη μακροχρόνιων δεσμών. Από τη άλλη πλευρά, οι γιατροί χρειάζονται τις νέες γνώσεις των φαρμακευτικών εταιρειών, όπως αυτές εξελίσσονται μέσα από την διαρκή κλινική και εργαστηριακή έρευνα. Έτσι η διαδικασία στη λήψη αποφάσεων είναι πολύπλοκη- μη δομημένη σε μεγάλο βαθμό, οπότε και χρειάζεται πλούσια και άμεση διαπροσωπική επικοινωνία. Για παράδειγμα, το φαρμακευτικό προϊόν έχει μη άμεσα απτές ιδιότητες (intangible), διότι την δράση του (απόδοσή του) δεν μπορούμε να τη γνωρίζουμε, αν ο ασθενής δεν το καταναλώσει. Επομένως, ο γιατρός θα πρέπει να αναπτύξει εμπιστοσύνη σε κάποιες παραμέτρους κατά περίπτωση (π.χ. όνομα φαρμάκου, κλινικές μελέτες, αξιοπιστία ιατρικού επισκέπτη, κλπ), που πάντως καθιστούν την διαδικασία λήψης απόφασης αρκετά πολύπλοκη. Την ίδια στιγμή, οι φαρμακευτικές εταιρείες προσπαθούν να ασκούν και τον ρόλο ενός εμπειρογνώμονα, ασκώντας επιρροή γνώσης (referent power) κάνοντας έτσι την σχέση μεταξύ των παραπάνω δρώντων πιο ισόρροπη και συμμετρική. Παρόλο το αυξημένο ενδιαφέρον που υπάρχει στην υπάρχουσα φαρμακευτική αγορά και τις μεμονωμένες μελέτες, απ’ όσο γνωρίζουμε μέχρι σήμερα, δεν έχει εμφανισθεί ένα ολοκληρωμένο μοντέλο, που να εξετάζει συνολικά τις σχέσεις μεταξύ ιατρών και των αντιπροσώπων των φαρμακευτικών εταιριών (των ιατρικών επισκεπτών). Σκοπός της παρούσας ποσοτικής μελέτης είναι να καλύψει σε ένα βαθμό αυτό το κενό στην υπάρχουσα βιβλιογραφία. Πιο συγκεκριμένα, ο σκοπός της παρούσας διατριβής συνίσταται στην μορφοποίηση ενός θεωρητικού μοντέλου ανάπτυξης μακροχρονίων σχέσεων μεταξύ γιατρών και ιατρικών επισκεπτών, που περιλαμβάνει αφ’ ενός μεν, ως ανεξάρτητες μεταβλητές τις επικοινωνιακές ικανότητες και ικανότητες ανάπτυξης σχέσεων εκ μέρους των ιατρικών επισκεπτών, αφ’ ετέρου δε, ως εξαρτημένες μεταβλητές μακροχρονίων σχέσεων, την εμπιστοσύνη και την δέσμευση των ιατρών και ως εξαρτημένες μεταβλητές αποτελεσματικότητας, την απόδοση των ιατρικών επισκεπτών και την ικανοποίηση των ιατρών. Το μοντέλο, επίσης, εξετάζει την ικανότητα περιβαλλοντικών μεταβλητών όπως είναι η αβεβαιότητα, ο δυναμισμός και η ένταση του ανταγωνισμού, της σύγκρουσης μεταξύ ιατρών-ιατρικών επισκεπτών, καθώς και των ψυχογραφικών χαρακτηριστικών των ιατρών, να παίξουν τον ρόλο των επιδρώντων παραγόντων (contingency factors) στις σχέσεις μεταξύ των ανεξάρτητων και εξηρτημένων μεταβλητών. Εκτός των άλλων, η έρευνα ειδικότερα επιχειρεί να αποτυπώσει και την εικόνα της ελληνικής φαρμακευτικής αγοράς, θεωρούμενης ως δυνητικό πλαίσιο ανάπτυξης σχέσεων γιατρών-ιατρικών επισκεπτών. Η μορφοποίηση του θεωρητικού μοντέλου βασίσθηκε στην υπάρχουσα βιβλιογραφία και αρθρογραφία που αντλήσαμε από τα επιστημονικά πεδία του μάρκετινγκ επιχειρήσεων (business-to-business marketing), του σχεσιακού μάρκετινγκ (relationship marketing), του φαρμακευτικού μάρκετινγκ, καθώς και της επιχειρηματικής ψυχολογίας. Επίσης βασίσθηκε σε πρωτογενή στοιχεία, με συνεντεύξεις από αντιπροσωπευτικούς συμμετέχοντες (key-informants), που αφορούσε κυρίως την προσαρμογή κλιμάκων μέτρησης στο περιβάλλον της έρευνάς μας. Τόσο η δειγματοληψία, όσο και οι στατιστικές αναλύσεις που χρησιμοποιήθηκαν, βασίσθηκαν στην σχετική επιστημονική βιβλιογραφία και αρθρογραφία. Το μοντέλο μας ελέχθηκε με μια σειρά αναλύσεων συσχέτισης, παλινδρομήσεων, t-test και ανάλυσης δομικών εξισώσεων (structural equation modeling), όλες βασισμένες σε αθροιστικές μεταβλητές (παράγοντες), οι οποίες είχαν προηγουμένως ελεχθεί ως προς την αντιπροσωπευτικότητα, αξιοπιστία και εγκυρότητά τους. Συμπερασματικά, όπως φάνηκε από τις αναλύσεις παλινδρόμησης, οι επικοινωνιακές ικανότητες και οι ικανότητες ανάπτυξης σχέσεων του ιατρικού επισκέπτη έχουν αρκετές στατιστικά σημαντικές συσχετίσεις με τις εξηρτημένες μεταβλητές του μοντέλου μας, την ανάπτυξη εμπιστοσύνης και δέσμευση του γιατρού, και στη συνέχεια με την αποτελεσματικότητα του ιατρικού επισκέπτη, επαληθεύοντας έτσι, τις περισσότερες από τις υποθέσεις της έρευνας. Επίσης, οι στατιστικοί δείκτες κατέδειξαν ότι το μοντέλο δομικών εξισώσεων που χρησιμοποιήσαμε συνολικά είναι δυνατό (έχει στατιστική σημαντικότητα). Ωστόσο, σύμφωνα με τα ευρήματα, φαίνεται να είναι διακριτός ο τρόπος ανάπτυξης σχέσεων των γιατρών με τους ιατρικούς επισκέπτες σε δύο επίπεδα, στο κοινωνικό και στο επαγγελματικό. Έτσι, εξαιρετικά ανεπτυγμένες προσωπικές σχέσεις με έναν γιατρό δεν συνεπάγονται αυτόματα και την συνταγογράφηση του φαρμάκου που εκπροσωπεί το ιατρικός επισκέπτης, από τον συγκεκριμένο γιατρό. Όσον αφορά την ανάλυση των ψυχογραφικών χαρακτηριστικών των γιατρών, προέκυψαν δύο ομάδες, οι αλτρουιστές και οι πραγματιστές. Από την συσχέτιση μεταξύ των δύο αυτών ομάδων με τις μεταβλητές της έρευνας φαίνεται ότι οι πραγματιστές εστιάζουν το ενδιαφέρον τους στην ανάπτυξη εμπιστοσύνης με τον ιατρικό επισκέπτη και στον τρόπο που αυτός ανταποκρίνεται στα αιτήματά τους. Από την άλλη πλευρά, οι αλτρουιστές φαίνεται ότι είναι στραμμένοι περισσότερο και προς την γενικότερη ανάπτυξη σχέσεων και την απόκτηση πληροφόρησης γύρω από τα φάρμακα, για αυτό και φαίνεται να δίνουν μεγάλη σημασία στην ικανοποίηση από την επικοινωνία. Αναφορικά με τους παράγοντες επιρροής (contingency factors) του περιβάλλοντος, παρατηρούμε ότι υψηλός ανταγωνισμός, υψηλός δυναμισμός (μεταβλητικότητα της τεχνολογίας) και υψηλή αβεβαιότητα επηρεάζουν τις σχέσεις μεταξύ των ανεξάρτητων και εξηρτημένων μεταβλητών. Το περιβάλλον είναι εκείνο μέσα στο οποίο λειτουργεί η σχέση και, όπως φαίνεται, επηρεάζει τις συνιστώσες της. Ομοίως, η σύγκρουση μεταξύ γιατρού-ιατρικού επισκέπτη, καθώς και η προσωπικότητα του γιατρού φαίνεται ότι επηρεάζουν τις υπό εξέταση σχέσεις της μελέτης μας. Tα συμπεράσματα οδηγούν σε ορισμένες επιπτώσεις και προτάσεις για τα στελέχη των φαρμακευτικών εταιρειών καθώς και σε προτάσεις για περαιτέρω έρευνα. / The pharmaceutical market is a key asset of the economy and the society in general, since drugs, its transaction products, are public goods. For almost a century, the main source of information for doctors, about medicines, are pharmaceutical representatives. The relationship between a physician and a pharmaceutical representative is particularly complicated, and it is not stringent professional but has also social implications. Of course, the doctor has the power in decision making, which is based on position and scientific authority (normative power). In such decision making context, relations between doctors and pharmaceutical industry would be expected to be rather asymmetrical, or unbalanced. In this sense, one would expect that the relationships of doctors and pharmaceutical representatives would be more distinct, without the basis for developing long term bonds. On the other hand, doctors need new scientific data, as knowledge progresses through the ongoing clinical and laboratory research of the pharmaceutical companies. So the decision-making process is complex, greatly unstructured, and requires frequent face to face communication. For example, medicines do not have directly tangible properties, because we cannot know the action (performance) of any medicine, if the patient does not consume it first. Therefore, the physician should initialliy develop confidence in some parameters of the drug as appropriate (e.g. brand name of the drug, clinical trials, pharmaceutical representative reliability, etc.), which, however, makes the decision process very complicated. At the same time, pharmaceutical companies are trying to perform the role of an expert, exerting influence knowledge (referent power) thus making the relationship between these actors more balanced and symmetrical. Despite the increased interest in the pharmaceutical market and the individual studies that exist to date, there has not emerged, to our knowledge, an integrated model that comprehensively address the relationships between doctors and representatives of pharmaceutical companies. The purpose of this quantitative study is to cater to a certain extent this gap in the existing literature. More specifically, the purpose of this study is to formulate a theoretical model for developing long-term relationships between doctors and pharmaceutical representatives, which includes on one hand, as independent variables communication skills and relationship development skills by pharmaceutical representatives, and on the other hand as dependent variables of longterm relationships, trust and commitment of doctors and dependent variables of effectiveness, the performance of pharmaceutical representatives and satisfaction of physicians. The model also examines the ability of a.) environmental variables such as uncertainty, dynamism and intensity of competition, b.) conflict between doctors and pharmaceutical representatives, and c.) psychographic characteristics of physicians, playing the role of contingency factors in relationships between independent and dependent variables. Among other things, the research specifically seeks to capture the image of the Greek pharmaceutical market, viewed as a potential framework for developing relations between doctors and pharmaceutical representatives. In conclusion, as shown by the regression analysis, communication skills and relationship skills development of the pharmaceutical representative have several statistically significant correlations with the dependent variables of our model, trust and commitment of the doctor, and the effectiveness of the pharmaceutical representative, confirming thus, most of the hypotheses of the research. Also, statistical indicators show that the structural equation model is overall possible (is statistically significant). However, according to the findings it appears that doctors are developing relationships with pharmaceutical representatives in two distinct levels, social and professional. So highly developed personal relationships with one doctor, does not automatically imply prescribing the drug, the pharmaceutical representative promotes, from the individual physician. Regarding the analysis of psychographic characteristics of the physicians, emerged two groups, altruists and pragmatists. From the correlation between these two groups with the variables of the survey it seems that pragmatists focus their interest on developing trust with the pharmaceutical representative and on his responsiveness. On the other hand, altruists seem to be mainly facing towards overall development of relationships, the acquisition of information about medicines, and to give great importance to the satisfaction from communication. With respect to contingency factors, as far as environment is concerned, we observe that high competition, high dynamism (variability technology) and high uncertainty affect the relations between the independent and dependent variables. The environment is the one in which the relationship operates and as it is shown affects its components. Similarly, conflict between doctor and pharmaceutical representative, and doctor's personality appear to influence ongoing relationships of our study. These conclusions lead to some implications and suggestions for managers of pharmaceutical companies as well as suggestions for further research.

This research utilised mixed methodology to gain insight into community pharmacists’ adoption of medicines and services related to two key innovative policy interventions aimed at enhanced minor ailment management; namely the ongoing legal status reclassification of medicines; and the introduction of the Scottish Minor Ailment Service. Prompted by the lack of qualitative and large scale quantitative evaluation from the pharmacists’ perspective, the aim was to investigate pharmacists’ adoption of these innovations. Data were generated to evaluate the process related aspects of innovation adoption from community pharmacists’ perspectives; and to identify and quantify key factors associated with the adoption of these innovations, thereby considering the wider relevance to new community pharmacy services. A range of methods was used including: formal systematic review of peer reviewed published literature on factors associated with innovation adoption following methods recommended by the Centre for Reviews and Dissemination at the University of York; extensive review of policy documents of all the devolved UK Governments; qualitative focus groups and interviews with 20 community pharmacists from four Scottish Health Boards; and lastly a cross sectional survey of the pharmacists responsible for nonprescription medicines from all Scottish community pharmacies (N=1138). The theoretical framework of diffusion of innovations was adopted to design the quantitative research instrument and interpret the data. Rigour was enhanced by consideration of aspects of validity and reliability at all stages. The highest standards of research governance and ethics were applied throughout the study. Qualitative interviews provided insight into the process related aspects of innovation adoption. Where current changes were embraced reluctantly by many who deemed the pace as fast and furious, others were keen to contribute to developments taking place within pharmacy and were eager to play a more proactive role in leading and introducing change to the public. Regardless of practice setting and ownership model, the merits of each innovation appeared to be considered at the individual practitioner level. Hence an organisational level decision to implement an innovation did not necessarily translate to adoption at the individual practitioner level. Using descriptive, bivariate and multivariate quantitative models informed by the results of the qualitative interviews and systematic review of the literature, the quantitative study showed pharmacists’ perceived attributes of innovations (such as benefits to their professional role development and patients); and patient demand and use of services had the highest association with whether or how far innovations were adopted. Issues such as differences in availability of resources were less able to explain differing level of innovation adoption by the pharmacist respondents. These findings suggest that as innovations around minor ailment management have not yet required reorientation of existing services, the issue of how pharmacists’ perceive the characteristics of the innovations such as: potential for financial benefits to pharmacy, professional role development and patients; is key to predicting whether future innovations of a similar nature will be successfully adopted by pharmacists.

This thesis represents an attempt to encourage a new perspective on health in the late-eighteenth and nineteenth century by concentrating on the ‘mundane maladies’ of the middle classes. The conventional approach to studies of urban health has been to concentrate on the killer diseases of the period. Thus tuberculosis, cholera and typhoid have all received much attention. But what about the everyday experience of health and illness? It is largely unrecorded as the occasional bout of stomach ache, constipation or chesty cough was rarely thought to be noteworthy, except by the odd hypochondriac. However, with the aid of advertisements for health and beauty products published in the provincial press, it is possible to explore the experience of less dramatic and less debilitating ailments. This study, therefore, has analysed the language and strategies employed by advertisers of health and beauty products and services to gain a clearer understanding of the middle-class experience of health and ill-health. Whilst product names and descriptions reveal the range of ‘mundane maladies’ that beset the middle classes, the language employed to sell them offers an indication of the public’s beliefs and expectations surrounding health. Attention has also been paid on how beauty products were employed to manage external appearances. As towns and cities grew during the late-eighteenth and nineteenth century, individuals increasingly judged others by their appearance. By analysing the language used to sell beauty products, it is possible to gain an insight into how members of the middle class wished to be perceived.

No description available.

Medical praescriptions in the Czech Republic Author: Petra Pečivová Tutor: RNDr. Jana Kotlářová, Ph.D. Department of social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czech Republic Aim of diploma thesis: Was detailed analyze of the medical prescriptions in the Czech Republic, their requirements, and manipulation with that. Prescriptions for medicines (LP) were analyzed in detail, their elements and handling were also described in detail, e-prescription, and current issues were discussed, eg. forgery of prescriptions or cross- border patient pharmaceutical care. Methods: Legislation of the Czech Republic were the starting basis as at 31 5th 2014 legislation were obtained from the website of the official institutions. From there comes the economic data, augmented by specific examples of smaller public pharmacies. Publications and magazines for pharmacists and health professionals were part of the sources, as well as similar websites. Knowledge at work, including discussion is also based on the author's own experience working in a pharmacy. Results: Medical prescriptions for medicines were distributed to recipes and order forms, vouchers and orders for medical devices were described only a bit. Each of the prescriptions were explained in detail....

Introdução: A obesidade é um problema de saúde pública com múltiplos determinantes e consequências. Objetivos: 1) Analisar a relação entre a disponibilidade domiciliar de produtos alimentícios processados e ultraprocessados e a prevalência de excesso de peso e obesidade; 2) Descrever o gasto familiar privado com saúde, segundo a presença de indivíduos obesos nos domicílios; e 3) Estimar a influência da presença de indivíduos obesos nos domicílios sobre o gasto total com medicamentos (obtidos nos setores privado e público). Métodos: Tese composta por três manuscritos baseados em dados da Pesquisa de Orçamentos Familiares (POF) 2008-2009. O primeiro manuscrito utilizou os 550 estratos amostrais da POF como unidade de análise e modelos de regressão linear para avaliar a relação entre a disponibilidade calórica domiciliar de produtos processados e ultraprocessados e a prevalência de excesso de peso e de obesidade, ajustados para variáveis de confusão. Ainda, foram estimados os valores preditos dos desfechos, segundo quartos de disponibilidade de produtos ultraprocessados. Os demais manuscritos consideraram os 55.970 domicílios como unidade de análise. O segundo manuscrito descreveu a distribuição do gasto privado mensal com saúde, considerando o gasto com medicamentos e com assistência à saúde, segundo a presença de obesos nos domicílios. O terceiro analisou a influência da obesidade sobre o gasto mensal per capita com medicamentos, obtidos nos setores privado e público, por meio de modelo de duas partes (two-part model), com ajuste para variáveis de confusão. Resultados: Com relação aos determinantes alimentares, verificou-se que a disponibilidade de produtos ultraprocessados, mas não a de processados, foi positivamente associada com a prevalência de excesso de peso e obesidade. No quarto superior de disponibilidade de ultraprocessados a prevalência de obesidade foi 37 por cento superior à do quarto inferior. No que tange as consequências financeiras, verificou-se que, na presença de obesos no domicílio, o gasto privado com medicamentos total e específico para doenças crônicas foi maior, o mesmo não sendo observado para a assistência à saúde. Ainda, considerando os medicamentos obtidos por desembolso direto e no SUS, a presença de obesos nos domicílios resultou em um gasto com medicamentos 18 por cento superior. Conclusões: A disponibilidade de produtos ultraprocessados é um dos determinantes alimentares da obesidade, que tem como uma de suas consequências financeiras o maior gasto com medicamentos resultando em impacto negativo para o orçamento familiar e para o SUS. / Introduction: Obesity is a public health problem with multiple determinants and consequences. Objectives: 1) To analyze the relationship between household availability of processed and ultra-processed products and the prevalence of excess weight and obesity; 2) To describe the private spending on health, according to the presence of obese individuals in households; and 3) To estimate the influence of the presence of obese individuals in households over the total spending on medicines (obtained in the public and private sectors). Methods: Thesis comprising three manuscripts based on data from the Brazilian Household Budget Survey (HBS) 2008-2009. The first manuscript used the 550 sampling strata of HBS as the unit of study and linear regression models to evaluate the relationship between household caloric availability of processed and ultra-processed products and the prevalence of excess weight and obesity in the stratum, adjusted for confounding variables. Furthermore, predictive values of outcomes were estimated according to quartiles of the household caloric share from ultra-processed products. The other manuscripts considered the 55,970 households as the unit of study. The second manuscript described the distribution of private spending on health, considering the spending on medicines and healthcare, according to the presence of obese individuals in households. The third manuscript analyzed the influence of obesity on the household spending on medicines, obtained in the private and public sectors, using two-part models controlling for potential confounders. Results: Relative to the dietary determinants, we verified that the availability of ultra-processed products, but not of the processed, was positively associated with both outcomes studied. Moreover, the prevalence of obesity was 37 per cent higher in the upper quartile of availability of ultra-processed products, compared with the lower quartile. In relation to the financial consequences, we verified that the presence of obese individuals in households resulted in higher total private spending on medicines and on medicines for non-communicable diseases, but for healthcare this was not observed. Furthermore, considering the medicines obtained in SUS and by out-of-pocket, the presence of obese in households increased the total spending on medicines by 18 per cent . Conclusion: The availability of ultra-processed products is one of the determinants of obesity and one of the financial consequences of this disease is the larger spending on medicines, resulting in negative impact to the household budget and to the public health system

Os genéricos surgiram na década de 60 nos Estados e são medicamentos que, no geral, são mais baratos que os inovadores; por isso têm um papel importante no controle e diminuição dos preços dos medicamentos. Os preços mais baixos devem-se a economia com o desenvolvimento e testes clínicos pois esses investimentos já foram realizados pela empresa detentora do medicamento inovador. Em 1999 com a promulgação da Lei 9.787, foi instituída a política de Medicamentos Genéricos no Brasil. A nova Legislação introduziu uma série de inovações e exigências na produção, testes de qualidade e bioequivalência, prescrição, dispensação e preços de medicamentos. Houve reações contrárias iniciais para as quais o Governo teve que tomar medidas regulamentadoras para tentar corrigir os problemas que surgiram. O objetivo do trabalho é analisar as situações que levaram a adoção de tais medidas e sua eficácia. Propõem-se fazer uma analise das mudanças da Legislação de medicamentos genéricos no Brasil durante o período de 1999 a 2002 tendo como pano de fundo as características do mercado farmacêutico brasileiro e as reações do mercado. Para tanto, foram utilizadas notícias em jornais de grande circulação, bem como entrevistas com membros do órgão regulador e da indústria farmacêutica. A legislação brasileira será ainda analisada sob a óptica das recomendações da Organização Mundial da Saúde a fim de termos parâmetros qualitativos para averiguar a sua qualidade e finalmente analisar a influência da mídia e da política nos resultados obtidos pelos genéricos. As alterações da Legislação mostraram-se um artifício interessante para auxiliar o processo de implantação dos genéricos no Brasil e auxiliaram na obtenção dos resultados positivos obtidos no processo de implantação dos genéricos. / Generics first appeared in the United States in the 1960’s, and they are medications which, by and large, are less expensive than the innovative ones. This is why they have an important role in controlling and reducing medication prices. The lower prices are due to the savings with development and clinical tests, since these investments have already been made by the innovative medication proprietor. In 1999, with the promulgation of Law 9.787, a Generic Medication policy was instituted in Brazil. The new Legislation introduced a series of production innovations and demands, product quality and bioequivalence tests, as well as medication prescriptions, dispensations and pricing practices. Initial contrary reactions and problems occurred, forcing the Government to make corrective regulatory measures. This research project aims at analyzing both the conditions that lead to such measures being taken and their efficacy. The proposal herein is to analyze the changes made to the generic medication Legislation in Brazil between 1999 and 2002, keeping the Brazilian pharmaceutical market characteristics and market reactions as a backdrop and also relying on articles published in the major newspapers and on interviews made with members of both the regulation agency and of the pharmaceutical industry. The Brazilian Legislation will also be analyzed from the angle of the World Health Organization’s recommendations in order to provide qualitative parameters to evaluate its quality and, finally, to analyze media and political influence in the results the generic medications reached. Legislation manipulation revealed to be an interesting device to assist in the generic implanting process in Brazil and helped in reaching the positive results obtained in such process.

Thesis advisor: James F. Keenan / Reviewing the current health care system in India which is grossly inadequate and inefficient, inaccessible and inequitable, this dissertation discusses the relevance of the principles of social justice such as equity, the common good and distributive justice, and the imperatives of social justice such as the option for the poor, subsidiarity, participation and solidarity and argues that a health care system informed and guided by these principles will be more effective, equitable and accessible to people. In addition to examining the numerous challenges faced by the primary health care system in the country, I also examine the many ethical challenges raised by the development of gene therapies in the country and suggest that the same principles of social justice offer guidelines to frame policies regarding the practice of them. This dissertation faces of the very complex health care situation in India. About 40% of people in the country have little or no access to basic health care because of poverty, abysmally low spending on health care by the government, neglect of basic health care facilities, and lack of social security measures like health insurance. However, the government in its effort to boost the country's GDP is making an all-out effort to promote health tourism in the country by investing in super specialty hospitals and in high-end medicines like gene therapy. The government also has been promoting and encouraging private investments in the sector, especially in setting up super-specialty hospitals and in the use of high-end medicines such as gene therapy. In an effort to boost health tourism and to earn greater foreign exchange, the government has drafted its industrial policies for the last three decades, encouraging private, for-profit health care sector. Substantial tax deductions and subsidies are provided to the private sector to allure private investment in the sector. However, in the process, the government has neglected primary health care centers that have been the primary source of health care for the poor and the underprivileged sections of people. In spite of announcing new policies in health care with high promises of programs and initiatives for the poor, women and children, the resource allocation to the sector betrays all promises. The administrative, structural, political and social anomalies, especially corruption at all levels, absenteeism among health care personnel, medical malpractices, a lack of political will, vision and transparency, poor allocation of funds, lack of monitoring and evaluation systems, etc., have crippled the health care system. It is in this context that I argue that the principles of social justice and its imperatives should inform and direct the government in its effort to provide health care in the country. These principles and imperatives should inform and direct not only provisions for basic health care but also the production and use of genetic medicines. A health care system that is based on equity, the common good, distributive justice, subsidiarity, solidarity and participation, that promotes health and meets the health care needs of all in an equitable way, irrespective of the socio-economic disparities that prevails, is the need of the hour in India. / Thesis (STD) — Boston College, 2010. / Submitted to: Boston College. School of Theology and Ministry. / Discipline: Sacred Theology.