International journal of health policy and management
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Int J Health Policy Manag · May 2015
EditorialRelevance and Effectiveness of the WHO Global Code Practice on the International Recruitment of Health Personnel--Ethical and Systems Perspectives.
The relevance and effectiveness of the World Health Organization's (WHO's) Global Code of Practice on the International Recruitment of Health Personnel is being reviewed in 2015. The Code, which is a set of ethical norms and principles adopted by the World Health Assembly (WHA) in 2010, urges members states to train and retain the health personnel they need, thereby limiting demand for international migration, especially from the under-staffed health systems in low- and middle-income countries. Most countries failed to submit a first report in 2012 on implementation of the Code, including those source countries whose health systems are most under threat from the recruitment of their doctors and nurses, often to work in 4 major destination countries: the United States, United Kingdom, Canada and Australia. ⋯ Consensus on how to balance competing ethical principles--giving due recognition on the one hand to the obligations of health workers to the countries that trained them and the need for distributive justice given the global inequities of health workforce distribution in relation to need, and the right to migrate on the other hand--was only possible after President Obama took office in January 2009. It is in the interests of all countries to implement the Global Code and not just those that are losing their health personnel through international recruitment, given that it calls on all member states "to educate, retain and sustain a health workforce that is appropriate for their (need) ..." (Article 5.4), to ensure health systems' sustainability. However, in some wealthy destination countries, this means tackling national inequities and poorly designed health workforce strategies that result in foreign-trained doctors being recruited to work among disadvantaged populations and in primary care settings, allowing domestically trained doctors work in more attractive hospital settings.
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Int J Health Policy Manag · Apr 2015
Strengthening core public health capacity based on the implementation of the International Health Regulations (IHR) (2005): Chinese lessons.
As an international legal instrument, the International Health Regulations (IHR) is internationally binding in 196 countries, especially in all the member states of the World Health Organization (WHO). The IHR aims to prevent, protect against, control, and respond to the international spread of disease and aims to cut out unnecessary interruptions to traffic and trade. To meet IHR requirements, countries need to improve capacity construction by developing, strengthening, and maintaining core response capacities for public health risk and Public Health Emergency of International Concern (PHEIC). ⋯ China has promoted the implementation of the IHR comprehensively, continuingly strengthening the core public health capacity and advancing in core public health emergency capacity building, points of entry capacity building, as well as risk prevention and control of biological events (infectious diseases, zoonotic diseases, and food safety), radiological, nuclear, and chemical events, and other catastrophic events. With significant progress in core capacity building, China has dealt with many public health emergencies successfully, ensuring that its core public health capacity has met the IHR requirements, which was reported to WHO in June 2014. This article describes the steps, measures, and related experiences in the implementation of IHR in China.
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Int J Health Policy Manag · Apr 2015
Needs and availability of snake antivenoms: relevance and application of international guidelines.
Snakebite has recently been declared a global public health emergency. Empirical data showing the true burden of snakebite is lacking. Treatment with specific antivenoms is considered the only cure. However, several factors have led to an ongoing antivenom crisis. This study offers recommendations concerning the improvement of antivenom access and control, by providing an overview of the factors limiting the successful implementation of international guidelines within the international industry and state institutions. It further investigates the reasons for the epidemiological knowledge gap regarding snakebites. ⋯ Snakebite ranks low on international public health agendas, and partially due to this low priority, NHAs have shown limited efforts in conducting epidemiological studies, training health workers on snakebite management and creating national snakebite management strategies. The lack of NHA involvement is reflected in poor access to appropriate antivenoms as well as a lack of antivenom regulation. Manufacturers are taking positive steps toward full implementation of international guidelines and are improving quality control procedures. However, in order for international guidelines to become truly useful in the field, more technical guidance is required. This study reflects that there is a general lack of knowledge transfer amongst various actors: most producers, health authorities, and experts expect increased and improved communication and guidance from leading international bodies. Due to the low response rates observed in this study, conclusions drawn herein are not representative of the global situation; yet provide an exploratory insight on the difficulties facing antivenom management.
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Int J Health Policy Manag · Apr 2015
The changing National Health Service: market-based reform and morality: Comment on "Morality and Markets in the NHS".
This commentary explores some of the issues raised by Gilbert et al. short communication, Morality and Markets in the NHS. The increasing role of market mechanisms and the changing types of healthcare providers together with the use of choice and competition to drive improvements in quality in the National Health Service (NHS), all have important ethical implications. In order for the NHS to continue providing the level of service quality that out performs many high-income countries, despite spending much less on healthcare, we need a re-think of creeping marketization and privatisation and a consolidation of the NHS as a publically owned resource run for the benefit of patients and the public, not commercial interests.