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  1. Article ; Online: Increasing access to essential medicines through partnership: experience in developing and delivering chlorhexidine gel for newborn cord care.

    DeAngelis, Elena / Clarke, Andrew / Gibson, Rachel / Karrar, Karrar / Williams, Pauline

    BMJ paediatrics open

    2022  Volume 6, Issue 1

    Abstract: Sustainable access to essential medicines in low-income and middle-income countries requires innovative cross-sectoral collaboration throughout the lifecycle of a medicine. Partnerships are essential to address the systemic challenges of global health ... ...

    Abstract Sustainable access to essential medicines in low-income and middle-income countries requires innovative cross-sectoral collaboration throughout the lifecycle of a medicine. Partnerships are essential to address the systemic challenges of global health and health inequity. Pharmaceutical companies, funders, governments, international non-governmental organisations (I-NGOs) and other key stakeholders can leverage, through effective partnership working, their unique expertise to help drive innovation and share learnings and risks. Here, we reflect on one approach taken in the development and supply of chlorhexidine digluconate 7.1% w/w gel (equivalent to 4% w/w chlorhexidine) for neonatal cord care. We describe and analyse the steps taken by GSK to increase access to chlorhexidine gel, including partnering with the I-NGO Save the Children in Western Kenya. Learning points gained along the journey are shared, together with subsequent steps taken to increase access, with the aim of making recommendations that may be applicable to similar enterprises in the future.
    MeSH term(s) Infant, Newborn ; Child ; Humans ; Chlorhexidine ; Government ; Global Health ; Kenya
    Chemical Substances Chlorhexidine (R4KO0DY52L)
    Language English
    Publishing date 2022-10-13
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ISSN 2399-9772
    ISSN (online) 2399-9772
    DOI 10.1136/bmjpo-2022-001467
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Pandemic preparedness and response

    Jennifer Miller / Abha Saxena / Anders Herlitz / Marc Fleurbaey / Nicole Hassoun / Brook K Baker / Caesar Alimisnya Atuire / Karrar Karrar / Amanda Banda / Esther Chiwa / Iwao Hirose

    BMJ Global Health, Vol 8, Iss

    beyond the Access to COVID-19 Tools Accelerator

    2023  Volume 1

    Abstract: Nationalism has trumped solidarity, resulting in unnecessary loss of life and inequitable access to vaccines and therapeutics. Existing intellectual property (IP) regimens, trade secrets and data rights, under which pharmaceutical firms operate, have ... ...

    Abstract Nationalism has trumped solidarity, resulting in unnecessary loss of life and inequitable access to vaccines and therapeutics. Existing intellectual property (IP) regimens, trade secrets and data rights, under which pharmaceutical firms operate, have also posed obstacles to increasing manufacturing capacity, and ensuring adequate supply, affordable pricing, and equitable access to COVID-19 vaccines and other health products in low-income and middle- income countries. We propose: (1) Implementing alternative incentive and funding mechanisms to develop new scientific innovations to address infectious diseases with pandemic potential; (2) Voluntary and involuntary initiatives to overcome IP barriers including pooling IP, sharing data and vesting licences for resulting products in a globally agreed entity; (3) Transparent and accountable collective procurement to enable equitable distribution; (4) Investments in regionally distributed research and development (R&D) capacity and manufacturing, basic health systems to expand equitable access to essential health technologies, and non-discriminatory national distribution; (5) Commitment to strengthen national (and regional) initiatives in the areas of health system development, health research, drug and vaccine manufacturing and regulatory oversight and (6) Good governance of the pandemic prevention, preparedness and response accord. It is important to articulate principles for deals that include reasonable access conditions and transparency in negotiations. We argue for an equitable, transparent, accountable new global agreement to provide rewards for R&D but only on the condition that pharmaceutical companies share the IP rights necessary to produce and distribute them globally. Moreover, if countries commit to collective procurement and fair pricing of resulting products, we argue that we can greatly improve our ability to prepare for and respond to pandemic threats.
    Keywords Medicine (General) ; R5-920 ; Infectious and parasitic diseases ; RC109-216
    Subject code 306
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Building power-ful health systems: the impacts of electrification on health outcomes in LMICs.

    Khogali, Alhadi / Ahmed, Almegdad / Ibrahim, Mona / Karrar, Karrar / Elsheikh, Mohamed / Abdelraheem, Elfatih / Cluver, Lucie / Elmukashfi, Elsiddig

    Psychology, health & medicine

    2022  Volume 27, Issue sup1, Page(s) 124–137

    Abstract: Critical disparities threaten health care in developing countries and hinder progress towards global development commitments. Almost a billion people and thousands of public services are not yet connected to electricity - a majority in sub-Saharan Africa. ...

    Abstract Critical disparities threaten health care in developing countries and hinder progress towards global development commitments. Almost a billion people and thousands of public services are not yet connected to electricity - a majority in sub-Saharan Africa. In economically fragile settings, clinics and health services struggle to gain and maintain their access to the most basic energy infrastructure. Less than 30% of health facilities in LMICs report access to reliable energy sources, truncating health outcomes and endangering patients in critical conditions. While 'universal health coverage' and 'sustainable energy for all' are two distinct SDGs with their respective targets, this review challenges their disconnect and inspects their interdependence in LMICs. To evaluate the impact of electrification on healthcare facilities in LMICs, this systematic review analysed relevant publications up to March 2021, using MEDLINE, Embase, Scopus, CENTRAL, clinicaltrials.gov and CINAHL. Outcomes captured were in accordance with the WHO HHFA modules. A total of 5083 studies were identified, 12 fulfilled the inclusion criteria of this review - most were from Africa, with the exception of two studies from India and one from Fiji. Electrification was associated with improvements in the quality of antenatal care services, vaccination rates, emergency capabilities and primary health services; with many facilities reporting high-quality, reliable and continuous oxygen supplies, refrigeration and enhanced medical supply chains. Renewable energy sources were considered in six of the included studies, most highlighting their suitability for rural health facilities. Notably, solar-powered oxygen delivery systems reduced childhood mortality and length of hospital stay. Unavailable and unreliable electricity is a bottleneck to health service delivery in LMICs. Electrification was associated with increased service availability, readiness and quality of care - especially for women, children and those under critical care. This study indicates that stable and clean electrification allows new heights in achieving SDG 3 and SDG7 in LMICs.
    MeSH term(s) Child ; Female ; Humans ; Pregnancy ; Developing Countries ; Health Facilities ; Prenatal Care ; Oxygen ; Outcome Assessment, Health Care
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2022-08-05
    Publishing country England
    Document type Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1477841-5
    ISSN 1465-3966 ; 1354-8506
    ISSN (online) 1465-3966
    ISSN 1354-8506
    DOI 10.1080/13548506.2022.2109049
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Flow Cytometry Analysis Versus E-Cadherin Immunohistochemistry for the Diagnosis of Pure Erythroid Leukemia: A Case Report.

    AlSwayyed, Aziza / Salamah, Basmah / Al-Moshary, May / Hussein Karrar, Karrar Ahmad E / Khan, Adnan

    Cureus

    2020  Volume 12, Issue 7, Page(s) e9055

    Abstract: Pure erythroid leukemia (PEL) is a rare form of acute myeloid leukemia characterized by the neoplastic proliferation of erythroblasts. PEL is associated with inferior survival outcomes, particularly among patients harboring complex karyotype ... ...

    Abstract Pure erythroid leukemia (PEL) is a rare form of acute myeloid leukemia characterized by the neoplastic proliferation of erythroblasts. PEL is associated with inferior survival outcomes, particularly among patients harboring complex karyotype abnormalities. In this case, we present a 21-year-old Sudanese man who presented to our ER with a two-week history of fever, shortness of breath, fatigue, and exercise intolerance. He had no significant personal medical history or family history of malignancy. A bone marrow biopsy revealed hypercellularity and infiltration by cells with an immature appearance. A flow cytometry (FC) analysis of the bone marrow aspirate revealed that approximately 21% of the total nucleated cells were negative for CD45 and positive for CD71, glycophorin A, and CD36 but negative for myeloperoxidase (MPO), CD33, CD13, CD61, CD41, and other lymphoid and myeloid markers. Consistent with the microscopic analysis, <1% of the total cells were identified as CD34/CD13/CD117-positive myeloblasts. Notably, all stains (CD45, MPO, CD34, CD163, CD61, glycophorin A) were negative except E-cadherin, which positively stained >80% of the cells. Our findings suggested a differential diagnosis that included erythroid leukemia and myelodysplastic syndrome (MDS). The morphological, FC, immunohistochemistry, and cytogenetic findings strongly supported a diagnosis of PEL.
    Language English
    Publishing date 2020-07-07
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.9055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Pandemic preparedness and response: beyond the Access to COVID-19 Tools Accelerator.

    Saxena, Abha / Baker, Brook K / Banda, Amanda / Herlitz, Anders / Miller, Jennifer / Karrar, Karrar / Fleurbaey, Marc / Chiwa, Esther / Atuire, Caesar Alimisnya / Hirose, Iwao / Hassoun, Nicole

    BMJ global health

    2023  Volume 8, Issue 1

    Abstract: Nationalism has trumped solidarity, resulting in unnecessary loss of life and inequitable access to vaccines and therapeutics. Existing intellectual property (IP) regimens, trade secrets and data rights, under which pharmaceutical firms operate, have ... ...

    Abstract Nationalism has trumped solidarity, resulting in unnecessary loss of life and inequitable access to vaccines and therapeutics. Existing intellectual property (IP) regimens, trade secrets and data rights, under which pharmaceutical firms operate, have also posed obstacles to increasing manufacturing capacity, and ensuring adequate supply, affordable pricing, and equitable access to COVID-19 vaccines and other health products in low-income and middle- income countries. We propose: (1) Implementing alternative incentive and funding mechanisms to develop new scientific innovations to address infectious diseases with pandemic potential; (2) Voluntary and involuntary initiatives to overcome IP barriers including pooling IP, sharing data and vesting licences for resulting products in a globally agreed entity; (3) Transparent and accountable collective procurement to enable equitable distribution; (4) Investments in regionally distributed research and development (R&D) capacity and manufacturing, basic health systems to expand equitable access to essential health technologies, and non-discriminatory national distribution; (5) Commitment to strengthen national (and regional) initiatives in the areas of health system development, health research, drug and vaccine manufacturing and regulatory oversight and (6) Good governance of the pandemic prevention, preparedness and response accord. It is important to articulate principles for deals that include reasonable access conditions and transparency in negotiations. We argue for an equitable, transparent, accountable new global agreement to provide rewards for R&D but only on the condition that pharmaceutical companies share the IP rights necessary to produce and distribute them globally. Moreover, if countries commit to collective procurement and fair pricing of resulting products, we argue that we can greatly improve our ability to prepare for and respond to pandemic threats.
    MeSH term(s) Humans ; COVID-19/prevention & control ; COVID-19 Vaccines ; Pandemics/prevention & control ; Poverty ; Pharmaceutical Preparations
    Chemical Substances COVID-19 Vaccines ; Pharmaceutical Preparations
    Language English
    Publishing date 2023-01-14
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2022-010615
    Database MEDical Literature Analysis and Retrieval System OnLINE

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