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Why the MDGs need good governance in pharmaceutical systems to promote global health
Open accessAbstract
BACKGROUND: Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent, responsive, equitable and inclusive, effective and efficient, follows the rule of law, is participatory and should in theory be less vulnerable to corruption. By focusing on the pharmaceutical system, we explore some of the key lessons learned from existing initiatives in good governance. As the development community begins to identify post-2015 Millennium Development Goals targets, it is essential to evaluate programs in good governance in order to build on these results and establish sustainable strategies. This discussion on the pharmaceutical system illuminates why. DISCUSSION: Considering pharmaceutical governance initiatives such as those launched by the World Bank, World Health Organization, and the Global Fund, we argue that country ownership of good governance initiatives is essential but also any initiative must include the participation of impartial stakeholders. Understanding the political context of any initiative is also vital so that potential obstacles are identified and the design of any initiative is flexible enough to make adjustments in programming as needed. Finally, the inherent challenge which all initiatives face is adequately measuring outcomes from any effort. However in fairness, determining the precise relationship between good governance and health outcomes is rarely straightforward. SUMMARY: Challenges identified in pharmaceutical governance initiatives manifest in different forms depending on the nature and structure of the initiative, but their regular occurrence and impact on population-based health demonstrates growing importance of addressing pharmaceutical governance as a key component of the post-2015 Millennium Development Goals. Specifically, these challenges need to be acknowledged and responded to with global cooperation and innovation to establish localized and evidence-based metrics for good governance to promote global pharmaceutical safety.
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Conflict-of-interest declarations can be used to monitor relationships between physicians and the pharmaceutical industry and to avoid pre-bidding corruption, provided there are adequate follow-up measures.
“Conflict-of-interest declarations can also be used to monitor relationships between physicians and the pharmaceutical industry and to avoid pre-bidding corruption, so long as there are adequate follow-up measures to address conflict of interest once it is revealed [22].”
From The risk of corruption in public pharmaceutical procurement: how anti-corruption, transparency and accountability measures may reduce this risk (2020) · cites this paper as [22]
The Background (page unavailable) discusses physician-directed pharmaceutical marketing transparency laws, while the Discussion, ‘Assessment of pharmaceutical governance initiatives’ (page unavailable), discusses evaluating conflict-of-interest policies. The paper also describes electronic bidding as a way to curb procurement corruption, but our copy does not say that conflict-of-interest declarations monitor physician–industry relationships or prevent pre-bidding corruption when followed up. (LLM, conf=0.75)
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Metadata
- Authors
- Kohler, J. C., Mackey, T. K., & Ovtcharenko, N.
- Affiliations
- University of California San Diego (US)
- University of Toronto (CA)
- ORCID
- Mackey, Tim Ken
- Venue
- BMC Public Health
- Published
- 2014-01-21
- Volume
- 14
- Issue
- 1
- Pages
- 63-63
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3909282
- OpenAlex
- W2091703239
- Cited by
- 51
- References
- 17
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 7 · 2021: 1 · 2020: 9 · 2019: 3 · 2018: 3 · 2017: 7 · 2016: 4 · 2015: 4 · 2014: 1
- FWCI
- 13.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pharmaceutical Quality and Counterfeiting
- Keywords
- good governance, pharmaceutical systems, health sector corruption, Millennium Development Goals, post-2015 development agenda, country ownership, stakeholder engagement, governance indicators, drug safety, Global Fund, World Bank, World Health Organization, transparency and accountability
- MeSH terms
- Drug Industry, Pharmaceutical Preparations, Health Services Accessibility, Humans, Pharmaceutical Services, United Nations, Global Health, Healthy People Programs
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