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Over 60% of deaths in the world are due to noncommunicable diseases (NCDs), principally referring to cardiovascular diseases, diabetes, cancer and chronic respiratory disease. Nearly 80% of these NCD deaths occur in low- and middle-income... more
Over 60% of deaths in the world are due to noncommunicable diseases (NCDs), principally referring to cardiovascular diseases, diabetes, cancer and chronic respiratory disease. Nearly 80% of these NCD deaths occur in low- and middle-income (LMIC) countries, where it is difficult for people to access essential medicine for treatment. The problem of effective access results in part from the exorbitantly high prices that arise from the negative effects of global patent protection. The WTO Trade-Related Aspects of Intellectual Property Rights Agreement (TRIPS) offers flexibilities, such as compulsory licenses and parallel importing, to remedy those negative effects. Hence, two fundamental questions arise. To what extent do LMIC countries benefit from these safeguards when it comes to providing essential medicines for their populations? What options and political barriers do these countries have when making the case for being able to make NCD essential medicines accessible to their populations, and what lessons can be learned from the successes of increased and affordable access to AIDS/HIV medicines from the early 2000s? Through introspection of emerging case studies, this article explores ways to reduce barriers to essential medicines for NCDs under the WTO TRIPS frameworks and other relevant regulations related to pharmaceutical trade and patents.
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Background: This study was conducted to gauge how the demographic profile of smokeless tobacco (SLT) users from Gujarat and Andhra Pradesh, India, differs from that of smokers. It also addresses how factors associated with the initiation... more
Background: This study was conducted to gauge how the demographic profile of smokeless tobacco (SLT) users from Gujarat and Andhra Pradesh, India, differs from that of smokers. It also addresses how factors associated with the initiation and continuation of smokeless tobacco vary by age, gender, and education.
Materials and Methods: We analyzed 2011 cross-sectional survey data collected from 4,759 respondents (smokers/SLT users/non-users) in both states. Chi-square analysis was used to make comparisons between the demographic profiles of smokers and SLT users. Multivariable logistic regression analysis was used to obtain the odds ratios (ORs) for initiation and continuation factors regressed on socio-demographic variables (age, gender, education).
Results: Initiation-women were less likely than men to report “peer pressure”, “fashion statement”, and “stress/coping” as
relevant factors for SLT use (OR: 0.45 CI: 0.30-0.70; OR: 0.42 CI: 0.24-0.74; OR: 2.47, CI: 1.47-4.15). Older age groups had lower odds of choosing “peer pressure” than the 15-24 year olds. Respondents with 11 or more years of education were more likely to report “stress/coping” than those with no education (OR: 2.82, CI: 1.06-7.48).
Continuation-women were less likely than men to choose “relaxation”, and “distance from family” as important continuation factors (OR: 0.50, CI:0.32-0.80; OR: 0.20, CI: 0.06-0.65). All age groups were less likely to choose “stimulation” as a factor than the youngest group. Conclusions: Along with confirming and expanding upon previous literature, the findings of this study should encourage further SLT research in women and younger age groups (15-24 and 24-44). They also confirm the need for SLT prevention and cessation interventions in India in other community-based settings, besides schools.
Materials and Methods: We analyzed 2011 cross-sectional survey data collected from 4,759 respondents (smokers/SLT users/non-users) in both states. Chi-square analysis was used to make comparisons between the demographic profiles of smokers and SLT users. Multivariable logistic regression analysis was used to obtain the odds ratios (ORs) for initiation and continuation factors regressed on socio-demographic variables (age, gender, education).
Results: Initiation-women were less likely than men to report “peer pressure”, “fashion statement”, and “stress/coping” as
relevant factors for SLT use (OR: 0.45 CI: 0.30-0.70; OR: 0.42 CI: 0.24-0.74; OR: 2.47, CI: 1.47-4.15). Older age groups had lower odds of choosing “peer pressure” than the 15-24 year olds. Respondents with 11 or more years of education were more likely to report “stress/coping” than those with no education (OR: 2.82, CI: 1.06-7.48).
Continuation-women were less likely than men to choose “relaxation”, and “distance from family” as important continuation factors (OR: 0.50, CI:0.32-0.80; OR: 0.20, CI: 0.06-0.65). All age groups were less likely to choose “stimulation” as a factor than the youngest group. Conclusions: Along with confirming and expanding upon previous literature, the findings of this study should encourage further SLT research in women and younger age groups (15-24 and 24-44). They also confirm the need for SLT prevention and cessation interventions in India in other community-based settings, besides schools.