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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Marc-David Munk, MPH, BA, Jefferson Medical College, Thomas Jefferson University, 834 Chestnut St, Philadelphia, PA 19107, 215 627-7279, mdmunk3@mindspring.com
The rising cost of Western medicine suggests that rationing decisions in the developing world are bound to become increasingly frequent and difficult. Usually medical availability in the Third World is directly related to the cost of the intervention because medications come from the West at a fixed cost and with a Western margin of safety. This has allowed no latitude for local rationing decisions on the basis of drug safety. Several years ago the introduction of the contraceptive medication quinacrine to the developing world allowed for the first practical development of a non-Western rationing ethic. Quinacrine, which bypassed the Western drug approval processes, allowed public health authorities to approve a potentially unsafe drug that could cause harm to a few citizens in order to benefit many. With no Western pre-approval, quinacrine demanded that developing countries develop their own rationing models with consideration for local morality and social conditions, and for the first time introduced these variables into the rationing equation. This presentation examines the consequences of increased latitude for local decision-making. It argues that as complex rationing decisions become more frequent, adherence to a centralized and traditional rationing values may simply leave the world’s poorest citizens with limited, unrealistic and culturally insensitive medical options.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to
Keywords: Ethics, International Reproductive Health
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.