The politics and governance of drug production in public-private partnerships: Brazil's response to hepatitis C.

The local manufacture of advanced pharmaceutical products has been a long-standing objective of health and industry policy in many developing countries, including in Latin America. This strategy has been applied to fight epidemics such as HIV/AIDS, malaria, and the COVID-19 pandemic. However, we still know little about the politics and governance that enable such arrangements, especially when there is no consent from the originator company. This study focuses on the case of Brazil, a country that is well-known for its health-industry policy, which includes the local production of direct-acting antivirals (DAAs), a new treatment for hepatitis C. We seek to explain the factors that have contributed to Brazil's successful production of generic versions of DAAs, and, later, to the decision by the Ministry of Health (MoH) to procure drugs from multinational pharmaceutical companies rather than from local laboratories. A lack of support for domestic production by important stakeholders, the patent holder's attempt to block domestic production and the MoH's adoption of more modern treatment guidelines under a different procurement logic all created an unfavourable environment for local production and procurement of DAAs. Our study draws implications for middle-income countries that wish to produce drugs domestically without voluntary license agreements.

Is there more to bitcoin mining than carbon emissions?

Critics decry cryptocurrency mining as a huge waste of energy, while proponents insist on claiming that it is a green industry. Is Bitcoin mining really worth the energy it consumes? The high power consumption of cryptocurrency mining has become the latest global flashpoint. In this paper, we define the Mining Domestic Production (MDP) as a method to account for the final outcome of the Bitcoin mining industry's production activities in a certain period time, calculate the carbon emission per unit output value of the Bitcoin mining industry in China, and compare it with three other traditional industries. The results show that Bitcoin mining does not always have the highest when compared with others. The contribution of this paper is that we give a new perspective on thinking whether Bitcoin mining is more efficient to make more profit, in terms of the same amount of carbon emissions per unit compared to other industries. Moreover, it could even be argued that Bitcoin may present an opportunity for some developing countries to build out their electrical capacity and generate revenue.

Determinantes de la salud ambiental en el Perú: curva de Kuznets 1990-2015 / Determinants of environmental health in Peru: Kuznets curve 1990-2015

El ambiente es el lugar donde vive, trabaja y se desarrolla el hombre, compuesto básicamente por dos sistemas interrelacionados e independientes: por una parte, es el hombre conviviendo en una sociedad con características muy diferentes, y por el otro lado, los elementos de la naturaleza siendo transformados por los hombres donde viven inmersos. En ese sentido, la degradación y contaminación ambiental, tienen efectos notables en la vidad de los seres humanos, siendo responsable de la muerte de cientos de millones de personas que sufren de enfermedades respiratorias asociadas con la contaminación externa e interior del aire. En ese sentido, ya a partir de las últimas décadas, las emisiones de dióxido de carbono han alcanzado cifras record superando las 10 gigatoneladas. Este incremento está asociado al sector energético (47%), la industria (30%) y el transporte (11%) principalmente, lo que ha logrado un calentamiento global progresivo de la superficie terrestre con las consecuencias típicas asociadas al derretimiento de los glaciares, cambios en los ciclos hidrológicos, falta de alimentos, aumento de los fenómenos meteorológicos, migraciones descontroladas, enfermedades y pandemias. De este modo, surge la economía ambiental, una disciplina que intenta dar repuestas integrales entre ambos tópicos, medio ambiente y economía, donde diversas teorías tratan de explicar los fenómenos observados. El concepto de las Curvas de Kuznets Ambientales (CKA), señala una relación dinámica entre el PIB y la calidad del medio ambiente. El objetivo del artículo ha sido determinar si en el Perú, durante el periodo 1990-2015, ha habido una relación en forma de U invertida entre la producción interna y la contaminación del aire. La investigación prueba que, en el Perú, durante el periodo 1990-2015, no ha habido una relación en forma de U invertida entre la producción interna y la contaminación del aire, sino que la producción interna ha tenido un impacto positivo y lineal sobre el dióxido de carbono y el óxido de nitrógeno(AU)

The environment is the place where man lives, works and develops, basically composed of two interrelated and independent systems: on the one hand, it is man living together in a society with very different characteristics, and on the other hand, the elements of the nature being transformed by men where they live immersed. In this sense, environmental degradation and pollution have notable effects on the lives of human beings, being responsible for the death of hundreds of millions of people who suffer from respiratory diseases associated with external and internal air pollution. In this sense, already in recent decades, carbon dioxide emissions have reached record figures, exceeding 10 gigatons. This increase is mainly associated with the energy sector (47%), industry (30%) and transport (11%), which has achieved a progressive global warming of the earth's surface with the typical consequences associated with the melting of glaciers, changes in hydrological cycles, lack of food, increased weather events, uncontrolled migrations, diseases and pandemics. In this way, environmental economics arises, a discipline that tries to provide comprehensive answers between both topics, environment and economy, where various theories try to explain the observed phenomena. The concept of the Environmental Kuznets Curves (EKC), indicates a dynamic relationship between GDP and the quality of the environment. The objective of the article has been to determine if in Peru, during the period 1990-2015, there has been an inverted U-shaped relationship between internal production and air pollution. The research proves that, in Peru, during the period 1990-2015, there has not been an inverted U-shaped relationship between domestic production and air pollution, but rather that domestic production has had a positive and linear impact on air pollution. carbon dioxide and nitrogen oxide(AU)

The History and Current Situation of Medicinal Plants and Crude Drug Production in Tohoku Region / 日本東洋医学雑誌

Ninety percent of the crude drugs consumed in Japan depend on imports. Recently, the Japanese government has been promoting the domestic production of crude drugs. We investigated the history and current situation of the cultivation of medicinal plants and the production of crude drugs in the Tohoku region, where the 71st annual meeting of the Japan Society for Oriental Medicine was held in August 2021. In the Tohoku region, the cultivation of medicinal plants expanded after the Kyoho era of the Edo period. Several medicinal plants in this region have been successfully cultivated and distributed as local specialty products and are being preserved (e.g., Panax ginseng in Aizu, Carthamus tinctorius in Dewa). In some other areas, cultivation has just begun. In each cultivation area, a contractual relationship was established in which local governments, cultivation experts, farmers, Kampo-related associations, and pharmaceutical companies collaborated to continue and expand the cultivation business. To generate revenue, they have been trying to find sales channels not only for crude drugs but also for foods, cosmetics, textiles, and processed products. Although many issues remain to be solved in the distribution of medicinal plants as the source of crude drugs, this survey clarified the ingenuity of medicinal plant cultivation in various areas of the Tohoku region. The results of the investigation are available as videos on the website for members of the Japan Society for Oriental Medicine.

Analysis of long-term statistical data of cobalt flows in the EU.

Long-term statistical data was explored, acquired, processed, and analysed in order to assess the historical domestic production and international trade of a number of cobalt-containing commodities in the EU. Different data sources were examined for data, such as the British Geological Survey (BGS), the US Geological Survey (USGS), and the Eurostat and UN Comtrade (UNC) databases, considering all EU-member states before and after they joined the EU. For the international trade, hidden flows related to data gaps such as data reported in monetary value or recorded as "special category" were identified and included in the analysis. In addition, data from the Finnish customs database (ULJAS) was used to complement flows reported by Eurostat and UNC. From UNC, data was obtained considering the member states as reporters or as partners of the trade, due to internal differences of the database. Based on the acquired data the domestic production and international trade of the commodities were reconstructed for the timeframes 1938-2018 and 1988-2018, respectively. Next to the analysis of the trend of the production and trade of the different commodities, the importance of including hidden flows was revealed, where hidden flows represented more than 50% of the flow of a year in some cases. In addition, it was identified that even from reliable data sources, strong differences (more than 100% in some cases) can be found in the reported data, which is crucial to consider when utilizing the data in research.

An analysis of affordability of cigarettes and bidis in India.

BACKGROUND: Easy affordability of tobacco products is one of the reasons for increased tobacco consumption. The study attempts to project the affordability of cigarettes and bidis from 2017 to 2025 in India. METHODS: The affordability was measured in terms of Relative Income Price (RIP) and the price of smoked tobacco products. RIP depends upon per capita gross domestic production (GDP) required to purchase 100 packets of cigarettes. The GDP per capita was calculated using data from National Accounts Division, Central Statistics Office, 2017. The price of cigarettes and bidis was calculated using data from WHO global report on tobacco epidemics, 2017. The projections were done from 2017 to 2025 assuming constant rise of per capita GDP as in the year 2017 (7%) and price rise of cigarette and bidis due to inflation (4%). Four and Six scenarios for cigarettes and bidis respectively, of different tax rises (0%-200%) in the years 2017-2025 were taken. RESULTS: Bidis were more affordable at lower increments in tax as compared to cigarettes. Affordability for cigarettes decreased to - 9.9% after a 100% increase in tax whereas affordability of bidi decreased to - 8.61% after a 200% increase in tax by the end of 2025. CONCLUSION: Since bidis are more easily affordable than cigarettes, an adequate increase in taxes of bidi should be made to make it less affordable.

Statistic Analysis About the Actual Situation of Crude Drug Prescription Based on the Survey Conducted by the Board of Crude Drug Materials of JSOM / 日本東洋医学雑誌

The treatment by Kampo decoction is partly covered by National Health Insurance in Japan. However, this system is facing bankruptcy crisis because of rising prices of crude drugs in China, their main producer. The board of crude drug materials of the Japan Society for Oriental Medicine (JSOM) distributed questionnaires to 7416 JSOM member doctors, and performed statistical analysis (with JSOM approval) of 1877 answers to visualize the data. Twenty-six percent of respondents said that they had prescribed a decoction, and 29% of respondents said they had not, but wanted to prescribe a crude drug. Eighty-eight percent of doctors who prescribe decoctions offered medical treatment primarily to insured patients. Nine percent offered medical treatment at patients' own expense. The latter group prescribed decoctions more frequently. Many doctors were aware of the financial risk of prescribing crude drugs imposed by the drug price standard and rising crude drug import prices. Four hundred and fifty­-five doctors explained when they were most inclined to prescribe a decoction. Thirty-five percent of these said they used decoctions when they couldn't treat patients with extracts. This result implies a necessity for decoctions. Many doctors said they prescribed decoctions for autoimmune or allergic diseases. Financial constraints were the most frequently cited barrier to treatment with decoctions. This survey made clear the financial difficulties clinics are facing. We therefore calculated the amount of crude drugs used for decoctions to validate the possibility of their domestic production.

[Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report].

Objective: To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs. Methods: A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on. Results: All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on. Conclusions: The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical, economical, adjustable, universal and portable. The domestic external fixator could meet the clinical demand for fixation of the osteotomy end of the limbs, the correction of the deformity, the repair of the defects and the limb lengthening.

Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report / 中华外科杂志

Objective@#To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs.@*Methods@#A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on.@*Results@#All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on.@*Conclusions@#The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical, economical, adjustable, universal and portable. The domestic external fixator could meet the clinical demand for fixation of the osteotomy end of the limbs, the correction of the deformity, the repair of the defects and the limb lengthening.

The Current Situation and Problems of Domestic Crude Drug Production / 日本東洋医学雑誌

The consumption and sales of Kampo products, as well as the crude drugs that make up the products, have been increasing recently. However, the Kampo industry has been exhibiting a long-term decline due to the rise in price of imported crude drugs and reduction in standard prices of crude drugs by the Japanese National Health Insurance scheme. As the production of crude drug in Japan has been decreasing for the past thirty years, efforts have been made to improve the situation. Although the production of Aizu Ginseng decreased from 153 metric tons to 8 metric tons in Fukushima, university research institutes have initiated research on expansion of the farm field for Ginseng and reduction in a cultivation term. In Nara, farmers, pharmaceutical and food manufacturers, and university research institutes, aiming to develop new products using Yamato Angelica root, organized a joint council and have been working together to establish integrated systems from cultivation to sales. The Ministry of Agriculture, Forestry and Fisheries, the Ministry of Health, Labour and Welfare, and Japan Kampo Medicines Manufacturers Association have held local meetings with farmers and pharmaceutical companies in different areas throughout Japan over the past three years from fiscal year 2013. In order to reduce national healthcare costs by Kampo medicine, it is necessary to upgrade the health care system where not only Kampo extract products but also medicinal plants as raw materials including decoctions can be used. Discussions on measures to cover the costs of domestic production of crude drugs should be required.

Revisiting the emissions-energy-trade nexus: evidence from the newly industrializing countries.

This paper applies Pedroni's panel cointegration approach to explore the causal relationship between trade openness, carbon dioxide emissions, energy consumption, and economic growth for the panel of newly industrialized economies (i.e., Brazil, India, China, and South Africa) over the period of 1970-2013. Our panel cointegration estimation results found majority of the variables cointegrated and confirm the long-run association among the variables. The Granger causality test indicates bidirectional causality between carbon dioxide emissions and energy consumption. A unidirectional causality is found running from trade openness to carbon dioxide emission and energy consumption and economic growth to carbon dioxide emissions. The results of causality analysis suggest that the trade liberalization in newly industrialized economies induces higher energy consumption and carbon dioxide emissions. Furthermore, the causality results are checked using an innovative accounting approach which includes forecast-error variance decomposition test and impulse response function. The long-run coefficients are estimated using fully modified ordinary least square (FMOLS) method, and results conclude that the trade openness and economic growth reduce carbon dioxide emissions in the long run. The results of FMOLS test sound the existence of environmental Kuznets curve hypothesis. It means that trade liberalization induces carbon dioxide emission with increased national output, but it offsets that impact in the long run with reduced level of carbon dioxide emissions.

Update of antivenom supply for redback spider bites in Japan.

In autumn 2014, with great effort by the Ministry of Health, Labour and Welfare, the research group will obtain several vials of redback spider (RBS) antivenom for emergency use. However, these small amounts of antivenom are insufficient to cover the demands from majority of hospitals in Japan. The research group carefully discussed the domestic RBS antivenom production by themselves for this emergency. We have now entered the second stage for large-scale antivenom production. Although the domestic production of RBS antivenom has started, great caution is required as we move forward with this plan.

Investigation of carbon dioxide emission in China by primary component analysis.

Principal component analysis (PCA) is employed to investigate the relationship between CO2 emissions (COEs) stemming from fossil fuel burning and cement manufacturing and their affecting factors. Eight affecting factors, namely, Population (P), Urban Population (UP); the Output Values of Primary Industry (PIOV), Secondary Industry (SIOV), and Tertiary Industry (TIOV); and the Proportions of Primary Industry's Output Value (PPIOV), Secondary Industry's Output Value (PSIOV), and Tertiary Industry's Output Value (PTIOV), are chosen. PCA is employed to eliminate the multicollinearity of the affecting factors. Two principal components, which can explain 92.86% of the variance of the eight affecting factors, are chosen as variables in the regression analysis. Ordinary least square regression is used to estimate multiple linear regression models, in which COEs and the principal components serve as dependent and independent variables, respectively. The results are given in the following. (1) Theoretically, the carbon intensities of PIOV, SIOV, and TIOV are 2573.4693, 552.7036, and 606.0791 kt per one billion $, respectively. The incomplete statistical data, the different statistical standards, and the ideology of self sufficiency and peasantry appear to show that the carbon intensity of PIOV is higher than those of SIOV and TIOV in China. (2) PPIOV, PSIOV, and PTIOV influence the fluctuations of COE. The parameters of PPIOV, PSIOV, and PTIOV are -2706946.7564, 2557300.5450, and 3924767.9807 kt, respectively. As the economic structure of China is strongly tied to technology level, the period when PIOV plays the leading position is characterized by lagging technology and economic developing. Thus, the influence of PPIOV has a negative value. As the increase of PSIOV and PTIOV is always followed by technological innovation and economic development, PSIOV and PTIOV have the opposite influence. (3) The carbon intensities of P and UP are 1.1029 and 1.7862 kt per thousand people, respectively. The carbon intensity of the rural population can be inferred to be lower than 1.1029 kt per thousand people. The characteristics of poverty and the use of bio-energy in rural areas result in a carbon intensity of the rural population that is lower than that of P.

Evaluation of analgesic effectiveness of 30 mg morphine sulfate gelules from domestic production on cancer patients

The analgesic efficacy of Morphin sulfate capsule 30mg manufactured domestically was evaluated in 59 cancer patients. Time of action onset after the first 30mg dose was 15-60 minutes (35-45 min in 70.6% patients) and the analgesic effect lasted from 2.5 to 12 hrs (4-5 hrs in 59.3% patients), depending on patients' pain score prior to administration of drug. Generally, 77.9%, 11.9% and 10.2% patients acquired good, moderate and poor results from analgesic treatment, respectively