Publications

Résultats 1909 à 1920 de 2000
23 octobre 2012

La rhétorique et le chemin de l’enfer: le régime International de contrôle des stupéfiants et l’accès aux médicaments essentiels

Cinquante ans après la mise en place du régime international de contrôle des stupéfiants, 80% de la population mondiale a peu ou n’a pas du tout accès aux opiacés médicinaux utilisés pour soulager la douleur et la souffrance, alors que les problèmes liés à la dépendance à la drogue dans le monde ne sont pas résolus. Pour en savoir plus, en anglais, veuillez lire les informations ci-dessous. Abonnez-vous à l'Alerte mensuelle de l'IDPC pour recevoir des informations relatives à la politique des drogues. This article by Katherine I. Pettus, PhD, identifies key rhetorical dimensions of the legal framework governing access to “essential medicines” and analyzes how they obstruct effective public health strategies for palliative care worldwide. The World Health Organization (“WHO”), palliative care physicians from around the world, and civil society organizations such as Human Rights Watch, the Open Society Institute, and the Pain Policy Studies Group at the University of Wisconsin, have focused attention in recent years on the fact that essential medicines are unavailable for palliative care in “low and middle income countries” (LMICs). Identified barriers to access include lack of effective systems for assessing medical needs; laws and regulations and their administration or interpretation that unduly impede the availability of opioids; under-resourced healthcare systems; fear of addiction among professionals and the public, and lack of up-todate professional training in the use of opioids to treat pain. These “external barriers” are distinguished from what I consider to be the true source of the problem of access, the internal barriers, or tensions within the mandates of the global narcotics regime itself.Efforts to remove the external barriers will be unproductive and incoherent until tensions between the internal barriers are addressed and resolved. To begin this process key texts of the regime are analyzed as well as more recent conceptual additions such as the socalled “principle of balance,” which has become an integral part of the palliative care advocacy discourse. Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.
23 octobre 2012

Guide sur la mise en place de services spécialisés en hépatite C

Pour réduire la transmission de l’hépatite C, les Directeurs de Santé Publique doivent absolument prendre conscience de l’importance des programmes de dépistage et d’éducation. Pour en savoir plus, en anglais, veuillez lire les informations ci-dessous. Abonnez-vous à l'Alerte mensuelle de l'IDPC pour recevoir des informations relatives à la politique des drogues. The number of people who die from liver disease in England has risen by 25% in the last decade. This is in contrast to the other major causes of death in this country, which affect fewer people at a later age than ever before, while liver disease affects growing numbers of increasingly younger people. Liver disease causes approximately 2% of all deaths 90% of people who die from liver disease are under 70 years old More than 1-in-10 deaths of people in their 40s are from liver disease People dying from liver disease often have complex end of life care needs and over 70% die in hospital The NHS and Public Health Outcomes Frameworks both set an ambition for reduction of mortality in people under 75 years from liver disease. The main causes of liver disease are alcohol abuse, obesity and viral hepatitis B and C. The Office of National Statistics has listed hepatitis C as the only liver disease which is ‘amenable’, meaning death from hepatitis C can be avoided through good quality healthcare. It also lists hepatitis C and other liver diseases are ‘preventable’, meaning death can be avoided by public health interventions in the broadest sense. As hepatitis C is curable and as such the only liver disease deemed amenable to intervention, addressing hepatitis C will be crucial in efforts to achieve a reduction in mortality from liver disease. The inclusion of under-75 mortality rate from liver disease within the Commissioning Outcomes Framework means commissioners at clinical commissioning group level will have a major role to play in ensuring that services are commissioned that focus on the identification of people with, and those at risk of contracting, hepatitis C. Hepatitis C is included within four of the five domains in the NHS Outcomes Framework 2012/13 Technical Appendix. The Public Health Outcomes Framework shares this outcome on reducing the under-75 mortality rate from liver disease. The working draft of the Guidance to Support the Provision of Healthcare Public Health Advice to Clinical Commissioning Groups for Directors of Public Health highlights in its appendix the importance of protection functions including blood borne virus prevention and case identification for hepatitis C and other blood borne viruses. To reduce the transmission of hepatitis C it is crucial that Directors of Public Health are aware of the importance of screening programmes and education. Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.