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WORLD HEALTH ORGANIZATION BACKGROUND GUIDE

Prepared By: Anand Mrinalini Chairperson(World Health Organization)-RomeMUN 2013 Attrams Siaw Prince Director (World Health Organization)-RomeMUN 2013

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CONTENTS
World Health Organization ............................................................................................................................................1 Background Guide .........................................................................................................................................................1 PRESENTATIONS CHAIR AND DIRECTOR-ROMEMUN 2013 ...........................................................................................4 TOPIC a: MDG6-Target 6.A/target 6.b ...........................................................................................................................6 Have halted by 2015 and begun to reverse the spread of HIV/AIDS ......................................................................6 Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it .....................................6 INTRODUCTION .........................................................................................................................................................6 CURRENT SITUATION .................................................................................................................................................7 HIV/ AIDS ...............................................................................................................................................................7 MALARIA ................................................................................................................................................................9 TUBERCULOSIS .....................................................................................................................................................10 CONCLUSION ...........................................................................................................................................................12 TOPIC B: TARGET 8.E ....................................................................................................................................................13 In cooperation with pharmaceutical companies; provide access to affordable essential drugs in developing countries ..................................................................................................................................................................13 INTRODUCTION ...................................................................................................................................................13 CURRENT SITUATION ...............................................................................................................................................15 ESSENTIAL MEDICINES .............................................................................................................................................17 FUNDS TO BRIDGE THE GAP ....................................................................................................................................17 TRIPS (Trade Related Aspects of Intellectual Property Rights) ................................................................................18 WHO/HAI (WORLD HEALTH ORGANIZATION / HEALTH ACTION INTERNATIONAL) ................................................18 CONCLUSION ...........................................................................................................................................................19 GUIDING QUESTIONS ...............................................................................................................................................21

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BIBLIOGRAPHY .............................................................................................................................................................23 TOPIC A ....................................................................................................................................................................23 Topic B .....................................................................................................................................................................23

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PRESENTATIONS CHAIR AND DIRECTOR-ROMEMUN 2013


Chair - MRINALINI ANAND- chair_who@romemun.org Hey Everyone, Its a big honor for me to be part of Rome MUN 2013.I am a fourth year medical student. I am a German national with Indian ethnicity. I have grown up in two amazing cultures.I have enjoyed the mystic air of the Himalayas and the exotic life of Dahme Spreewald. My MUN journey began in 2009. I have got the opportunity to be a participant/chair/secretary general of many prestigious conferences such as BUMUN, Rome MUN, NMUN etc. For me being chair of WHO, Rome MUN is not only a great opportunity but also its a platform where major issues would meet the bright ideas of young minds. As the big year 2015 is fast approaching, its time we take responsibility for our actions, plans and visions. Each drop adds to the ocean-its time we realize how important our contributions as the youth are towards making this world a better place to live in. I am pretty excited to be part of the enthusiasm and spirit of Rome MUN 2013. Hope to see you there ! PRINCE SIAW ATTRAMS- director_who@romemun.org A highly motivated personality with great passion for the work of the United Nations, Prince Siaw Attrams is a Senior at the Ghana Telecom University College in Accra Ghana, currently studying Telecommunications Engineering. He has a strong interest in international relations and Diplomacy with a very rich experience in the Model United Nations Process. He is the current P.R.O of the IYC-Ghana Chapter and has served on many other youth organizations. He hopes to use his expertise to cause a great change in the world and hopes that the opportunity given to him to serve on the RomeMun Secretariat will be a chance for him to impart on participating delegates for them to have an unending experience that they can carry along forever.

VERY IMPORTANT: PLEASE REMIND THAT EACH COUNTRY HAS TO PRESENT A COPY OF THE POSITION PAPER ABOUT THE TWO AGENDA TOPICS OF THIS COMMITTEE BY MARCH 1ST , EMAILING IT AS ATTACHMENT IN WORD FORMAT TO position_paper@romemun.org ALL THE INDICATIONS ABOUT HOW TO PREPARE A POSITION PAPER IS NOT IN THIS GUIDE BUT IN THE DELEGATE GUIDE (AVAILABLE ON ROMEMUN FORUM)

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COUNTRIES RERESENTED AT WHO ROMEMUN 2013 Albania Angola Argentina Armenia Australia Azerbaijan Bahrain Belarus Belize Bhutan Bosnia and Herzegovina Botswana Brazil Burkina Faso Burundi Cambodia Canada Central African Republic Chad China Cuba Czech Republic Democratic Peoples Republic of Korea Dominican Republic El Salvador Equatorial Guinea Eritrea France Gabon Germany Grenada

Guatemala Guinea-Bissau Haiti Honduras Iceland India Italy Jamaica Kazakhstan Kiribati Kuwait Liberia Lithuania Luxembourg Mali Malta Mauritius Micronesia (Federated States of) Morocco Myanmar Pakistan Paraguay Republic of Korea Russian Federation Rwanda Slovakia Togo United Kingdom United States

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TOPIC A: MDG6-TARGET 6.A/TARGET 6.B

HAVE HALTED BY 2015 AND BEGUN TO REVERSE THE SPREAD OF HIV/AIDS ACHIEVE, BY 2010, UNIVERSAL ACCESS TO TREATMENT FOR HIV/AIDS FOR ALL THOSE WHO NEED IT

INTRODUCTION

We are working towards a shared vision of the future for health among all the worlds people. A vision future in which we develop new ways of working together at global and national level. A vision which has poor people and poor communities at its center. -Gro Harlem Brundtland

With almost two years to go, MDG 6 is still a major worry for a lot of nations.HIV AIDS has predominantly taken lead ,incidence and prevalence wise, as compared to other diseases.

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CURRENT SITUATION HIV/ AIDS

HIV (Human Immunodeficiency Virus) is commonly transmitted sexually and parenterally. AIDS (Acquired Immunodeficiency Syndrome) is the set ofcomplications that develop in HIV positive patients later on. Since the beginning of the epidemic, more than 60 million people have been infected with the HIV virus and approximately 30 million people have died of AIDS. More than 2 million children under 15 are infected with HIV, and 15 to 24-year-olds accounted for half of all new HIV infections.1.8 million people died in the WHO African Region in 2010, making it the most effected region [1].

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The figures are huge and alarming. Some major questions are-how can things get under control? How well has the situation been accessed? There have been multiple preventive, prophylactic and curative actions that have been taken at global and national levels. Timely counseling, screening, proper breast feeding practices, safe sex and antiretroviral treatment can prevent the unpreventable. Anti retroviral therapy (ART), consist of combination of medicines which prevent the replication of the HIV virus and rebuild the immune system. As of the end of 2011, over 8 million people had access to ART in low- and middle-income countries. An example of a successful integrated effort was the3 by 5intiative in 2003 by the UNICEF, the World Health Organization (WHO) and UNAIDS which aimed to ensure that 3 million people got access to anti-retroviral treatment by the end of 2005.ART has fortunately been available in many infected areas due to the constant efforts of local low cost generic firms, who have significantly reduced the costs of ART from 12000$/person to 350$/person. Breastfeeding is also closely related to HIV positive cum new mothers. In middle or low income countries, HIV positive mothers are highly encouraged to take ART while breastfeeding ,to prevent the transmission of HIV to the child. In high income countries, breastfeeding is discouraged altogether in HIV positive mothers. They are instead encouraged to give replacement feed, as there is easy access to clean water, sanitation and health services. Counseling in HIV and AIDS has become a core element in a holistic model of health care, in which psychological issues are recognized as integral to patient management. HIV and AIDS counseling has two general aims: (1) the prevention of HIV transmission and (2) the support of those affected directly and indirectly by HIV. It is vital that HIV counseling should have these dual aims because the spread of HIV can be prevented by changes in behavior [2].Safe sex is another area which has to be more focused on to prevent HIV. Condom effectiveness in reducing heterosexual HIV transmission, a Cochrane review suggested that the incidence of HIV infection among those who reported always using condoms was 1.14 per 100 person-years (95% confidence interval 0.56-2.04), while it was 5.75

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per 100 person-years (95% CI 3.16-9.66) among those who never used them. This gave an 80% reduction in the incidence of infection with condom use [3].

Also, the male latex condom is the single, most efficient, available technology to reduce the sexual transmission of HIV and other sexually transmitted infections.[4]The wide distribution and marketing strategies of various condom brands and campaigns have made a significant impact e.g. the Great American Condom Campaign. As far as the future of this viral infection is concerned, we need to make sure that all effective preventive and prognostic interventions are in place. Success stories like Ugandas National HIV program, which lead to significant drop in HIV infection rates, provides a huge motivation to the rest of its counterparts.

MALARIA

Malaria is primarily a tropical disease which spreads through mosquito bites. The complications depend on the underlying microorganism involved. Malarial precipitating factors are wet surroundings, poor immunity, poor sanitation and poor access to health care. In 2010, an estimated 216 million cases occurred, and the disease killed approx. 655 000 people most of them children under five in Africa. On average, malaria kills a child every minute and around3.3 billion people are at risk of contracting malaria. The human toll is tragic, and the economic cost is enormous. Most of these deaths could be avoided, however, as effective and affordable ways to prevent and treat malaria exist. In recognition of the scope of the problem, malaria control is embedded in one of the millennium development goals of the United Nations: to Combat HIV/AIDS, malaria and other diseases.[5]. Some basic preventive measures are using insecticides, ITNs (Insecticide treated mosquito nets), avoiding stagnant water collections and using the correct medications based on chloroquine/artemisine/primaquine. UNICEF, along with the United Nations Development

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Program and the World Bank, joined with the WHO in 1998 to found the global partnership Roll Back Malaria, with the goal of halving the burden of malaria by 2010. With UNICEF heading activities in East and West Africa, the group of some 90 global partners including governments of malaria-endemic countries, donor governments, international organizations, private foundations and academic institutions works together on a range of interventions to control malaria. Foremost among these is mass-purchasing ITNs, the most effective prevention against malaria, and developing local distribution systems for them. If every African child under five years slept under an ITN, costing only $4, nearly 500,000 child deaths could be prevented every year. A factory in Tanzania was the first ever to product a net with long-lasting insecticides woven into the fabric. Home management of the disease which involves educating and training families and providing pre-packaged high-quality medicines allows families to care for their own children effectively and quickly, an important asset as malaria can kill within hours. [6]As they say actions speak louder than words, its a big success for a country like Mozambique to be able to reduce the Malaria incidence rates by 60% solely by free distribution of ITNs. Since 2000, some 1.7 million bed nets have been distributed through the public health system in Mozambique. Two-thirds of those nets have been delivered via UNICEF-supported programs.[7]Globally since 2000,there has been a drop in the incidence rates of Malaria by 25%, but we have to work harder towards the ultimate goal.
TUBERCULOSIS

Tuberculosis (TB) is a bacterial disease that is primarily associated with the lungs. Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent.In2011; 8.7 million people fell ill with TB and 1.4 million died from TB. Over 95% of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44. In 2010, there were about 10 million orphan children as a

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result of TB deaths among parents. TB is a leading killer of people living with HIV causing one quarter of all deaths. [8]

TB is a curable and preventable disease. The proper medications, preventive measures and prognostic measures such as DOTS (Directly supervised therapy), can make an impact. Since 1995, over 51 million people have been successfully treated and an estimated 20 million lives saved through use of DOTS and the Stop TB Strategy recommended by WHO. A multidimensional approach involving medical careers, governmental organizations, research and pharmaceutical negotiations seems to be a silver lining. Nepal has emerged one of the successful fighters of TB. In 1990, only 45 percent of people were cured of TB, now it up to 90 percent. In addition, Nepal has also seen improvements in other health factors such as malaria, maternal health, and AIDS. This has been primarily achieved through a centrally controlled governmental strategy .To deal with further complications of child and maternal health. Nepal has recently also signed contracts with, DFID, the World Bank, and the GAVI Alliance.

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CONCLUSION

Its time to prove that actions actually do speak louder than words! The mere factual knowledge of the main contributors of morbidity and mortality wont help. Its time we realize how important their prevention and cure are. Constructive ideas and precise resolutions should take lead in making a positive impact on society. 2015 is a year by which we need to ensure that no child dies sweating of malaria, no mother gets worried about her developing baby and no man ails with something preventable like TB.At a simulated platform like Rome MUN and as the future leaders of tomorrow, we need to analyze the past, present and future.

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TOPIC B: TARGET 8.E

IN COOPERATION WITH PHARMACEUTICAL COMPANIES; PROVIDE ACCESS TO AFFORDABLE ESSENTIAL DRUGS IN DEVELOPING COUNTRIES

INTRODUCTION

If countries are to maintain and accelerate progress towards the MDGs, then people need equitable access to a health system that can deliver high quality services, where and when they are needed. Health is an established human right. In a review, 135 of 186 national constitutions (73%) include provisions on health or the right to health, and access to essential affordable medicines has been recognized as one part of that right to health (Hogerzeil et al., 2006; Perehudoff, 2008). Most illnesses, especially infectious diseases, are either preventable or to some extent treatable with a relatively small number of medicines. Despite this fact, a large proportion of the worlds population today still has either only limited access to appropriate medicinal treatment, or no access at all. The effect of this shortfall constitutes huge losses of life from diseases that are highly preventable or treatable. Most of such diseases include tuberculosis, pneumonia, malaria, diabetes and hypertension. The dire aspect of this unfortunate situation is particularly common among the poor and susceptible populations of the world. Illness has also been identified as one of the major factors that slide the nearly poor into profound poverty. It decreases the efficiency of the human capital of every nation and supporting access to medicine for more than 2 billion poor people is directly in line to the fundamental principle of health as a human right.

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Improving access to essential medicines forms an integral part of the MDGs. Target 8.E under the MDG 8 tries to assess the fundamental contribution of pharmaceutical companies in developing countries. The target indicator of Target 8.E Indicator 8.13, tries to measure the ratio of the total population to the population with access to essential medicines periodically in each member country. One of the main problems lies with the difficulty to measure the delivery gap of essential medicines which is due to the lack of data and the lack of numerical targets and commitments. The access, affordability and sustainability components of the indicator depends to a large extent on both local and international factors. It is therefore of great importance to bridge the gaps and seek for a more proactive way in addressing this issue. The following gaps as provided by the MDG Gaps Task Force reiterate this stance [1]. 1) Lack of numerical targets prevents proper monitoring of global commitments. 2) Availability of medicines in developing countries is low, 42 per cent in the public sector and 64 per cent in the private sector (in countries with available information). 3) Prices of medicines remain high. Median prices of generic medicines are, on average, between 2.7 and 6.1 times higher than international reference prices, in the public and private sectors, respectively. 4) Essential medicines are unaffordable to large segments of population in developing countries. Monthly costs of medicines to treat chronic diseases are often equivalent to several days salary of the lowest paid

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CURRENT SITUATION

Currently, one of the key barriers to access of medicines is the poor medicine availability particularly in the public sector. Notably, public-sector availability of a selection of generic medicines is less than 60% across WHO regions ranging from 32% in the Eastern Mediterranean Region to 58% in the European Region (WHO, 2011). WHO defines generic medicines as Pharmaceutically equivalent or pharmaceutically alternative products that may or may not be therapeutically equivalent It is also reported according to the WHO general report 2006, as Multisource pharmaceutical products that is therapeutically equivalent or interchangeable. Prices of these medicines and their availability serve as strong indicators to treatment in both public and private sectors. In order to define the medium by which medicines are obtained, some factors must first be considered. Some of these factors include: safeguarding all health and supply systems and assuring their accessibility, making sure that both government and individuals have the capacity to afford medicines highly required for maintaining good health, guaranteeing the availability of funds for these medicines as and when the patients need them, and ensuring that all patients have appropriate medicine in their right dosages depending on their ailment. Most health goals mainly relate to individuals. International commitments thus comes in the form of developing access but these efforts are restricted to either taking pragmatic preventive measures such as provision of insecticide-treated bed nets, vaccines, and potable water or yet still curative measures such as the provision of medicines such as ARTs for HIV/AIDS. Most importantly, it is of great importance that these measures are tailored to those who need them and most especially the poor, the aged, and the disabled in each and every country.

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It is to be noted that in the private sector, availability if generic medicines are much higher than that in the public sector and this cuts across all regions. Yet, in the Western Pacific, South-East Asia and Africa Regions, availability is still less than 60%.In countries where patients pay for medicines in the public sector, average prices of generic medicines range from 1.9 to 3.5 times international reference prices (IRPs) in the Eastern Mediterranean and Western Pacific Regions, respectively. While public sector availability of originator brand medicines is low, when these medicines were sold to patients their average costs ranged from 5.3 times IRPs in the Eastern Mediterranean Region to 20.5 times IRPs in the European Region. For lowest-priced generic products it also ranged from 2.6 times IRPs in South-East Asia to 9.5 times IRPs in the Americas.[2] This adverse effect thus forces patients to buy at a much higher price and this increases cost of treatment significantly. An example given in the worlds medicine situation 2011, states that:to treat an adult respiratory infection with a 7-day course of treatment with ciprofloxacin would cost the lowest-paid government worker over a days wage in most countries. Costs escalate when originator brands are used: the same treatment would cost the lowest-paid unskilled government worker over 10 days wages in the majority of the countries studied; in Armenia and Kenya, over a months salary would be needed to purchase this treatment. Situations become very critical when patients with ailments that last over a long period of time would have to sustain treatments. According to Waning et al, 80% of all donor-funded annual purchase volumes of antiretroviral medicines (ARVs) in 2008 were supplied by Indian manufacturers. The impact of some low and middle-income countries has become very significant in recent times in terms of the production of generic medicines and vaccines. The Republic of Korea, India and China are major examples of such countries and their efforts to the production of generic pharmaceuticals, vaccines and active pharmaceutical ingredients have been very significant. India especially has been of a great influence as indications show that more than half of the worlds children are immunized with Indian produced vaccines.

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ESSENTIAL MEDICINES

Essential medicine is a highly important factor to consider when measuring the adequacy of access. This is because the evaluation of the products that are supplied should be assessed and checked to meet the requirements of the patient population. WHO identified essential medicines as medicines that is considered to meet high-priority health care needs of a population and they are selected with regard to disease prevalence, evidence of efficacy, safety, and comparative cost - effectiveness. Yet, India and Africa together account for 54 percent of the worlds population without access to essential medicines. Recent global economic crisis has also contributed to the increase of the population of people in developing countries without access to affordable medicines. Another challenge the crisis brings is the rise in demands on public health services. This is due to rising unemployment and lower incomes which will in turn make people less capable to maintain their health and consequently expose them to greater health risks. In order to measure the impact of the global economic crisis on health systems, the World Health Organization (WHO), in cooperation with IMS Health, has put in place a program to track the consumption of medicines.
[4]

However,

South Africa remains the only country in sub-Saharan Africa with available IMS Health data.
FUNDS TO BRIDGE THE GAP

Also, the creation of the High Level Taskforce on International Innovative Financing for Health System has prompted efforts to approximate the cost of intensifying health systems and reaching the health-related MDGs in low-income countries [5]. This incorporated the costing of essential medicines needed to treat a selection of severe conditions in 49 countries mostly in sub-Saharan Africa with a gross national income (GNI) per capita of $935 or less in 2007. Estimated Results shows that, to attain the health related MDGs in these countries, funding for treatments excluding those covered by MDGs 4, 5 and 6 should be increased by about $630 million in 2009. It also estimates that incremental costs per year would increase from $150

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million in 2009 to $1.17 billion in 2015. The annual per capita cost of these essential medicines is estimated to range from slightly less than $0.50 in 2009 to almost $2 in 2015.[4] With the above analysis and estimates, it should be affordable to meet these gaps in access to essential medicines because it will only add less than $1 per capita to a countrys annual pharmaceutical expenditure. Raising such amounts should be attainable with adequate financing mechanisms since requirements to meet Target 8.E form small fractions of a countrys annual per capita health expenditure.
TRIPS (TRADE RELATED ASPECTS OF INTELLECTUAL PROPERTY RIGHTS)

The Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) is an international agreement administered by the World Trade Organization (WTO) that sets down minimum standards for many forms of Intellectual Property (IP) regulation as applied to nationals of other WTO members. The DOHA declaration is a WTO statement that also clarifies the scope of TRIPS, stating for example that TRIPS can and should be interpreted in light of the goal to promote access to medicines for all.[6] Despite this fact, the agreement is leading to the patenting of new medicines in countries that traditionally have been important producers of generic essential medicines. As a result, generic versions of new medicines will become only available after 20-year patent has expired. Patented medicines are in general more expensive. To meet the deadline to achieve the MDGs target 8.E, it is imminent that contrary action taken will be very useful. WHO recommended first-line regimen for HIV/AIDS for a year costs $87 when generic medicines are used whiles originator products costs $613 and $1,033.
WHO/HAI (WORLD HEALTH ORGANIZATION / HEALTH ACTION INTERNATIONAL)

Collaborative efforts between the department of medicine policy and standards of the World Health Organization and Health Action International (HAI) have seen the priority to improve access to essential medicines throughout Africa and particularly among the most resource

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restricted communities. The program is funded by the UK Department of International Development (DFID) and a number of 15 countries thus far have been on the target. Close collaboration with civil society has also been implemented. It is mainly focused on using a model of cross-sector partnership building to make progress in the five areas that are vital for securing safe and accessible medicines. It also supports policies and programs which increases the mutual engagement of government and civil society. This has also created a network of National Professional Officers (NPOs) who provide technical support and pharmaceutical expertise in each of the 15 countries. [7] This initiative allows Governments, civil society groups and other organizations interested and concerned about the prices of medicines to take surveys because reliable data is deemed as the first step to exploring policy options and taking necessary actions to reduce prices and also improve the availability and affordability of essential medicines. Many other measures are currently in place towards the achievement of the target 8.E. However, the efforts are yet to yield significant results and the targets for 2015 are far from being hit. Other result-oriented measures, therefore urgently need to be set into motion.
CONCLUSION

Delegates in this committee have the enormous task of coordinating efforts to bring pragmatic and feasible solutions to the problems and challenges that impede the success of the MDGs. Solutions must be time-bound and goal oriented as the time frame is very short to the final deadline - 2015. Delegates should therefore take a critical look at the above mentioned challenges and come up with approaches that can aid in attaining the Target 8.E In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries.

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This background guide gives a summary of some of the challenges presently. There are no restraints however to personal researches on the issues before this committee. The spirit of consensus is highly encouraged among delegates. We look forward to having a progressevoking conference.

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GUIDING QUESTIONS

These Questions serve as guidance to the resolution needed at the end of all deliberations. It is not by any means restrictive.As such, other useful questions and corresponding answers are highly encouraged.

Topic A
1) How do you think can cost effective treatments be accessed in better ways as far as HIV is concerned? 2) Could the youth play an active role in advocating preventive measures in regards to HIV? If yes, what ways could they be? 3) What changes should be brought about in healthcare systems, to lower the incidence rates of HIV, Malaria and TB? 4) What kind of measures should be in place where the public and healthcare professionals can together control the impact of these major diseases? 5) What key points do you think have not been stressed upon enough in the past, that eradication of HIV/Malaria/TB still seems like a dream?

Topic B
1) What efforts should countries intensify to regularly measure and monitor prices and availability?

2) What role does the World Health Organizations have to play considering the current status of the issue?

3) What measures can be taken to reduce prices of medicines in the private sector or should they remain the same?

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4) Should policies be regulated to avoid excessive add-on costs in the supply chain?

5) Is there a need to take contrary actions regarding the existing TRIPS (Trade Related aspects of Intellectual Property Rights) Agreement?

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BIBLIOGRAPHY
TOPIC A
[1][7][8] World Health Organization, Health topics, MDG 6, Retrieved on 24/11/2012 from

http://www.who.int/topics/millennium_development_goals/diseases/en/ [2] British Medical Journal, Clinical Review, Sarah Chippindale-Lesley French, HIVcounselling and the psychosocial management of patients with HIV or AIDS.BMJ 2001;322:1533. Retrieved on 24/11/2012 from

http://www.bmj.com/content/322/7301/1533 [3] RHL ,The WHO Reproductive Health Library, Weller SC, Davis-Beaty K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD003255. DOI: 10.1002/14651858.CD003255.Retrieved http://apps.who.int/rhl/hiv_aids/cd003255/en/index.html [4] CDC, 'Male latex condoms and sexually transmitted diseases', Fact sheet for public health personnel.Retrievedon24/11/2012 from http://www.cdc.gov/condomeffectiveness/latex.html [5] British Medical Journal, Paper-Achieving the millennium development goals for health, Chantal Morel, Jeremy A Laue, David B Evans Cost effectiveness analysis of strategies to combat malaria in developing countries, BMJ 2005;331:1299.Reviewed on 24/11/2012 fromhttp://www.bmj.com/content/331/7528/1299 [6] UNICEF website, Millenium development goals, MDG 6.Reviewed on 24/11/2012 from on 24/11/2012 from

http://www.unicef.org/mdg/index_disease.htm

TOPIC B
[1] MDG Gap Task Force Matrix of Global Commitments August 2011 [2]The World Medicines Situation 2011 - Medicines Prices, Availability and Affordability [3] Local Production for Access to Medical Products World Health Organization. www.who.int/entity/phi/Local_Production_Policy_Framework.pdf

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[4]WHO. (2011). Access to affordable essential medicines. Geneva: World Health Organization. [5]IMS Health, Indicators for tracking the effect of the economic crisis on pharmaceutical consumption, expenditures and unit prices, report prepared for the World Health Organization, 20 May 2009 (available at http://www.who.int/entity/medicines/areas/policy/imsreport/en/index.html). [6] World Trade Organization Part II- Standards concerning the availability, scope and terms of use of intellectual Property Rights; section 5 and 6. [7]A good example is shown in Health Organization and Amsterdam, Health Action International, 2008. Available at: http://www.haiweb.org/medicineprices/manual/documents.htm World Health Organization. (2011). THE WORLD MEDICINES SITUATION - Medicines Prices, Availability and Affordabilty . Geneva: W.H.O.

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