Australia’s position on medicines policy in international forums: Intellectual property protection and public health

Universal access to affordable medicines, which are safe, efficacious and of high quality, and which are appropriately used, depends on national legislation that is in turn constrained by a range of international agreements. This regulatory configuration also affects the profitability of the pharmaceutical industry, domestic and international. Tensions and contradictions between industry profitability and public health objectives relate to access, innovation and regulation.

Evaluation of AUSDRISK as a screening tool for lifestyle modification programs: international implications for policy and cost-effectiveness

OBJECTIVE: To evaluate the current use of Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) as a screening tool to identify individuals at high risk of developing type 2 diabetes for entry into lifestyle modification programs.

RESEARCH DESIGN AND METHODS: AUSDRISK scores were calculated from participants aged 40-74 years in the Greater Green Triangle Risk Factor Study, a cross-sectional population survey in 3 regions of Southwest Victoria, Australia, 2004-2006. Biomedical profiles of AUSDRISK risk categories were determined along with estimates of the Victorian population included at various cut-off scores. Sensitivity, specificity, positive predictive value (PPV), negative predictive value, and receiver operating characteristics were calculated for AUSDRISK in determining fasting plasma glucose (FPG) ≥6.1 mmol/L.

RESULTS: Increasing AUSDRISK scores were associated with an increase in weight, body mass index, FPG, and metabolic syndrome. Increasing the minimum cut-off score also increased the proportion of individuals who were obese and centrally obese, had impaired fasting glucose (IFG) and metabolic syndrome. An AUSDRISK score of ≥12 was estimated to include 39.5% of the Victorian population aged 40-74 (916 000), while a score of ≥20 would include only 5.2% of the same population (120 000). At AUSDRISK≥20, the PPV for detecting FPG≥6.1 mmol/L was 28.4%.

CONCLUSIONS: AUSDRISK is powered to predict those with IFG and undiagnosed type 2 diabetes, but its effectiveness as the sole determinant for entry into a lifestyle modification program is questionable given the large proportion of the population screened-in using the current minimum cut-off of ≥12. AUSDRISK should be used in conjunction with oral glucose tolerance testing, fasting glucose, or glycated hemoglobin to identify those individuals at highest risk of progression to type 2 diabetes, who should be the primary targets for lifestyle modification.

Policy responses to address student “brain drain”: An assessment of measures intended to reduce the emigration of singaporean international students

For several decades,Singapore has experienced a high rate of outbound degree mobility with around 1 in 10 higher education students currently studying outside the country according to UNESCO figures. Singapore’s successful economic development strategy, which has seen it become a key Asian hub for knowledge-intensive industries for internationalized services, has benefited from the presence of large numbers of graduates who have been educated abroad. However, significant numbers of Singaporean students do not return home after their studies, and since the late 1990s, the government has expressed concern about the resulting “brain drain.” This article examines four strategies that have been used by the Singapore government to address this concern: reducing the number of outbound students through improvements to domestic study options, promoting the return of graduates after their studies, engagement with the Singaporean diaspora, and recruitment of incoming international students into the workforce. While data are limited, the measures adopted to support each of these approaches appear to have had some success over the past decade. While the circumstances of each sending country vary, the case of Singapore is illustrative of the types of practical measures that are effectively adopted by governments to moderate the negative impacts of student emigration.

Book review: Hannah Murphy, The Making of International Trade Policy: NGOs, Agenda-setting and the WTO (Cheltenham, UK: Edward Elgar, 2010), 240 pp., £65.00, ISBN 978 18498 00181 (hbk).

The nexus between states,non-state actors and intergovernmental organisations is an increasingly important area in both the study and practice of global governance. Hannah Murphy makes a meaningful contribution to this area in examining the informal role of non-governmental organisations (NGOs) in relation to agenda-setting within the World Trade Organization (WTO). © Dean Coldicott, Deakin University 2012.

The national interest in international relations theory

The concept of the 'national interest' is an ever-present feature of contemporary diplomatic discourse, and has been widely analysed by historians and political scientists. However, there has not been a systematic investigation of the term from the range of theoretical perspectives which comprise the discipline of International Relations. This book fills this gap by explaining how the term is variously understood by realist, Marxist, anarchist, liberal rationalist (English School) and constructivist theories of International Relations. It is argued that far from having a clear and unambiguous meaning, 'the national interest' is a problematic term which is largely devoid of substantive content. While realists traditionally, and constructivists more recently, claim that 'the national interest' is a key explanatory tool in the analysis and understanding of contemporary foreign policy.
Scott Burchill argues that beyond the narrow aspect of security policy, the national interest has little residual value as an insight into the motivations of state policy in the external realm.

International commercial law : principles and practices

International Commercial Law: Principles and practices considers the multifaceted nature of international commercial law and explains the rules, principles, policies and practices that comprise this area of law and the wide-ranging influences that shape it

The book provides an extensive analysis of the wider policy, moral, economic and political considerations underpinning international commercial law.
- It analyses and evaluates existing standards and practices, and suggests proposals for reform.
- It encourages readers to make informed judgments regarding the interpretation of relevant legal standards and to make predictions about how the law is likely to develop.

Globalization, international trade and welfare

The term globalization is generally used to describe an increase in international transactions in markets for goods and services and factors of production, plus the growth and expanded scope of mar.y institutions that straddle international borders. Globalization has also led to a more liberal economic environment where issues such as labour standards, human rights, the environment, intellectual property rights, investment codes and competition policy are now considered legitimate topics in the trade debate. Free global markets cannot guarantee that air, water or energy resources are accurately priced for sustainable development since there is no mechanism to internalize environmental costs. Economic growth, although a powerful tool for increasing a country's wealth, cannot guarantee that such wealth will be equally distributed. What is needed is environmental and social policy to redistribute the benefits.
Recent empirical studies show that there are clear signs of income convergence among countries that integrate more fully with the world economy but a divergence between these active participants and those who elect to remain insulated from global markets. The inequality within nations (distribution of income) has increased during the period of globalization over the last fifty years.

Global profit split: An evolutionary approach to international income allocation

International taxation is concerned mainly with the equitable allocation of cross-border income between countries in which income-earning activities take place. Such allocation has traditionally been governed by the arm’s-length principle, which has been interpreted as requiring a comparable transactional pricing approach. This approach assumes that each member of a multinational enterprise (MNE) group is a separate entity and that the transactions between related parties can be separated and compared with arm’s-length transactions. It has, however, proved difficult to apply comparable transactional pricing to internationally integrated businesses, especially those involving intangibles and services, and formulary apportionment has been suggested as an alternative. Essentially, formulary apportionment treats the MNE group as a single economic entity. The group’s profit is allocated to members according to a formula that reflects the particular member’s contribution to the production of that profit. A rich academic literature exists which either defends or attacks this alternative approach. The OECD and national governments have rejected formulary apportionment mainly on the ground that it violates the arm’s-length principle. This article proposes a global profit split (GPS) method for allocating international income. The GPS would allocate the global profit of an integrated business to each country in accordance with the economic contributions made by components of the business located in that country. The allocation would be based on a formula that would reflect the economic factors that contribute to profit making. While the GPS draws on elements of the traditional formulary apportionment and profit split methods, it also differs from them. The author discusses in detail the key issues involved in designing the GPS. She also presents and evaluates the main policy and pragmatic justifications for the adoption of this innovative approach. The author argues that the GPS is not only theoretically and practically superior to traditional income allocation methods, but also consistent with the arm’s-length principle. On the basis of historical developments, interpretation of article 9 of the OECD model tax convention, and international tax policy considerations, the author establishes that the GPS is not a radical departure from the arm’s-length principle, but rather a natural development in its evolution. She concludes that the law of evolution ison the side of reform because the GPS would provide for a fair and effective allocation of income derived from globally integrated business activities.

Retirement income policy and the taxation of superannuation in Australia

Superannuation is a form of savings for retirement. The savings are invested and earn income, but the proceeds are generally not available until the beneficiary reaches retirement age} The federal government's retirement income policy has three components, two of which relate to superannuation: the age pension, which provides income support to men aged 65 and over and to women aged 62 and over.2 The pension is means tested and does not depend on previous labour force participation or individual contributions; a compulsory superannuation scheme (under the Superannuation Guarantee Charge (Administration) Act 1992 (SGA Act)), which requires contributions to be made by employers on behalf of all employees, whether full-time, part-time or casual;3 and encouragement, through the taxation system, of voluntary contributions to approved superannuation funds.4 In May 2002, the government released a report, the "Intergenerational Report", 5 which identifies issues associated with Australia's ageing population and considers the fiscal implications of those changes. The Report noted that a steadily ageing population is likely to place significant pressure on government finances. It also noted that one of the key priorities for ensuring fiscal sustainability should be "maintaining a retirement income policy that encourages private saving for retirement and reduces the future demand for the Age Pension". 6 The main way the government has sought to encourage that private saving is through the tax system, primarily by the use of tax concessions. Over the past 20 years, however, the taxation of superannuation has grown in an extremely ad hoc manner and is now inequitable, inefficient and overly complex. This article suggests that the taxation of superannuation in Australia is in urgent need of a complete review. The article further asserts that, if an appropriate framework can be devised, changes could be introduced as budgetary pressures allow.

Casey: four decades in the making of Australian foreign policy

Richard Casey was involved in shaping Australian foreign policy for over four decades. Casey's attitudes, ideas, policies and actions towards the rest of the world are therefore an important part of a Liberal tradition in Australian foreign policy. To examine Casey's place in the Liberal tradition this article explores Casey's positions on the great international issues of two periods: the 1930s and the 1950s. The conclusion of the article is that three key ideas shaped Casey's foreign policy, and therefore also lie at the centre of the Liberal tradition; firstly, a strong attachment to the idea of the English speaking alliance; secondly, a realist perspective on international affairs; and, thirdly, a consistent strand of anti-communism.

Changing communities: international students in local government schools

Although fewer than 10% of international students are in the primary and secondary educational sectors, recent figures show the number of these students to have increased exponentially making Australia a leading player in school education provision along with Britain and the United States. The impact of these changes on local schools and the correspondent negotiation of globalising trends on secondary schools alter the ways that identity and difference are understood and played out and the ways that policy and practice in participating schools can be understood At the same time the terms and conditions that define these demands - particularly as they characterize them as marketable commodities. English language and as global and western education need to spelt out and interrogated. In this paper 1 interrogate the ways that community members within local government schools speak about the impact of fee-paying international students on their school. 1 suggest that these discussions are defined by the material and conceptual relations of identity and difference crisscrossed by the politics of consumption and production.

International sentencing law: in search of a justification and coherent framework

An international sentencing jurisprudence is emerging from the decisions by the International Criminal Tribunal for the Former Yugoslavia (ICTY or the Yugoslav tribunal) and the International Criminal Tribunal for Rwanda (ICTR or the Rwanda tribunal) (collectively, 'the tribunals'). This article examines international sentencing law and practice and discusses the justification for the practice. International sentencing law has several objectives. The main goals are reconciliation, deterrence, retribution and rehabilitation. The sentencing inquiry is marked by a high degree of discretion and has resulted in sentencers developing a large amount of aggravating and mitigating considerations, such as being in a position of authority, remorse and good character. It is argued that the current international sentencing approach is flawed - fundamentally so. Most of the stated goals of international sentencing in the form of reconciliation, retribution and rehabilitation are either highly speculative or misguided. The only justification for the practice is general deterrence. This is, however, significantly undermined by the selective and infrequent enforcement of crimes within the jurisdiction of such tribunals. The stated aggravated and mitigating considerations are not valid given that they are not justified by reference to the stated aims of sentencing and only serve to undermine the search for a penalty which is commensurate the serious of the offence. This article suggests a coherent framework for international sentencing policy and practice.

International and culturally inclusive curricula-an engineering management unit audit case study

SEB421 Strategic Issues in Engineering is a final-year engineering management study unit at Deakin University in which the enrolled student population has grown to include significant numbers of international students. Given this change, it was considered timely to conduct a review of the unit, with regard to principles of international and culturally inclusive curricula. Despite the historically white Anglo-Saxon male culture of engineering education in Australia, there are a wide range of international and cultural aspects related to engineering education. A review of the literature reveals a diversity of interpretations of 'internationalisation' and 'cultural inclusiveness'. From a pragmatic perspective, it is noted that organisational policy can provide guidance for academic staff seeking to make courses more inclusive. From a review of the literature and relevant university policies, a list of 'international and culturally inclusive curricula' guidelines for engineering management education was developed. Comparing a prior audit of SEB421 with these guidelines revealed progress on international and culturally inclusive curricula, but identified opportunities for improvement. The guidelines were applied to the curriculum/syllabus, content/study materials, conduct and assessment of the unit, to identify further opportunities for improvement. A plan for improvement of the unit and an associated timetable for this work were developed. It was noted that some changes can be made immediately, while others are contingent upon the timetable imposed by university systems. It was further noted that issues of change within a single study unit intersect with wider issues of program curriculum, and, while pilot activities can provide a start, eventually the wider issue of international and culturally inclusive curricula across the entire undergraduate engineering program needs to be considered.

Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies

A WHO expert consultation addressed the debate about interpretation of recommended body-mass index (BMI) cut-off points for determining overweight and obesity in Asian populations, and considered whether population-specific cut-off points for BMI are necessary. They reviewed scientific evidence that suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations. The consultation concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight (25 kg/m2). However, available data do not necessarily indicate a clear BMI cut-off point for all Asians for overweight or obesity. The cut-off point for observed risk varies from 22kg/m2 to 25kg/m2 in different Asian populations; for high risk it varies from 26kg/m2 to 31kg/m2. No attempt was made, therefore, to redefine cut-off points for each population separately. The consultation also agreed that the WHO BMI cut-off points should be retained as international classifications. The consultation identified further potential public health action points (23·0, 27·5, 32·5, and 37·5 kg/m2) along the continuum of BMI, and proposed methods by which countries could make decisions about the definitions of increased risk for their population.