Who Develops Innovations in Medicine for the Poor? Trends in Patent Applications Related to Medicines for HIV/AIDS, Tuberculosis, Malaria and Neglected Diseases

Who invents medicines for the poor of the world? This question becomes very important where the WTO allows low income countries to be unbound by the TRIPS agreement. This agreement concerns medicines for infectious diseases such as HIV/AIDS, tuberculosis and malaria. These diseases cause serious damage to low income countries. Under these circumstances, some scholars wonder if anyone will continue innovative activities related to treating these diseases. This paper sought to answer this question by collecting and analyzing patent data of medicines and vaccines for diseases using the database of the Japan Patent Office. Results indicate that private firms have led in innovation not only for global diseases such as HIV/AIDS but also diseases such as malaria that are spreading exclusively in low income countries. Innovation for the three infectious diseases is diverse among firms, and frequent patent applications by high-performing pharmaceutical firms appear prominent even after R&D expenditure, economies of scale, and economies of scope are taken into account.

Stigma, social relationship and HIV testing in the workplace : evidence from South Africa

This paper explores whether a worker's unwillingness to make his/her HIV-positive status or test-taking experience known by colleagues impedes his/her decision to test for HIV. After analyzing the new survey data provided by employees working for a large multinational enterprise in South Africa (2009-2010), this study finds that this unwillingness is negatively associated with test-taking (at the enterprise's on-site clinic) of workers who are extensively networked with close colleagues (i.e., know their phone numbers). It appears that the expected disutility associated with HIV/AIDS-related stigma prohibits test uptake. When introducing HIV counseling and testing programs into a corporate sector, providing all workers with an excuse to test in the workplace and/or inducing them to privately test outside the workplace may be effective in encouraging the uptake.

Impacts of an HIV counseling and testing initiative -- results from an experimental intervention in a large firm in South Africa

We have run experimental interventions to promote HIV tests in a large firm in South Africa. We combined HIV tests with existing medical check programs to increase the uptake. In the foregoing survey we undertook previously, it was suggested that fears and stigma of HIV/AIDS were the primary reasons given by the employees for not taking the test. To counter these, we implemented randomized interventions. We find substantial heterogeneity in responses by ethnicity. Africans and Colored rejected the tests most often. Supportive information increased the uptake by 6 to 16% points. A tradeoff in targeting resulting in stigmatizing the targeted and a reduction of exclusion error is discussed.

国際公共財としての感染症対策

HIV/AIDS、SARS、鳥インフルエンザといった新興感染症、薬剤耐性を持った病原体の出現によって問題が深刻化している結核、マラリア等再興感染症への関心が世界で高まっている。感染症の予防や治療はそれを個人に施すことのプラスの効果が国境を超えてスピル・オーバーすることが多く、国際公共財としての性質を持っている。また、新薬・ワクチンの成分・製法に関する情報および、感染症の流行に関する情報は典型的な公共財であり、誰しもがフリー・ライドするインセンティブを持っている。したがって、これら公共財の過少供給の問題を解決するためには国際的な協調行動が必要である。 　世界の感染症対策は、感染がより大規模に広まっている発展途上国を中心としたものにならざるを得ない。現在これをリードしているのはアメリカであり、日本はWHOへの出資については存在感を示しているものの、それ以外の機関への出資や二国間協力の面において、少なくとも今現在においては貢献度が大きいと見られていない。また、新薬・ワクチン開発については日本の財政的な面での貢献は全く目立たない。 　国際的な感染症対策に関する日本の印象を高めるためには、沖縄感染症イニシアティブの際になされたような形で金銭的貢献度を再び高める、あるいは、国際的に必要と考えられているものの他国が協力を決めていない分野への貢献をいち早く宣言する、等の対応が考えられる。

Myanmar migrant laborers in Ranong, Thailand

Thailand is the major destination for migrants in mainland Southeast Asia, and Myanmar (Burmese) migrants account for the dominant share. This paper sheds light on the actual working conditions and the life of Myanmar migrants in Thailand, based on our intensive survey in Ranong in southern Thailand in 2009. We found a wide range of serious problems that Myanmar migrants face in everyday life: very harsh working conditions, low income, heavy indebtedness, risk of being human-trafficking victims, harassment by the police and military (especially of sex workers), high risk of illness including malaria and HIV/AIDS and limited access to affordable medical facilities, and a poor educational environment for their children.