Pharmaceutical ecomonics and politics vs. patient safety : Lumiracoxib in Australia

Lumiracoxib (Prexige©) 200 mg was listed in Australia’s Pharmaceutical Benefits Scheme (PBS) schedules on 01 August 2006. The listing was intended as a cost-minimisation strategy, as lumiracoxib 200 mg was deemed equivalent in therapeutic effect to celecoxib (Celebrex©) 200 mg, and was available at a lower cost. By the time of listing on the PBS, a safety re-evaluation of the recommended daily dose of lumiracoxib was being considered in other national regulatory jurisdictions. Within 3 months of listing, the manufacturer revised the recommended dosage to half that of the PBS-listed dosage. However, the PBS listing was neither revoked nor modified. At the time of listing on the PBS, lumiracoxib was known to be 17 times as biochemically selective in inhibiting the COX-2 isoform as celecoxib, and twice as selective as rofecoxib, already withdrawn for safety reasons. Safety concerns had already been raised about adverse hepatic outcomes on daily doses of lumiracoxib 200 mg. Communication of information about the risk potential of lumiracoxib was inadequate. Economic and political considerations were prioritised over patient safety, and lumiracoxib 200 mg remained available via the PBS until 10 August 2007, when it was withdrawn for safety reasons following cases of hepatic morbidity and mortality.

The politics of developing reference standards for nutrient intakes : the case of Australia and New Zealand

Objective Nutrient Reference Values (NRV) are evidence-based benchmarks for assessing the dietary adequacy of individuals and population groups as well as informing public health nutrition policies and programmes. The present paper presents the findings of an analysis of the views of submitters to a draft document associated with the development of the 2006 NRV for Australia and New Zealand. The aim of the study was to explore how these views were reflected in the policy-making process and final policy document.

Design The information necessary to fulfil this aim required access to stakeholder submissions to the NRV development process and this necessitated exploiting the provisions of the Commonwealth of Australia’s Freedom of Information (FOI) Act 1982. We understand that the present research represents the first time that an FOI request seeking information about a National Health and Medical Research Council food and nutrition policy process has been made and therefore is novel in its approach to public health nutrition policy analysis.

Results The analysis of stakeholder submissions identified that stakeholders had particular concerns about the conduct of the review process and the future application of the nutrient values to policy and programmes. There is a lack of evidence that the majority of stakeholder comments were addressed in the final NRV document.

Conclusion Although these findings cannot be interpreted to assess the validity or otherwise of the set nutrient values, they do raise questions about the process for their development and the adequacy of the final document to reflect the views of key stakeholders.

Prediction politics : the politics of econometric modelling in Australia

Examines the scepticism that accompanies econometric modelling in Australia in the context of the shift from public to commercial funding. It subsequently assesses scientific status claims while arguing that taking the politics of econometric modelling seriously promotes both better debate and better policy formation.

Politics of accommodation of the Rise of China : the case of Australia

In the context of the rise of China, Southeast Asian countries and Australia have begun shifting towards an accommodation policy. Robert Ross examines the accommodation policy in South Korea, Mochizuki discusses Japanese accommodationists, and Manicom and O’Neil show some evidence of Australian accommodation of Chinese strategic preferences. The scholarship has, however, narrowly focused on and overestimated the role of security. Through a study of the origin, process, structural conditions and impacts of accommodation policy, this paper broadens the concept of accommodation to capture its multiple meanings and practices. It finds that a selective accommodation policy and strategy toward the rise of China developed in Australia is a sign of the changing power relations under which the mainstream paradigms of containment and engagement, hard balancing or bandwagoning, have proved inadequate to the task of dealing with China, and that economic interdependence has driven the politics of accommodation in Australia and several Asian countries.

The politics of solidarity with indigenous struggles in Southeast Australia

This research discerned and analysed the politics of non-Indigenous solidarity with Indigenous struggles in southeast Australia, producing a valuable resource for present and future generations of non-Indigenous activists. The research responds to Indigenous people’s challenges and attempts to draw non-Indigenous people into consideration of self-understanding, interests and complicity.

The politics of coastal policy, planning and governance in Canada and Australia : business as usual, at a distance, or collaborative?

Canada and Australia are countries with substantial coastal zones which provide significant economic, social and environmental benefits and opportunities. The coastal zones of Canada and Australia also share significant threats such as, pollution, loss of biodiversity, and climate change, while also facing different challenges that are unique to their particular contexts. Effective management of such zones therefore represents a considerable challenge because of the: complexity of biophysical processes; multiple threats faced; uncertainties associated with understandings of such processes and threats, and the multiple jurisdictions and stakeholder viewpoints as to how such environments should be managed. Further, coasts and the sustainability of coastal resources and ecosystems have been argued to represent ‘wicked problems’ such that their governability is called into question. Therefore drawing on recent experiences in coastal policy, planning and governance in Newfoundland, Canada, and Victoria, Australia, this paper assesses the adequacy of current approaches to coastal governance in the two jurisdictions. In doing so we draw on recent policy and governance literature to consider whether coastal policy, planning and governance in Newfoundland and Victoria, reflect a collaborative, neoliberal, or business as usual (ad hoc, top down) approach. Based on such an assessment we consider the prospects for more integrated coastal zone management in each jurisdiction, as well as broader implications for governance and the resilience of coastal systems. It is argued that while both jurisdictions would benefit from a more collaborative approach, the mechanisms for bringing about such an approach would vary and will not come easily in light of institutional and historic barriers.

A journey through places: politics of spatial location in the stories of South Asian diaspora in Australia

In this paper, I analyse the post-colonial and post-modern experiences in the light of questions and issues concerning the spatial identities or locations that the diasporans carry. By politics of spatial location, I mean a migrant's positions within power hierarchies created through geographic, historical, political, economic and other socially stratifying factors in the new homeland. This paper is mainly concerned with the theoretical ways in which a shift is accelerated in Australia's literary landscape by the South Asian diasporic writers who produce and cover the dynamics of politics of location in different contexts. It also focuses on South Asian diaspora's widely agreed ‘ability to recreate their cultures in diverse locations’. I conclude that these stories are not just of spaces but also of a promising future for the South Asian diaspora in Australia.