An economic case for providing free access to antiretroviral therapy for HIV-positive people in South Australia

Background As financial constraints can be a barrier to accessing HIV antiretroviral therapy (ART), we argue for the removal of copayment requirements from HIV medications in South Australia. Methods Using a simple mathematical model informed by available behavioural and biological data and reflecting the HIV epidemiology in South Australia, we calculated the expected number of new HIV transmissions caused by persons who are not currently on ART compared with transmissions for people on ART. The extra financial investment required to cover the copayments to prevent an HIV infection was compared with the treatment costs saved due to averting HIV infections. Results It was estimated that one HIV infection is prevented per year for every 31.4 persons (median, 24.0–42.7 interquartile range (IQR)) who receive treatment. By considering the incremental change in costs and outcomes of a change in program from the current status quo, it would cost the health sector $17 860 per infection averted (median, $13 651–24 287 IQR) if ART is provided as a three-dose, three-drug combination without requirements for user-pay copayments. Conclusions The costs of removing copayment fees for ART are less than the costs of treating extra HIV infections that would result under current conditions. Removing the copayment requirement for HIV medication would be cost-effective from a governmental perspective.

Submission to the Australian Government’s Online Copyright Infringement Discussion Paper

Now is not the time to increase the strength of copyright law. Copyright law is facing a crisis of legitimacy: consumers increasingly appear to doubt its moral weight. To a large extent, this can be traced to the fact that Australian consumers do not believe they are being treated fairly by (predominantly US-based) copyright producers and distributors. Compared to their overseas peers, Australian consumers pay much more for access to books, films, television, and computer games, and are often subjected to long delays before material is available in Australia. Our research shows that this perceived unfairness increases the willingness of Australian consumers to seek out alternative distribution channels. Put simply, the failure of content distributors to meet consumer demand in Australia is a leading factor in copyright infringement. This submission argues that the best strategy to reduce copyright infringement in Australia, at the present time, is for distributors to focus on providing timely, affordable, convenient and fair access to copyright goods. Until this is done, the prevalence of copyright infringement in Australia should be seen as essentially a market problem, rather than a legal one. The Australian Government, meanwhile, should address the recommendations of the IT Pricing Report as a matter a priority. As a first step, the Government should urgently consider repealing the IP exception to competition law in s 51(3), as recommended by the Ergas committee, the IT Pricing report, and the ALRC. This change alone may go a long way to enhancing the efficiency of the copyright market in Australia.

How does access to development finance shape our cities?

In market economies the built environment is largely the product of private sector property development. Property development is a high-risk entrepreneurial activity executing expensive projects with long gestation periods in an uncertain environment and into an uncertain future. Risk lies at the core of development: the developer manages the multiple risks of development and it is the capital injection and financing that is placed at risk. From the developer's perspective the search for development capital is a quest: to access more finance, over a longer term, with fewer conditions and at lower rates. From the supply angle, capital of various sources - banks, insurance companies, superannuation funds, accumulated firm profits, retail investors and private equity - is always seeking above market returns for limited risk. Property development presents one potentially lucrative, but risky, investment opportunity. Competition for returns on capital produces a continual dynamic evolution of methods for funding property developments. And thus the relationship between capital and development and the outcomes for the built environment are in a restless continual evolution. Little is documented about the ways development is financed in Australia and even less of the consequences for cities. Using publicly available data sources and examples of different development financing from Australian practice, this paper argues that different methods of financing development have different outcomes and consequences for the built environment. This paper also presents an agenda for further research into these themes.

Improving access to housing for low-income communities in Dhaka: From rhetoric to reality in community participation

The research explores how community participation can address affordable housing problems of the poor in Dhaka. The research, based on extensive interviews, community focus groups and household surveys in different Dhaka slums, identifies the limiting factors to promote community participation in affordable housing creation. In Dhaka housing options for poor are currently limited to affordable shelters in informal settlements. Public housing programs have failed to reach the poor and meet affordability levels due to a number of factors including lack of beneficiary participation. Beneficiary participation, though widely recognized for success in housing initiatives, often deteriorates in process of implementation into mere involvement, not reflecting community needs and aspirations and thus failing to meet its core objectives. This research identified the most significant impediments as well as opportunities to advance participation in their own housing provisions in Dhaka city.

Access to the Internet Submission to ALRC IP 46

This submission is directed to issues arising in respect of the need to recognise and support access to the internet for all Australian residents and citizens. As such it addresses the following questions only: Questions 2-1: What general principles or criteria should be applied to help determine whether a law that interferes with freedom of speech is justified? Question 2-2: Which Commonwealth laws unjustifiably interfere with freedom of speech, and why are these laws unjustified?

The effectiveness of communication interventions in providing older people with information on access to in-home health and social care services: A systematic review protocol

The objective of this review is to locate, critically appraise and synthesize evidence on the effectiveness of communication strategies for providing older people access to information regarding in-home health and social care services. The review question is: What is the effectiveness of communication interventions in providing older people with information about in-home health and social care services?

How an urban Aboriginal and Torres Strait Islander primary health care service improved access to mental health care

Aboriginal and Torres Strait Islander people experience higher levels of psychological distress and mental ill health than their non-Indigenous counterparts, but underuse mental health services. Interventions are required to address the structural and functional access barriers that cause this underuse. In 2012, the Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care employed a psychologist and a social worker to integrate mental health care into its primary health care services. This research study examines the impact of this innovation.

Incentives for global public health: Patent law and access to essential medicines

This portrait of the global debate over patent law and access to essential medicines focuses on public health concerns about HIV/AIDS, malaria, tuberculosis, the SARS virus, influenza, and diseases of poverty. The essays explore the diplomatic negotiations and disputes in key international fora, such as the World Trade Organization, the World Health Organization and the World Intellectual Property Organization. Drawing upon international trade law, innovation policy, intellectual property law, health law, human rights and philosophy, the authors seek to canvass policy solutions which encourage and reward worthwhile pharmaceutical innovation while ensuring affordable access to advanced medicines. A number of creative policy options are critically assessed, including the development of a Health Impact Fund, prizes for medical innovation, the use of patent pools, open-source drug development and forms of 'creative capitalism'.

Access to essential medicines: Public health and international law

Historically, there have been intense conflicts over the ownership and exploitation of pharmaceutical drugs and diagnostic tests dealing with infectious diseases. Throughout the 1980’s, there was much scientific, legal, and ethical debate about which scientific group should be credited with the discovery of the human immunodeficiency virus, and the invention of the blood test devised to detect antibodies to the virus. In May 1983, Luc Montagnier, Françoise Barré-Sinoussi, and other French scientists from the Pasteur Institute in Paris, published a paper in Science, detailing the discovery of a virus called lymphadenopathy (LAV). A scientific rival, Robert Gallo of the National Cancer Institute, identified the AIDS virus and published his findings in the May 1984 issue of Science. In May 1985, the United States Patent and Trademark Office awarded the American patent for the AIDS blood test to Gallo and the Department of Health and Human Services. In December 1985, the Institut Pasteur sued the Department of Health and Human Services, contending that the French were the first to identify the AIDS virus and to invent the antibody test, and that the American test was dependent upon the French research. In March 1987, an agreement was brokered by President Ronald Reagan and French Prime Minister Jacques Chirac, which resulted in the Department of Health and Human Services and the Institut Pasteur sharing the patent rights to the blood test for AIDS. In 1992, the Federal Office of Research Integrity found that Gallo had committed scientific misconduct, by falsely reporting facts in his 1984 scientific paper. A subsequent investigation by the National Institutes of Health, the United States Congress, and the US attorney-general cleared Gallo of any wrongdoing. In 1994, the United States government and French government renegotiated their agreement regarding the AIDS blood test patent, in order to make the distribution of royalties more equitable... The dispute between Luc Montagnier and Robert Gallo was not an isolated case of scientific rivalry and patent races. It foreshadowed further patent conflicts over research in respect of HIV/AIDS. Michael Kirby, former Justice of the High Court of Australia diagnosed a clash between two distinct schools of philosophy - ‘scientists of the old school... working by serendipity with free sharing of knowledge and research’, and ‘those of the new school who saw the hope of progress as lying in huge investments in scientific experimentation.’ Indeed, the patent race between Robert Gallo and Luc Montagnier has been a precursor to broader trade disputes over access to essential medicines in the 1990s and 2000s. The dispute between Robert Gallo and Luc Montagnier captures in microcosm a number of themes of this book: the fierce competition for intellectual property rights; the clash between sovereign states over access to medicines; the pressing need to defend human rights, particularly the right to health; and the need for new incentives for research and development to combat infectious diseases as both an international and domestic issue.

The race to patent the SARS virus: The TRIPS agreement and access to essential medicines

This article considers the race to sequence the Severe Acute Respiratory Syndrome virus ('the SARS virus') in light of the debate over patent law and access to essential medicines. Part II evaluates the claims of public research institutions in Canada, the United States, and Hong Kong, and commercial companies, to patent rights in respect of the SARS virus. It highlights the dilemma of ’defensive patenting' - the tension between securing private patent rights and facilitating public disclosure of information and research. Part III considers the race to patent the SARS virus in light of wider policy debates over gene patents. It examines the application of such patent criteria as novelty, inventive step, utility, and secret use. It contends that there is a need to reform the patent system to accommodate the global nature of scientific inquiry, the unique nature of genetics, and the pace of technological change. Part IV examines the role played by the World Trade Organization and the World Health Organization in dealing with patent law and access to essential medicines. The article contends that there is a need to ensure that the patent system is sufficiently flexible and adaptable to accommodate international research efforts on infectious diseases.

Evaluation of a remote drafting system for regulating sheep access to supplement

Remote drafting technology now available for sheep makes possible targeted supplementation of individuals within a grazing flock. This system was evaluated by using 68 Merino wethers grazing dry-season, native Mitchell grass pasture (predominantly Astrebla spp.) as a group and receiving access to lupin grain through a remote drafter 0, 1, 2, 4 or 7 days/week for 8 weeks. The sole paddock watering point was separately fenced and access was via a one-way flow gate. Sheep exited the watering point through a remote drafter operated by solar power and were drafted by radio frequency identification (RFID) tag, according to treatment, either back into the paddock or into a common supplement yard where lupins were provided ad libitum in a self-feeder. Sheep were drafted into the supplement yard on only their first time through the drafter during the prescribed 24-h period and exited the supplement yard via one-way flow gates in their own time. The remote drafter operated with a high accuracy, with only 2.1% incorrect drafts recorded during the experimental period out of a total of 7027 sheep passes through the remote drafter. The actual number of accesses to supplement for each treatment group, in order, were generally less than that intended, i.e. 0.02, 0.69, 1.98, 3.35 and 6.04 days/week. Deviations from the intended number of accesses to supplement were mainly due to sheep not coming through to water on their allocated day of treatment access, although some instances were due to incorrect drafts. There was a non-linear response in growth rate to increased frequency of access to lupins with the growth rate response plateauing at similar to 3 actual accesses per week, corresponding to a growth rate of 72.5 g/head. day. This experiment has demonstrated the application of the remote drafting supplementation system for the first time under grazing conditions and with the drafter operated completely from solar power. The experiment demonstrates a growth response to increasing frequency of access to supplement and provides a starting point with which to begin to develop feeding strategies to achieve sheep weight-change targets.

Safeguard your access to trial by jury

In Watney v Kencian & Wooley [2014] QDC 290 Morxone QC DCJ considered the implications for defendants who desired a trial by jury, but who had relied on the election for that mode of trial made by the plaintiff in the statement of claim.

Access To Justice In The ASEAN The Key Role Of UNCITRAL

UNCITRAL’s operation as a subsidiary of the UN General Assembly, tasked to unify and harmonise international trade law is a necessary and indispensable element of the UN’s mandate to maintain international peace and security. Strong legal frameworks which are compatible with those of international trading partners often accompany accelerated growth in economic capacity and stability. Over time, access to markets and resultant growth in economic and human development creates a disincentive for instability as incomes and standards of living rise. Human and economic development, facilitated by a modernised and just legal framework that is available to the broadest range of recipients goes hand in hand with the maintenance of domestic and regional peace, particularly in regions such as the ASEAN , one of the fastest growing in the world covering approximately 30% of global population and with a number of strong global economic neighbours including Japan, Korea, China (to the north), Australia (to the south) and Singapore (to the west). In an increasingly interconnected world, the ability of government, enterprise and individuals to participate in the global supply chain offers opportunities for economic growth and development. Over its almost 50 years of operations, UNCITRAL has produced a range of important texts that are designed to underpin world trade. A key implicit assumption underpinning the development of UNCITRAL texts is that the texts, once adopted can and will be applied in adopting states.

Digital access to knowledge in the preschool classroom: Reports from Australia

Australian preschool teachers’ use of Web-searching in their classroom practice was examined (N = 131). Availability of Internet-enabled digital technology and the contribution of teacher demographic characteristics, comfort with digital technologies and beliefs about their use were assessed. Internet-enabled technologies were available in 53% (n = 69) of classrooms. Within these classrooms, teacher age and beliefs predicted Web-searching practice. Although comfortable with digital access of knowledge in their everyday life, teachers reported less comfort with Web-searching in the context of their classroom practice. The findings identify the provision of Internet-enabled technologies and professional development as actions to support effective and confident inclusion of Web-searching in classrooms. Such actions are necessary to align with national policy documents that define acquisition of digital literacies as a goal and assert digital access to knowledge as an issue of equity.