Illicit Opiate Abuse

Illicit opiate use, especially injected drugs, contributes to premature mortality and morbidity in many developed and developing societies. The economic costs of illicit drug use are substantial. Fatal overdoses and HIV/AIDS resulting from sharing dirty needles and injecting equipment are major contributors to mortality and morbidity. Illicit opioid use accounted for 0.7 percent of global disability–adjusted life years in 2000. An estimated 15.3 million people, or 0.4 percent of the world population ages 15 to 64, used illicit opioids in 2002, with more than half using heroin and the rest using opium or diverted pharmaceuticals such as buprenorphine, methadone, or morphine. The most popular interventions for illicit opioid dependence in many developed societies have been law enforcement efforts to interdict the drug supply and enforce legal sanctions against drug use. One consequence has been that illicit opioid users have been exposed to the least effective intervention: imprisonment for drug or property offenses. The most effective intervention to reduce blood–borne virus infection resulting from illicit drug injections is provision of clean injecting equipment to users. This intervention has been widely supported in developed countries, but less so in developing countries. In addition, vaccinations are effective against hepatitis B. In treatment settings, the most popular interventions have been detoxification and drug–free treatment, which has proven the least productive in retaining opioid–dependent people in treatment. Opioid agonists have a niche role in treatment of opioid dependence, especially if their efficacy improves with development of long–acting injectable forms of the drug.

Improved case management and continued government investment are needed for malaria eradication in Henan Province, China

A two-year study of malaria control began in Henan Province following cuts in government malaria spending in 1993. Cost data were collected from all government levels and on treatment-seeking (diagnosis, treatment) from 12,325 suspected malaria cases in two endemic counties. The cost burden was found to fall mainly on patients, but using government infrastructure. Good stewardship requires continuing government investment, to at least current levels, along with improved case management. In mainland China, vivax malaria is a significant factor in poverty and economic underdevelopment.

An Economic Analysis of the Legal Concept of Trustees' Power of Investment

Authorised trustee status is a legal concept which has economic implications; one of the major implications is that it assists in the direction of investment funds into particular securities and areas of the economy. The concept of authorised trustee status, while attempting to achieve specific outcomes for the beneficiaries of trusts cannot be relied upon to secure these results. Economic analysis of the role of the trustee maintains that this role is one of portfolio manager; a role which is complex but which is explicable in terms of definable procedures and practices. The role of trustee as portfolio manager is one which requires greater financial knowledge than can be assumed is possessed by all trustees. The trustee as portfolio manager is required to maintain a review of decisions make under powers to invest trust assets. A solution to the problem of authorised trustee status is proposed. The solution takes two parts: the first is the adoption of the prudent person approach but with the codification of duties of the trustee and the explicit listing of the factors that a trustee should consider in using the investment powers. The second part of the proposed solution is to link the investment powers of trustees to the best practice features of securities advisers who are now licensed by a regulatory body, the Australian Securities and Investment Commission.