Guy Ash's List: WK3 Discussion: Analysis and Strategy for NPO

"Doctors without Borders? Relicensing
Requirements and Negative Selection
in the Market for Physicians
Adriana D. Kugler,
University of Houston, Universitat
Pompeu Fabra, CEPR, CREA, and IZA
Robert M. Sauer,
University of Southampton and IZA
Relicensing requirements for professionals who move across borders
are widespread. In this article, we measure the effects of occupational
licensing by exploiting an immigrant physician retraining assignment
rule. Instrumental variables and quantile treatment effects estimates
indicate large returns to acquiring an occupational license and neg-
ative selection into licensing status. We also develop a model of op-
timal license acquisition that, together with the empirical results,
suggests that stricter relicensing requirements may lead not only to
practitioner rents but also to lower average quality of service in the
market for physicians."

"I have long admired the organization Medecins Sans Frontieres (MSF), or Doctors Without Borders. My experiences as a doctor in Haiti left a yet unanswered void in me, which the voice of Doctors Without Borders continually calls to. Although originally of French origins, its member doctors and other personnel now come from every area of the globe.

“Today, MSF provides aid in over 70 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion of health care, or natural disasters,” DoctorsWithoutBorders.org explains.

MSF’s history is replete with humanitarian missions and bravery beyond what most can imagine. If the terms first, second and third world are considered, MSF has gone into fourth world regions, where unspeakable occurrences of horror and cruelty are happening, to offer their medical help.

“On any one day, more than 27,000 committed individuals representing dozens of nationalities can be found providing assistance to people caught in crises around the world,” the site continues. “They are doctors, nurses, logistics experts, administrators, epidemiologists, laboratory technicians, mental health professionals, and others who work together in accordance with MSF’s guiding principles of humanitarian action and medical ethics.”"

"Doctors
without (Virtual) Borders:
Internet
Effects on
Epistemic Communities
Maj James D. Fielder, USAF
Department of Political Science
The University of Iowa
james
-
fielder@uiowa.edu
Abstract:
Epistemic communities
existed long before the widespre
ad adoption of Internet
technology in the mid
-
1990s. However, the Internet offers an array of new opportunities for
epistemic communities
, particularly non
-
government organizations (NGOs). The purpose of this
research design is to propose a method
to com
par
e the effects of
Internet use between NGOs
founded before widespread Internet adoption, or
legacy
NGOs, and NGOs founded
post
-
adoption
, or
transformative
NGOs.
To build
my argument
,
I
first
present
NGOs
and the Internet
through the
framework of constru
ctivism.
I
contend that not only do epistemic communities
reflect constructivist thought, but that Internet can also be viewed as a physical constructivist
structure in both design an
d use.
I
then
propose a qualitative content
analysis
research design
to
analyze two NGOs:
Médecins Sans Frontières
(legacy)
and Team Rubicon
(transformative).
I
expect to find differences between each
case based on language content, which should indicate
how epistemic comm
unities adapt to the Internet."

"An outstanding charity that is unlucky enough to get a few bad reviews can receive a mediocre rating from GreatNonprofits. The highly regarded Doctors Without Borders, which receives an A rating from CharityWatch, receives only 3.5 out of 5 stars from GreatNonprofits as of February 2012. Why? Largely because two of only six reviewers downgraded the charity—one for a billing error that was not immediately resolved, and one for a misunderstanding that the charity's low cost of raising funds was too high. "

"There is an American group called Homeopaths without Borders (HWB), who claims that it provides humanitarian aid, in the form of homeopathic “medicine”, to devastated areas of the world. The more famous group that does real lifesaving work across the world, Doctors without Borders, are probably too busy, utilizing real evidence-based medicine with real medications, risking their own lives, and performing great service humanity, to be worried that a bunch of pseudoscientific homeopaths stole their noble trademark to push quackery.

HWB is sending their water magicians to Haiti, Guatemala, Dominican Republic, Sri Lanka, and El Salvador, all countries that have suffered so much during the past few years. During their time in Haiti, “the team will be in Port-au-Prince to complete the final session of the Fundamentals Program—a foundational curriculum in homeopathic therapeutics incorporating theoretical and clinical training.” So not only are they providing nonsense, useless, unscientific healthcare to Haiti, they are training new homeopaths there. Haiti needs to train real doctors who use science based medicine, not quack medicine."

"New agreement on patents for medicines in
Francophone Africa threatens health of populations
Doctors Without Borders calls upon the Francophone countries of Africa not to sign
the new patent agreements (Bangui 99)

Abidjan/New York, May 11, 2000. In a press conference today in Abidjan, Ivory Coast, the international medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) called on 15 French-speaking African countries* not to sign the revised regional trade agreement (Bangui 99). A joint report** released by the World Health Organization (WHO), UNAIDS and Doctors Without Borders warns of the negative consequences of such an agreement on access to essential medicines.

The revised arrangement relating to intellectual property (Bangui 99) reinforces the monopoly given to patent-holders beyond existing requirements in international trade rules and would cause a major obstacle to access to medicines. It also discourages the transfer of technology necessary for the development of the regional pharmaceutical industry and threatens to increase dependence on imports of medicines.

"Doctors in Africa are increasingly faced with a lack of life-saving medicines--either because they are too expensive, or because they do not exist. The revised Bangui Agreement means Francophone countries in Africa will no longer be able to shop around for the cheapest medicines, nor will they be able to produce drugs locally," said Bernard Pécoul, M.D., director of the Doctors Without Borders Access to Essential Medicines Campaign.

During the process of revising Bangui, extensive technical assistance was provided by international organizations. Yet, the advice did not lead to the inclusion of the flexible use of safeguard features recommended by US President Clinton, French President Chirac and WHO Director General Dr. Brundtland, such as parallel imports and compulsory licensing. Doctors Without Borders demands that technical assistance that is offered to countries to change their laws takes into consideration the public health needs of developing countries and the advice of world leaders.

The joint MSF-WHO-UNAIDS report shows that, in addition to extending the duration of patents to 20 years, in accordance with international intellectual property rules (Trade Related Aspects of Intellectual Property Rights)***, the new Bangui agreement is more restrictive than necessary under World Trade Organization (WTO) rules:

it imposes stricter conditions on the use of compulsory licenses
it prohibits parallel imports from countries outside the 15-country-bloc involved

"The new rules mean the price of medicines will be 10 to 20 times more than they would be if they were generic. For people suffering from AIDS or other serious infections such as meningitis or pneumonia, this is basically a death sentence," added Dr. Pécoul.

Doctors Without Borders therefore makes the following recommendations to the States affected:

Do not sign the Bangui Accord of 1999 in its current form
Revise the agreement before signing
Allow the ten "least developed" countries that qualify for another 5 year "transition period" (until 2006) under WTO rules not to revise their laws until then.

In addition Doctors Without Borders recommends that the expertise of WHO be sought in the revision of the agreement to ensure that the interests of public health are preserved.

If the protection of pharmaceutical innovation is essential to public health,
then so is the affordability of medicines.

______________________________________

* Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Congo (Brazzaville), Gabon, Guinea, Guinea-Bissau, Ivory Coast, Mali, Mauritania, Niger, Senegal, and Togo.

**Boulet, Pascale and Forte, Gilles Bernard, “Review of the Pharmaceutical Policy in Cameroon: Medicine patents in Francophone Africa,” Joint Mission MSF-WHO-UNAIDS (Report available in English and French).

***Right of governments to produce locally or import a medicine that is still under patent, while respecting certain obligations to patent holders.

"

"Somalia: Reality of Doctors Without Borders Departure Sets in
By Abdi Moalim, 20 August 2013
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Photo: Siegfried Modola/MSF
Lab technician

Mogadishu — Citizens across Somalia are beginning to sense the full ramifications of the decision of international aid agency Doctors Without Borders (MSF) to stop all operations in Somalia due to insecurity.

"Beyond the killings, abductions, and abuses against its staff, operating in Somalia meant MSF had to take the exceptional measure of utilising armed guards, which it does not do in any other country, and to tolerate extreme limits on its ability to independently assess and respond to the needs of the population," MSF said August 14th.

"MSF's decision will have a huge impact on the Somali public because the organisation provided a very wide range of medical services such as treatment to malnourished children, patients with various injuries, and delivering mothers needing operations," said Ahmed Mohamed Khalif, director of Beledweyne General Hospital.

Khalif should know, MSF stopped operations at his hospital in December 2012. Since the hospital re-opened its doors in 2007, Khalif said 72,000 patients have received medical assistance from MSF. But since the international aid agency left at the end of last year -- along with its skilled personnel and financial resources -- the hospital has been struggling to cope.

After MSF left, services provided at the Beledweyne hospital were severely cut, he said. In addition to losing MSF's international staff, medical supplies and equipment, the hospital also lost most of its local staff because it could no longer afford to pay them without the agency's financial support.

Small local organisations are helping the hospital keep its doors open, but in no way have they filled the gap MSF has left, he said.

Other entities, such as African Union Mission in Somalia (AMISOM) clinics, are also trying to fill the vacuum, but many of these are temporary and target only specific ailments like cholera.

"

"Doctors Without Borders/Médecins Sans
Frontières (MSF)
is an international,
independent, medical humanitarian
organization that delivers emergency aid to
people affected by armed conflict, epidemics,
natural disasters and exclusion from
healthcare in nearl
y 70 countries.
MSF began
providing antiretroviral (ARV) treatment for
HIV/AIDS in 2000, and now treats 222,000
people in HIV/AIDS projects in 23 countries.
More than
80% of the AIDS drugs that MSF
uses worldwide are generics from India.
MSF routinely also relies on generic drugs to
treat TB, malaria, and a wide range of
infectious diseases.
MSF is concerned about the public health implications of the U.S.’s IP demands
on the countries
currently negotiating the TPP.
Furthermore
, as the final text of the TPP is likely to become a precedent
for future trade agreements and IP negotiations, MSF is concerned that these restrictive IP policies,
known as “TRIPS
-
plus” provisio
ns, will be imposed on additional developing countries, including where
MSF works, affecting access to medicines for millions of patients."

"Ninety-five percent of this movie is digital. Actors mingle with digital characters, puppets, and people wearing "rubber heads;" and they all move through landscapes and cities on three planets, Tatooine, Coruscant, and Naboo, which have been assembled from bits and pieces of live-action footage, miniature sets, digital models, and matte paintings. Machines are sometimes physical models, sometimes digital models, sometimes background paintings. Water, dust, fire, and smoke might be real elements in a digital environment, or digital elements in a miniature set. At ILM, the artists, technical directors (TDs), and animators used every computer graphics technique in the shop, and when those weren't enough, they invented new ones. "This is the digital back lot George [Lucas] talked about" says Barry Armour, a CG supervisor. "