Global Update

Indian Pediatrics 2002; 39:607

News in Brief

Windows shopping: The internet continues to make ripples in the lives of patients, doctors and now pharmacists. A Bavarian insurance company in Germany has advised it’s patients to call for drugs via the internet site Doc Morris. This will result in 20% cheaper drugs for patients because it bypasses the pharmacists. Doctors in Germany are happy because they have to be within a particular drug budget for every patient. If they exceed the budget they are punished. The insurance companies stand to save $363.3. But this new system may well wipe out the pharmacists from Germany. The speed and access of the internet has been a boon for the customer but entire professions will have to redefine their functions (eBMJ 27 April 2002).

Time is money: Now doctors in Kentucky, USA are being paid $50 for listening to a short sales pitch from medical representatives. The American Medical Association guidelines say that doctors should not accept cash, and only gifts that are educational, patient care or practice related if worth less than may be accepted. But the doctors involved do not find it unethical and feel it barely covers the cost of their time. A previous attempt to manage doctors time effectively in Cincinnati called the Queen City Physicians used to charge $65 for 10 minutes of time and the money generated was used to fund an electronic patient database (eBMJ 11May 2002).

Two valuable reports related to health and development were released last month. The first was the Planning Commission’s, National Human Development Report. The human development index, comprising eight key indicators including incidence of poverty, access to safe drinking water, and infant mortality improved by 26% nationally during the 1980s and by another 24% in the 1990s, says the report. The BIMARU states had an index which was 50% of Kerala’s in the 80’s, but while UP, MP and Rajasthan have spruced up, Orissa continues to lag. Poverty has declined from 44% of the total population in 1983 to 26% in 1999-2000. Paradoxically , Kerala which tops in human development index has worst access to drinking water. Private spending on health has shot up from 2% in the 80’s to 7.5% in the 90’s ( http://planningcommission.nic.in/)

The UNICEF’s 12 year study of the child heath, education, nutrition, and protection in nearly 150 countries is being touted as the most comprehensive study ever of children’s health. Though child mortality fell by 11%, from 93 to 83 deaths per 1000 live births during the 1990s, in Africa and South Asia it remains extremely high with malnutrition playing a role in half of such deaths in those regions. The study urges national leaders that "investing in children from the earliest years is neither a charitable gesture nor an extravagance, but is rather the best way to ensure long-term development," It quoted a 1998 study by the Rand Corporation concluding that for every $1 (69p; C1) invested in the physical and cognitive development of infants and young children there is a $7 return-mainly from future savings on costs, such as health care, remedial education, unemployment, and crime. (We the Children: Meeting the Promises of the World Summit for Children is accessible on the Unicef website www.unicef.org).

Email [email protected]