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    Social networks and health policy: the case of misoprostol and the WHO model essential medicine list. 
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    Social networks and health policy: the case of misoprostol and the WHO model essential medicine list.

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    Published version
    Embargoed until: 2100-01-01
    Reason: Publisher won't allow use of published version
    Accepted Version (1.972Mb)
    Volume
    132
    Pagination
    190 - 196
    DOI
    10.1016/j.socscimed.2015.03.011
    Journal
    Soc Sci Med
    Metadata
    Show full item record
    Abstract
    The WHO Essential Medicines List (EML) was established to help countries prioritise medicines according to their health care needs. Selection for the List is based on rigorous scrutiny of public health relevance, evidence on efficacy and safety, and comparative cost effectiveness. The WHO ideal is that a medicine and its efficacy are based on science, but in reality a medicine has a social life and the acceptance of a pharmaceutical intervention involves the interaction of a wide array of governmental and civil society organisations, and industry. Misoprostol is a medicine widely used for both abortion and prevention of postpartum haemorrhage in low income countries. Although the evidence for the latter is highly contested it was nevertheless added to the WHO EML in 2011. We use social network analysis to examine the social, political and economic field surrounding the WHO EML applications and health policy. We describe a chronology of the drug's use and of the applications to the WHO EML and carry out a social network analysis of the organisations and individuals involved in the applications, research and dissemination. The research identified a network of 238 organisations and individuals involved in the promotion of misoprostol for postpartum haemorrhage and present at the time of the WHO EML applications. There is a strong interdependency between the funding bodies, civil society organisations, researchers and clinician organisations. The research was part of an EU FP7 funded project on Accessing Medicines in Africa and South Asia (2010-2013).
    Authors
    Millard, C; Brhlikova, P; Pollock, A
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/12728
    Collections
    • Centre for Primary Care and Public Health [1467]
    Language
    eng
    Licence information
    doi:10.1016/j.socscimed.2015.03.011
    Copyright statements
    Crown copyright © 2015 Published by Elsevier Ltd.

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