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dc.contributor.authorBrhlikova, Pen_US
dc.contributor.authorHarper, Ien_US
dc.contributor.authorJeffery, Ren_US
dc.contributor.authorRawal, Nen_US
dc.contributor.authorSubedi, Men_US
dc.contributor.authorSanthosh, Men_US
dc.date.accessioned2016-07-20T12:18:25Z
dc.date.available2011-04-29en_US
dc.date.issued2011-04-29en_US
dc.date.submitted2016-07-07T10:45:29.523Z
dc.identifier.other10.1186/1744-8603-7-10
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/13582
dc.descriptionThis article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
dc.description.abstractBACKGROUND: Building appropriate levels of trust in pharmaceuticals is a painstaking and challenging task, involving participants from different spheres of life, including producers, distributors, retailers, prescribers, patients and the mass media. Increasingly, however, trust is not just a national matter, but involves cross-border flows of knowledge, threats and promises. METHODS: Data for this paper comes from the project 'Tracing Pharmaceuticals in South Asia', which used ethnographic fieldwork and qualitative interviews to compared the trajectories of three pharmaceuticals (Rifampicin, Oxytocin and Fluoxetine) from producer to patient in three sites (north India, West Bengal and Nepal) between 2005-08. RESULTS: We argue that issues of trust are crucial in reducing the likelihood of appropriate use of medicines. Unlike earlier discussions of trust, we suggest that trust contexts beyond the patient-practitioner relationship are important. We illustrate these arguments through three case studies: (i) a conflict over ethics in Nepal, involving a suggested revised ethical code for retailers, medical representatives, producers and prescribers; (ii) disputes over counterfeit, fake, substandard and spurious medicines, and quality standards in Indian generic companies, looking particularly at the role played by the US FDA; and (iii) the implications of lack of trust in the DOTS programmes in India and Nepal for the relationships among patients, government and the private sector. CONCLUSIONS: We conclude that the building of trust is a necessary but always vulnerable and contingent process. While it might be desirable to outline steps that can be taken to build trust, the range of conflicting interests in the pharmaceutical field make feasible solutions hard to implement.en_US
dc.description.sponsorshipThis paper emerged from the collaborative research project Tracing Pharmaceuticals in South Asia (2006-2009) that was jointly funded by the Economic and Social Research Council and the Department for International Development (RES-167-25-0110).en_US
dc.format.extent10 - ?en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofGlobal Healthen_US
dc.titleTrust and the regulation of pharmaceuticals: South Asia in a globalised world.en_US
dc.typeArticle
dc.rights.holder© Brhlikova et al; licensee BioMed Central Ltd. 2011
dc.identifier.doi10.1186/1744-8603-7-10en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/21529358en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
pubs.volume7en_US
dcterms.dateAccepted2011-04-29en_US


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