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  • Second governments can play an important part in providing

    2019-04-22

    Second, governments can play an important part in providing incentives for industry to invest in discovering new uses for old drugs. For example, it cotransport could consider the extension of patent protection for old drugs that have found new uses, for example, as embodied in the Hatch-Waxman Act in the USA. Third, it can provide more funding to support research aimed at better understanding of the modes of action of drugs, a fundamental requisite in discovering new uses for old drugs. Such support should emphasise the application of newer in silico approaches and the harnessing of computer power in the fields of computational drug discovery, biomedical informatics, and so-called big data analytics.
    Xpert MTB/RIF (Cepheid, Sunnyvale, CA, USA) is the biggest recent advance in tuberculosis diagnosis, and since 2010 more than 15 million cartridges have been procured through concessional pricing ($9·98 per cartridge in 2015). However, even in countries with a high tuberculosis burden, the private sector is not eligible for concessional pricing for Xpert, nor for other WHO-endorsed tests such as line probe assays (LPA) and liquid cultures. Manufacturers set higher prices for reagents and instruments for private laboratories and institutions than for the public sector, and there are additional costs (such as import duties), and margins imposed by distributors, intermediaries, and laboratories. Why does private sector pricing and access matter? The cotransport private sector is a major source of health care in 12 of the 22 countries with the highest tuberculosis burden, including India, Pakistan, the Philippines, Bangladesh, Afghanistan, Kenya, Uganda, Vietnam, Indonesia, Myanmar, Nigeria, and Cambodia. In these economies, even poor patients with tuberculosis seek care from private health-care providers, and delayed diagnosis and misdiagnosis are important problems.
    We reported the results of the PRECOG study in the inaugural issue of (July, 2013). Although visual outcomes of cataract surgery have usually been assessed weeks or months after surgery, isotonic study of 4000 patients at 40 hospitals in low-income and middle-income countries (LMICs), where few patients return after operations, demonstrated that assessment of vision the day after surgery could reliably measure operative quality. We felt the readers of might be interested to hear about the next chapter of this work.
    Lancet Glob Health —The fourth sentence of the second paragraph should have read “Vasectomy prevalence is 12% in Northern America and 11% in Oceania and Northern Europe”; “Northern America” is the UN-designated name for the USA and Canada combined. A citation to reference 1 has also been added. This has been corrected online as of Jan 26, 2016.