International Public Health

Col. Dr. Gilvan Ramos, MD, MPH      
Member of the Bolivian Society of Public Health, Bolivia; Member, National Pharmaco-therapeutic Committee on HIV, Bolivia.

[emedpub – International Public Health :   Vol 1:2]                   [Date of Publication: 07.08.2011]
ISSN pending


Global HIV epidemic brought a set of responses, both with the advent of antiretroviral (ARV) drugs and the management models needed to purchase them. Medication management is an indispensable process in response to any epidemic. In case of HIV in many countries it was learning through trial and error; at the beginning of the epidemic. However, in recent years there have been great strides in the international management of drugs, many of them motivated by the dynamics of antiretrovirals. According to preliminary information from the Clinton Foundation, Bolivia is the country that is buying ARVs at the lowest price in the region. This is contrary to the usual logic of procurement process, since Bolivia is also one of the countries that buys the least amount of medications.

This article summarizes the positive and negative experiences of Bolivia in the process of procurement of these drugs and also describes the factors that contributed and those that hindered the process.

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S.K.Verma,MD1, R.Prasad,MD2
1. Professor, Department of Pulmonary Medicine
2. Prof & Head, Department of Pulmonary Medicine.

[emedpub – International Public Health : Vol 1:1] [Date of Publication: 06.30.2011]
ISSN pending


Objectives:To determine if the results of PPD change by keeping PPD vials at room temperature (320 C-350 C) for 72-120 hours. The control comprised of PPD vials maintained in the cold chain (20C-80C).

Design of study: Prospective study from 15 July to 31 August, 2008.

Material and methods: For this study, both suspected and confirmed tuberculosis patients attending the Chest department during 15 July to 31 August, 2008 were recruited and were divided into different groups. For patients of first group (suspected tuberculosis patients), both vials of PPD were used and PPD was given in both the forearms of the same patient. Left forearm was given PPD which was refrigerated while on the right forearm, PPD kept at room temperature (320 C-350 C) for 72 – 120 hours was given. For the second group, (confirmed tuberculosis patients), patients were alternatively given PPD (one given refrigerated while the next patient was given PPD kept at room temperature).

Results: In the first group, of 80 patients, 72 (90%) had exactly identical results on both forearms. In the second group too, no difference was found with the size of PPD reaction.

Conclusions: The results suggest that one time loss of refrigeration up to 120 hours did not alter efficacy of PPD.

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