E-DRUG: Research article: 2015 India-Nepal border blockade, Trade in medicines & the public's health
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Dear E-drug Colleagues
We would like to share our paper "Trade in medicines and the public's
health: a time series analysis of import disruptions during the 2015
India-Nepal border blockade", recently published in *Globalization and
Health*. In this paper that I co-authored with Shiva Raj Mishra (Nepal
Development Society/University of Queensland) and Warren Kaplan (Boston
University), we assessed the impact of the 2015 India-Nepal border blockade
on the volume and prices of medicines imported into Nepal.
Open-access links to the article:
Manuscript:
https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-017-0282-0
As many of you may know, in early 2015 Nepal was struck by devastating
earthquakes and this was followed by the unfortunate border-blockade
imposed by Indian government. Several national and international media/news
articles covered stories on the India-Nepal border blockade with particular
focus on the observed shortages of essential commodities like fuel,
medicines and healthcare in Nepal.
However, the actual impact of the blockade has never been quantified.
In our study, we explore the impact of this blockade on the Nepalese population's access to many health care commodities which Nepal imported from India, by analyzing real-world trade data on unit prices and volumes before, during and after the blockade.
More generally, while there have been long-standing debates focused on aligning
trade policies with human rights and improving access to essential health
technologies, these have been limited primarily to the global intellectual
property rights regime. There is a general lack of empirical evidence on
how international trade, particularly the cross-border movement of health
technologies, enhances or deteriorates population health.
We asked how well Nepal's trading history with India prior to the
earthquake and blockade was able to predict unit prices of health
commodities imported into Nepal during and after the earthquake and the
blockade.
We found that, during the blockade period (September 2015-early
February 2016), the volume of all retail medicines traded across the
India-Nepal border was reduced by 46.5% compared to same months in
2014 / 2015. For medical dressings, large volumes were exported from India to
Nepal during and shortly after the earthquakes (May - June 2015), but
decreased soon thereafter.
During the earthquake, trade in various biomedical commodities showed no
unusual patterns. However, for several months during the border blockade, Nepal paid over USD 22.3 million more for retail medicines than one would have
predicted based on its prior trading history with India, enough to provide healthcare to nearly half of Kathmandu's citizens for 1 year.
Our study found that the money spent by Nepal on medicines over and above that predicted from 4 years of prior trade had significant opportunity costs with respect
to the public's health.
This study also demonstrates what it means for one country to be,
in effect, dependent on a single exporter. In principle, nations will
engender public health risk if they are not regularly importing biomedical
commodities from other nations worldwide and are most vulnerable if they
have no or limited local production.
Please feel free to share the article with those who might be interested,
and we will be glad to receive your feedback/comments.
Thanks
Abhishek
Abhishek Sharma, BPharm, MPH
Department of Global Health
Center for Global Health and Development
Boston University School of Public Health
801 Massachusetts Ave, 3rd floor, Boston, MA, USA
Associate Health Economist
Precision Health Economics (Evidence Strategy & Generation)
1505 West 2nd Avenue, Suite 302, Vancouver, BC, Canada
abhishek sharma <abhisheksharma0991@gmail.com>