Mostrando las entradas con la etiqueta European Union. Mostrar todas las entradas
Mostrando las entradas con la etiqueta European Union. Mostrar todas las entradas

16 mayo, 2012

EU Parliament and EMA conflict of interests

Flag of the European Parliament 1973-1983. Lat...
Flag of the European Parliament 1973-1983. Later replaced by the common European flag. (Photo credit: Wikipedia)
 EU Parliament says no and no again to EMA: Independent groups echo decision
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PRESS RELEASE

Brussels, 15 May 2012 - Health Action International (HAI) Europe, the International Society of Drug Bulletins (ISDB) and the Medicines in Europe Forum (MiEF) welcome and support the European Parliament's decision to postpone the discharge of the European Medicines Agency's (EMA) accounts (2012).  For the second year in a row, the Parliament has postponed this decision due to concerns, among others, about the management of conflict of interest risks at the Agency.

Greater independence is needed to ensure the reliability of EMA's advice. The EMA relies on scientific experts to evaluate the safety and efficacy of medicines that could enter the European market. However, findings of inconsistencies and omissions in experts' interest declarations have motivated the European Parliament to call for an overhaul of the system that is now "primarily based on trust rather than on verification" (European Parliament, 2012).  We echo the Parliament's call on the EMA to check, systematically and at random, declarations of interest and to verify their contents in order to avoid conflicts of interest that could harm public health (European Parliament, 2012).

Katrina Perehudoff of HAI Europe, states: "The EMA is ultimately responsible for the quality and independence of scientific advice provided by its experts, therefore it is essential for the EMA to be not only accountable for experts' complete and accurate declarations of interest, but also for their thorough scrutiny."

Improved policies to remove the risk of conflicts of interest are still needed at EMA. Disappointingly, in 2012, the EMA's policy on handling the declared interests of its staff members still does not guarantee that medicines files will at all times be handled by independent regulatory staff (EMA, 2012). We call not only for the adoption of stronger staffing rules to ensure public trust in the regulatory process, but also for their rigorous enforcement.

The European Parliament has already asked for further information about how EMA's policy on handling the declared interests of its staff members is being implemented (European Parliament, 2012). Last week, the European Parliament also reflected concerns raised by civil society about the EMA's application of the Staff Regulation. Citing the example of the Agency's former Executive Director and his post-service employment by a consultancy that advises, among others, pharmaceutical companies, the European Parliament described the EMA's management of the case as "clear proof that the Agency did initially not apply the Staff Regulations properly, which in turn raises serious questions about their application of the rules in general" (European Parliament, 2012). 

Jörg Schaaber of ISDB, states: "Improperly handled risks of conflicts of interest notably arising from managing staff who join the EMA after working for the industry, or who leave the Agency to work for pharmaceutical companies, casts a shadow on the independence of the EMA and on its capacity to independently evaluate medicines."

The EU Parliament has a crucial role to play in eliminating conflicts of interest at EMA. Last week's vote is a step in the right direction. As part of its role in holding Agencies accountable to European citizens, we urge the European Parliament to commit to the elimination of conflicts of interest at the EMA. It is particularly important that conflicted experts do not participate in EMA's Committees. Among others, two concrete and short term actions could be:

- ensuring that the future patient and healthcare professional representatives belonging to the Management Board (EMA, online) and/or to the Scientific Committees, for example as proposed Commission appointees, do not represent organisations sponsored by the drug and medical device industry, and are free of conflicts of interest (MiEF and ISDB, 2010).

- requiring that the European Court of Auditor's Special Report on conflicts of interest management is made publicly available, and requiring the Agency to explain any shortcomings identified and the measures taken or intended to take to rectify shortcomings and prevent any further shortcomings.

ENDS

References:
European Medicines Agency, 2012. Decision on rules relating to Articles 11a and 13 of the Staff Regulations concerning the handling of declared interests of employees of the European Medicines Agency [online]. Article 4.3. Available at : http://www.ema.europa.eu/docs/en_GB/document_library/Other/2012/02/WC500122908.pdf

European Medicines Agency. Management Board [online]. Available at:http://www.ema.europa.eu/ema/index.jsp?curl=pages/about_us/general/general_content_000098.jsp&mid=WC0b01ac0580028c2f Accessed on 15 May 2012.

European Parliament, 2012. Decision of 10 May 2012 on the closure of the accounts of the European Medicines Agency for the financial year 2010 [online]. Point 1. Available at: http://www.europarl.europa.eu/sides/getDoc.do?type=TA&language=EN&reference=P7-TA-2012-175 Accessed 15 May 2012.

European Parliament, 2012. Resolution of 10 May 2012 with observations forming an integral part of its Decision on discharge in respect of the implementation of the budget of the European Medicines Agency for the financial year 2010 [online]. Points 25, 27, 29, 31, 33 and 34. Available at:http://www.europarl.europa.eu/sides/getDoc.do?type=TA&language=EN&reference=P7-TA-2012-175 Accessed 15 May 2012.

Medicines in Europe Forum and International Society of Drug Bulletins, 2010. EMA's policy on conflict of interest: improvements needed [online]. Available at:http://www.isdbweb.org/documents/uploads/press/EMA_COI_Final.pdf

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Link to this press release online: http://haieurope.org/wp-content/uploads/2012/05/15-May-2012-Press-Release-EU-Parliament-says-no-and-no-again-to-EMA.pdf

HAI Europe. Health Action International (HAI) is an independent global network of health, consumer and development organisations working to increase access to essential medicines and improve their rational use. More info:www.haieurope.org. Contact Katrina@haieurope.org

ISDB. International Society of Drug Bulletins (ISDB), founded in 1986, is a world wide network of bulletins and journals on drugs and therapeutics that are financially and intellectually independent of pharmaceutical industry. Currently, ISDB has nearly 80 members in more than 40 countries around the world. More info: www.isdbweb.org. Contact: press@isdbweb.org

MiEF. Medicines in Europe Forum (MiEF), launched in March 2002, covers 12 European Member States. It includes more than 70 member organizations representing the four key players on the health field, i.e. patients groups, family and consumer bodies, social security systems, and health professionals. Such a grouping is unique in the history of the EU, and it certainly reflects the important stakes and expectations regarding European medicines policy. Admittedly, medicines are no simple consumer goods, and the Union represents an opportunity for European citizens when it comes to guarantees of efficacy, safety and pricing. Contact: pierrechirac@aol.com

Katrina Perehudoff

European Projects Manager
Health Action International, Europe
Overtoom 60/II
1054 HK Amsterdam
The Netherlands
Tel: +31 20 683 3684
Fax: +31 20 685 5002
Email: katrina@haieurope.org
Follow HAI Europe on Twitter or Facebook  

09 febrero, 2012

Drugs: Free Trade Agreement that would prove harmful to access to medicines

NEW YORK, NY - JUNE 08:  Demonstrator Arifa Za...
Image by Getty Images via @daylife
Source: List E-Drugs                                En Castellano 


Dr Unni Karunakara, International President of Medecins Sans Frontieres,
has written an open letter to Indian Prime Minister Dr Manmohan Singh,
setting out MSF's concerns over remaining provisions in the EU/India Free
Trade Agreement that would prove harmful for access to medicines:

The Honourable Dr. Manmohan Singh
Prime Minister of India
South Block, Raisina Hill
New Delhi -110 011
India
Geneva, 8 February 2012

Honourable Prime Minister,

Ahead  of  the  India-Europe Summit on 10 February 2012, where a roadmap to
conclude  the  EU-India free trade agreement (FTA) is set to be agreed, the
international  medical  humanitarian  organization Medecins Sans Frontieres
(MSF)  would  like to draw your attention to specific harmful provisions in
the  proposed  intellectual  property (IP) and investment chapters, that if
included would have serious implications for access to affordable medicines
in India and throughout the developing world.

MSF  today  relies  overwhelmingly on affordable generic HIV/AIDS medicines
produced  in  India to treat nearly 180,000 people in 20 countries, as well
as  using medicines from India to treat other diseases such as tuberculosis
and  malaria.  India  has  played  a  pivotal  role in supplying affordable
generic  versions  of  drugs  used  throughout the developing world.  It is
vital  therefore  that  further  barriers are not created that threaten the
supply of affordable generic medicines from India.

As  such,  the  March  2011  official  statement  by Minister Anand Sharma,
against  the  introduction  of  'data  exclusivity' was welcomed by MSF and
others  given  the  harmful  effect  it  would have on access to affordable
medicines  produced in India. We urge the Indian government to stand strong
in  this  and  in  future  free trade agreements, such as the one currently
being  negotiated  with  the  European  Free Trade Association countries of
Switzerland, Iceland, Norway and Liechtenstein.

However   the  enforcement  and  investment  provisions  within  the  draft
agreement  are  still  a  matter for serious concern as unchanged they will
have  significant negative implications for generic production critical for
ensuring  access  to  affordable  medicines  in  India  and  throughout the
developing world.

We therefore urge India to take a similarly strong stand in relation to the
remaining harmful provisions, particularly:

Enforcement  provisions:
-  The European Commission's proposed text is broad
in  scope and goes well beyond what has already been agreed and implemented
by  India  under  the  TRIPS  Agreement.
-  The EC had reproduced some of the enforcement  measures  contained in the Anti-counterfeiting Trade Agreement (ACTA)  over which the Indian government has raised serious concerns at the
WTO,  stating  that  the  agreement will 'impede legitimate competition and
shift  the  escalated  costs  of  enforcing  private  commercial  rights to
governments, consumers and taxpayers' [1].

The EU is proposing an ambitious enforcement agenda that:

     Widens the enforcement net so that life-saving legitimate medicines,
     under alleged trademark infringement, could be detained or destroyed
     at the border when being exported, simply because their label appears
     similar to the originator product. Although this is often justified
     on the basis of protecting the public from fake medicines, this issue
     is entirely separate, and will do nothing to improve medicines
     safety.  It would in fact have a negative impact on access to
     treatment, as is evident from the recent seizures of Indian generic
     medicines in EU countries. The impact of any such detentions will be
     felt directly by patients awaiting the arrival of crucial generic
     medicines in the many countries that do not have manufacturing
     capacity to produce medicines, and therefore rely on importing more
     affordable generics from India;

     Substantially increases the penalties for alleged patent and
     trademark infringements.  On a mere allegation - and not proof -
     including allegations brought by a competitor, generic suppliers
     allegedly infringing a patent or a trademark may face a ban on
     production, delay or destruction of goods, disproportionate damages,
     and  potential bankruptcy;

     Limits the Indian courts' ability to balance commercial and public
     health interests and the Indian Constitution's guarantee to the right
     to life, by making use of a variety of alternative remedies rather
     than as the EU proposes, routinely granting provisional injunctions;
     and

     Extends liability to third parties, thereby putting at risk of
     injunctions and provisional measures a wide variety of public health
     stakeholders, including: suppliers of active pharmaceutical
     ingredients used for producing generic medicines; distributors and
     retailers who stock generic medicines; NGOs such as MSF who provide
     treatment; funders who support health programmes; and drug regulatory
     authorities who examine medicines. This could act as a significant
     deterrent to anyone involved in the production, sale or distribution
     of affordable generic medicines.

Investment  Chapter:  The European Commission is also pushing for the trade
deal  to  be  expanded  in  scope  so that it covers investments, including
intellectual property, and supports an 'investor-to-state' mechanism.

This  would  allow  multinational  drug  companies  to  bypass  the  Indian
judiciary and take the Indian government to private arbitration courts over
investment  disputes in relation to intellectual property, in order to seek
to  reverse  domestic health policies like tobacco warnings and measures to
reduce  prices  of  medicines.  Pharmaceutical  companies  must be given no
additional  avenues  to  pressure  India  on policies and laws that promote
access  to  medicines.  India  is already reeling from multiple litigations
filed  by  companies  like  Novartis  and  Bayer  against health safeguards
enshrined in India's patent law.

In  order  to  ensure  that  the  EU-India FTA does not undermine access to
medicines,  the  additional threats posed by the enforcement and investment
provisions  must  be  addressed.  At  a  minimum,  we would urge the Indian
Government to request the following safeguards are contained in the roadmap
to ensure that damage caused to people's access to medicines is minimised:

     The withdrawal of the IP enforcement measures, and as a minimum
     safeguard, the deletion of patents from the entire scope of the
     enforcement section;

     The withdrawal of third party liability from the enforcement
     provisions;

     The withdrawal of specific provisions dealing with injunctions from
     the enforcement provisions in order to preserve the existing
     flexibilities of the Indian judicial system;

     Border enforcement should be limited to the requirements of the TRIPS
     Agreement and as such exclude exports and trademark infringements;
     and

     The withdrawal of IP and the investor-to-state mechanisms from the
     scope of the investment chapter.

India  has  already  shown that it is prepared to stand firm against harmful
demands  from  the  European  Commission.  As the negotiations are reaching
their final stages we urge you to maintain your vigilance and commitment to
preserving  the  space  for  continuation  of  the  generic  production  of
medicines that we and so many in India and beyond rely upon.

Yours sincerely,
Dr Unni Karunakara
International President
Medecins Sans Frontieres

c.c. Honourable Minister of Commerce and Industry of India Shri Anand
Sharma
c.c. Honourable Minister of External Affairs of India Shri S. M. Krishna

[1]
http://arstechnica.com/tech-policy/news/2010/06/india-launches-offensive-against-acta-cites-due-process.ars

Joanna Keenan
Press Officer
Medecins Sans Frontieres - Access Campaign
E: joanna.keenan[at]geneva.msf.org
T: @joanna_keenan


II Part
Reputable manufacturers exporting medicines into countries of high
temperature and/or humidity are clearly testing their medicines and making them fit
for climate zone III and IV in particular when a drug regulatory authority
of the importing country makes it a prerequisite. Appropriate testing
requiremens can be found, for example at the homepage of the World Health
Organization:

http://www.who.int/medicines/areas/quality_safety/quality_assurance/regulato
ry_standards/en/index.html


Unfortunately, on national scale, many countries accept much lower drug
development standards for medicines moving into commerce. For example, in
India, all products are labelled "to be stored below 25 degree Celsius". Here,
local manufacturers are pushing the responsibility for product stability
downstream into the supply chain, for example to the shop keepers and consumers.
This is nationally accepted standard and done even though knowing that
medicines is frequently sold in drug outlets openly without air conditioning or even
a refrigerator. As India gradually became "the pharmacy of the developing
world" these low standards moved along with them. And you just saw the
consequences.

Yours sincerely

Richard Jähnke, PhD
Project Management

Global Pharma Health Fund e.V. (GPHF)
Otto-Meßmer-Straße 1, 60314 Frankfurt, Germany
Head Office: T +49-69-962387-600, F +49-69-962387-609, info@gphf.org
Project Office: T +49-69-46939-662, F +49-69-46939-852,
richard.jaehnke@gphf.org

07 junio, 2011

Peligro por E.Coli La bacteria asesina


DAÑO. Hat más de 1800 infectados en Europa y unos 18 años. La OMS dice que se trata de un problema a nivel global y expertos creen que la fuente de contagio está en Alemania. Sin embargo, esta cepa es una vieja conocida en América Latina.

Agencias e Internet.


¿Peligro a la vista? Un fuerte brote de la cepa Escherichia coli o  también llamada E. coli ha puesto en alarma a toda Europa  con más de 1800 casos de contagio y unas 18 muertes.

Los científicos apuntan a que esta situación se debería al consumo de  vegetales o alimentos contaminados con la referida bacteria. 

Sumado a esto, la situación se torna alarmante más aún con la postura de la Organización Mundial de la Salud (OMS), al indicar que la bacteria es conocida pero jamás hubo un brote así en el mundo.

Ataca a los intestinos

Se sabe incluso que esta E. coli, por sí sola no genera ningún mal en la salud, sin embargo, la cepa que ya está originando las infecciones y muertes en el mundo posee la característica de adherirse fuertemente a las paredes de los intestinos donde bombea toxinas provocando en algunos casos diarrea sangrienta u otras severas complicaciones.

Además, la citada cepa letal  sería en verdad la combinación de dos cepas, lo cual tiene como resultado una cepa mucho más dañina, según dijo a la BBC el Dr. Alfredo Torres, coordinador de la Red Latinoamericana de Investigación en Escherichia coli.
Conocida en América Latina

Refirió también que diferentes variedades de la E. coli están presentes principalmente  en las regiones de  América Latina, Asia y África.

Asimismo, la bacteria es considerada como una de las principales causas de infecciones gastrointestinales en niños menores de 5 años en el mundo que está en desarrollo.

Incluso se calcula que un 7% de la población infantil de las regiones antes citadas, muere a causa de las diarreas provocadas por la E.coli. En los casos de los que sobreviven, tienen graves secuelas como malnutrición y complicaciones digestivas por el resto de su vida.

Por otra parte, la Organización Mundial de la Salud (OMS)  informó que la diarrea mata cada año en el mundo a 2.2 millones de personas, de los cuales 1.5 millones son niños menores de cinco años.

Lanzan advertencia

Entre las recomendaciones que se están dando en los países afectados con el brote de la E.coli, destaca la promoción de una higiene  personal, dado que el contagio también puede darse de una persona a otra.

También las precauciones implican el almacenamiento de vegetales en lugares limpios, algunos especialistas hasta recomiendan evitar comer verduras crudas.

Actualmente, el país que enfrenta un grave problema con la E.coli es la Argentina, donde la variante 0157 H7 produce el síndrome umérico hemolítico (SUH), que causa insuficiencia renal y hasta la muerte.

La alarma ya está dada y según los especialistas, un descuido en esta parte de la región sería “devastador”.


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26 noviembre, 2010

Delayed FDA Removal of Painkiller Propoxyphene

FdaImage via Wikipedia
Delayed FDA Removal of Painkiller Propoxyphene (Darvon, Darvocet) From U.S. Market Has Cost More Than 1,000 U.S. Lives

Statement by Dr. Sidney Wolfe, Director, Public Citizen’s Health Research Group

Note: Public Citizen petitioned the FDA in 1978 and 2006 to ban propoxyphene.

The announcement by the U.S. Food and Drug Administration (FDA) that propoxyphene-containing products are finally going to be taken off the market * because of dangers previously known and acted upon, with bans announced in the UK almost six years ago, and in Europe, almost 1½ years ago * is a serious indictment of the FDA’s long-lasting unwillingness to protect people in this country from a deadly but barely effective painkiller. In announcing the ban in 2005, the UK stated that the efficacy of propoxyphene (sold generically and under the brand name Darvon) “is poorly established and the risk of toxicity in overdose, both accidental and deliberate, is unacceptable” and that “[I]n relation to safety, there is evidence that fatal toxicity may occur with a small multiple of the normal therapeutic dose and a proportion of fatalities are caused by inadvertent overdose.” The FDA’s claim that this is the first evidence that the drug is dangerous at the “standard therapeutic dose” thus rings dangerously hollow.

The FDA’s deadly delay in this case starkly illustrates how one of the most important public health concepts, the precautionary principle, was embraced by the UK and Europe, but was for too long recklessly rejected by the FDA.

Evidence going back more than 30 years indicates that propoxyphene is not very effective, is toxic at doses not much higher than the recommend dose because a heart-toxic metabolite accumulates in the body, and is somewhat addictive. It has been linked to many thousands of U.S. deaths since 1981, a large proportion of which were likely caused by cardiac toxicity, including the interruption of electrical conduction in the heart.

Since the time of the UK announcement in January 2005 of a phased, two-year withdrawal of this drug (which was followed by an immediate steep decline in use), approximately 120 million retail prescriptions have been filled in the U.S. for propoxyphene-containing drugs. These include Darvocet, which contains propoxyphene and acetaminophen and, primarily, the generic versions of the drug.

Due to FDA negligence, at least 1,000 to 2,000 or more people in the U.S. have died from using propoxyphene since time the UK ban was announced. The best forensic data, the kind relied upon in those countries for the UK and European bans, come from Florida where, because of routine drug testing required by the state medical examiner as part of many autopsies, deaths are categorized as being “caused” by certain drugs if the levels found are to be above a certain level. From 2005 through 2009, in Florida alone, 395 deaths were “caused” by propoxyphene. If data from 2007 are representative, in that year, 78 percent of the Florida deaths caused by propoxyphene were ruled accidental.

Our February 2006 petition to the FDA to ban the drug, following the UK ban announcement, did not even result in an FDA advisory committee hearing until we had sued the agency in 2008 to force them to respond to our petition. The subsequent January 2009 FDA advisory committee hearing resulted in a 14-12 vote in favour of banning propoxyphene, despite some FDA efforts to sway the committee against voting for a ban. In July 2009, several weeks after the European Medicines Agency announced its ban, the FDA denied our petition to ban the drug.

The FDA’s pitiful excuse that it needed to order a human study to find that “the drug puts patients at risk of potentially serious or even fatal heart rhythm abnormalities” before deciding whether to ban propoxyphene only emphasizes how out-of-step the agency is with the rest of the world * which already had enough human evidence of death and near-death in tens of thousands of people to act accordingly.

In a study on dogs published 31 years ago, researchers at Lilly, the discoverer of propoxyphene, stated that “cardiac conduction depression may be a factor in some of the [human] cardiac toxicities associated with propoxyphene overdose.” This study examined the same kind of function measured in the human study now being put forth by the FDA as a justification for belatedly banning propoxyphene.

We will ask for and support a congressional investigation into whom in the FDA, specifically in the Centre for Drug Evaluation and Research, was responsible for the loss of so many lives in this country. It is clear that long before today, many drug safety experts in the Office of Surveillance and Epidemiology had decided the drug should be removed from the market.

Note: For a chronology of events related to Darvon and Darvocet, go to
http://www.citizen.org/documents/chronologyofinactions.pdf

Public Citizen is a national, non-profit consumer advocacy organization based in Washington, D.C. For more information, please visit www.citizen.org.

Regards

Sidney M. Wolfe MD
Director, Health Research Group at Public Citizen
1600 20th St. NW
Washington, DC 20009
Phone: +1 202 588-7735
Swolfe@citizen.org
www.worstpills.org
www.citizen.org/hrg