Delving into the Developing World

The purpose of this blog is to explore the state of affairs of biotechnology in the developing world. In regions of the world where people have some of the gravest medical issues, financial constraints often prohibit adequate treatment. Despite the difficulties encountered when trying to remedy this situation, individuals, governments, and corporations across the world are working towards improving health outcomes. In an attempt to investigate biotechnology in the developing world, we divided the topic into three subtopics: Devices and Procedures (juliana); Medical Tourism (mansi); and Vaccines and Pharmaceuticals (raj and ben). The entries highlight some of the important challenges and accomplishments in each category. While biotechnology has accomplished much in the Western world, its potential has yet to be realized in the developing world.

Raj, Mansi, Juliana, and Ben

Tuesday, November 20, 2007

“The state of the art is not compatible with the state of our purse.”

The Management of End-Stage Renal Disease in India
By MUTHU KRISHNA MANI
Published: 1998
Artificial Organs Volume 22, Issue 3

     This article, written by a doctor working in an Indian hospital, discusses the economic impact of treating renal disease in a developing country.
There are currently 3 treatment options for patients suffering from end stage renal disease (ESRD) in India:
-- renal transplantation (which encompasses both live and cadaveric donor programs)
-- maintenance hemodialysis
-- continuous ambulatory peritoneal dialysis (CAPD)
     All of these treatments are routinely performed in the United States, and in other developed countries. However, the median American income in 1997 was $42,294, while the article states that the per capita income in India in 1995-96 was 9,321 Rupees per year, which is approximately $260. As the author chillingly concludes, “A renal transplant would therefore take more that 20 years’ earnings of the average Indian, and only a miniscule minority can afford to pay for it.” (The average cost of a renal transplant is 200,000 Rupees.) Dialysis, both hemodialysis and CAPD, is even more expensive, much more expensive, than this, and is usually only employed during the preparation period before a transplant is performed, rather than used for long-term treatment.
     Most of the population relies on health care that the government provides. But renal treatments are not provided for by the government, and must come out of pocket. The huge cost of renal transplantation may lead some to believe that not many are performed in India, but this is not the case. Many patients in need of a renal transplant take out loans, sell some of their possessions, or ask for help from their employers or charity organizations. Some patients also ask family members to pitch in or loan them money, but because the average annual income is so low, these loans hardly ever get repaid, and the family ends up poorer than before. Dialysis is even more out of reach, with CAPD being affordable exclusively to the very rich.
     In contrast, in the United States, renal treatment is paid for by the government, regardless of need. People have the option of either doing dialysis in the comfort of their own homes, or in a hospital setting. It is sickening to think that people in India and other developing countries are barely able to get the care they need to treat their end stage renal disease, while people in America are bringing their pets to the vet to have them undergo dialysis for $5000 a week. If only this money and these devices could be used to help the people of the developing world…
     Thus, the sad conclusion we must make is that while the biotechnology and the doctors are there, the resources, supplies, and funds are just not available to these developing countries to implement these simple and lifesaving procedures that are taken for granted in developed countries.

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