BMJ  2005;331:904-905 (15 October), doi:10.1136/bmj.331.7521.904-c

Letter

Health in Africa

It's time for good guidelines on health financing practice

The first 150 words of the full text of this article appear below.

EDITOR—The intervention of global organisations in the public health systems of African countries^{1 2} is a form of research involving humans and should be subject to the Declaration of Helsinki and good clinical practice guidelines.^{3 4}

In structural reforms, global organisations (the investigators) work to convince the governments of countries (legal representatives of the study subjects) to take part in health financing reforms (or policy experiments, the new "medical" procedure). Since the health consequences of the interventions are largely unknown and the outcomes are used as a basis of an evidence base, these policy interventions are a form of experimentation (medical research) and should be subject to the same scrutiny as other studies. But they fall far short.

The Declaration of Helsinki is infringed from the main consideration being related to financial outcomes rather than the wellbeing of the human subjects (reduced government budget deficit is a poor surrogate marker . . . [Full text of this article]

Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait dball@hsc.edu.kw

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