Prompt 8: Describe existing and proposed strategies to address your issue. Discuss the advantages and disadvantages of the proposed strategies. Describe contrasts in the way different people, places, and things are impacted by these strategies.

    It should first be noted that for these strategies to be ever planned out and applied to these situations, comprehensive research must be done first. High-income countries such as the United States and the United Kingdom have the financial stability to invest in these types of research to find proper solutions for these issues. But middle-income and low-income countries still don’t have the financial stability for them to properly research these matters. Research isn’t the only way to find solutions even though it might give ideas for solutions that we may never have thought of it. Strategies can also be created by just looking at obvious problems and plenty of hospitals in middle- and low-income countries have done just that. Some strategies that lots of hospitals of all income countries have implemented are always recommending alternative pain medications before prescribing a serious dose of opioids, communicating with suppliers for alternative short pain-relieving medicine, looking out for supply and usage, and updating to new medications whenever necessary that is better than opioids as for chances of addictiveness. These strategies are advantageous to all countries because they help solve problems of individuals not getting addicted quickly to opioids, if opioids are not available, alternatives can help in countries where individuals need some sort of pain medication, and always keeping track of supply helps alert everybody when there could be the chance of shortage so arrangements can be made to handle them.

    For high-income countries, shortages tend to rise but the main problem that occurs is people start to rely too much on these drugs. There are a few strategies applied by these countries to tackle shortages of individuals being dependent on opioids, and opioids mixed with other substances that roam in certain communities. Some of these strategies are to create programs for populations that abuse drugs, education and prevention methods, stricter enforcement and policies, and a tracking system that warns hospitals when shortages could start to arise. The advantage of these strategies is that it helps people recover from their addictive behaviors and if warnings of shortages can be spotted, proper planning can occur to solve that problem. The only disadvantage of this would be that there is always that chance of people not recovering at all and their life becoming worse than before.

    For middle-income and low-income countries, their strategies will be similar and different depending on the situation. For certain countries where individuals have plentiful access to cheap drugs, governmental policies and international guidelines need to be changed. By doing so, these would be the advantages, drug smuggling would stop tremendously, it would stop the flow of drugs which in turn help individuals that need those drugs and stop others from being dependent on them, and by working on international guidelines, it will help countries work together to distribute these drugs wherever it may be needed at certain times. As for disadvantages, there always be people that will seek ways to smuggle these drugs into these countries and even mix them with dangerous substances because people have been too dependent from the start. For certain countries where individuals need these pain medications but can’t due to regulations, strategies that need to be implemented are to change government restrictions, communicate with suppliers, and provide alternatives when needed. From this, the advantages would be that surgeries can take place, and individuals can be given proper opioids when needed and don’t have to suffer a great deal of pain. Providing alternatives can be somewhat effective in helping individuals who could not have the addictive behaviors that opioids have. The only disadvantage would be that this would take a considerable amount of time no matter when they start.

Prompt 7: Describe as many of the parties involved in your issue as possible. Don’t stop with those directly involved (those that experience disease or health inequity). Examine your issue as one that connects to other people and groups? Explain what connects all these people to the issue. How are they impacted? What might be their outlook on the issue? What shapes their outlook? Nationality? Class? Rich or poor? Educated versus uneducated? Race? Historical circumstances? A sense of injustice? A right to a livelihood? Give these people motivations for taking a particular outlook on this issue?

    Everyone is entitled to have the right access to medical services and medicine to aid them whenever their health is threatened. As for which parties are involved in this issue, any person that needs medications to relieve some type of pain is certainly involved in this issue. The first party that is involved in this matter would be the pharmaceuticals, doctors, nurses, medical faculty, and patients in countries that can afford to have these drugs available when needed. Lots of medical treatments require anesthesia and pain drugs before and after surgery so no additional pain occurs. But in countries with developed medical systems, there are chances of certain individuals taking advantage of their powers and that’s where doctors will abuse their powers and possibly certain patients start to become addicted. More nurses and medical faculty will be needed to help patients recover from addictive behaviors which cause more funds to be spent on that. These patients can also start to become so addicted that they must be released from the hospital because they spend their money on the drug instead of treatment. High-income countries have well-developed medical systems but also have drugs circulating in communities not well organized and funded in these countries. These opioids are also mixed with other dangerous substances such as fentanyl, which caused lots of patients that become addicted to dying. The rich doctors earn more money prescribing these drugs to patients and the patients if they get addicted will soon become poor and crave the need for these pain drugs which ultimately tends in their death.

    It’s quite different when discussing which parties are involved when talking about middle and low-income countries. The government is the first main party involved in these types of countries. The reason is that they mainly control the rules and regulations of the flow of certain drugs coming into their countries and restrict what drugs are allowed. Their main reason is that they don’t want their citizens to abuse these drugs, get addicted to them, and ultimately die from them. The government would also have to diverge its finances to create rehab and recovery center for patients wanting to recover from this even though there are chances they won’t. For creating these restrictions, they wouldn’t have diversified their funds and used them on essential things since they already aren’t comfortable with what they have. This then affects another party of the middle- and low-income countries which are the citizens themselves. Depending on the country, certain citizens are affected in different ways. Middle-income countries such as India and China produce a variety of drugs for a very affordable price compared to the prices of high-income countries. Due to these cheap prices, some citizens buy these opioids and have been dependent on them because of how effectively relieve their pain but don’t realize they're addicted to them. Because of this, another party comes in which are drug smugglers who smuggle these cheap drugs to low-income countries. But certain low-income countries such as Nigeria and Sudan have extremely strict regulations and they can’t even receive drugs when certain individuals are in dire need of them. That’s the other party that gets affected, the individuals that need surgery and don’t have any pain medications to suppress any pain before and after their medical treatment. As you can see, each party affects the other and that’s why the opioid crisis has become a worldwide health problem. As for what connects all these people and parties, it is the government. The government has the ultimate power over what rules they want to apply and how sternly they want to enforce its policies. When looking at this situation from an outside perspective, countries considered rich often suffer the problem of individuals abusing the availability of these drugs. Countries considered poor or in the middle of rich and poor usually either have individuals that need opioids but don’t have access to them or individuals have access to cheap versions of these opioids causing them to be addicted to them. All these countries have different varieties of races so it wouldn’t be just saying that certain races have the availability of these pain medications. Education could help these individuals because they can learn about their government regulations and with time, they can create some type of change to better get access to drugs to people that need them and ban them in areas where it is not needed. People that are not affected by this situation should still understand that other individuals suffer a great deal of pain because of strict regulations and availability. And others have no need for them all but use them because they have grown to be dependent on them. This is the injustice of this worldwide problem.

Prompt 6: Defining a global health issue and the relevant information for understanding it? What issue or problem has your group selected? Craft a problem statement using the ones provided to you in class. What countries or regions of the wolrd will focus on for your issue? What do you need to explain to communicate this issue to someone who doesn't know anything about it? How does social justice and fairness matter for this issue? Provide 3 URLs that provide useful background information.

 URLS:

1) https://www.frontiersin.org/articles/10.3389/fphar.2021.693426/full 

2) https://qz.com/1198965/the-surprising-geography-of-opioid-use-around-the-world 

3) https://www.goodrx.com/healthcare-access/medication-education/why-do-drug-shortages-happen 

Most countries around the world have suffered the struggle of some sort of drug shortage due to a variety of reasons. But to easily categorize these countries, it will be best to organize them into high-income, middle-income, and low-income countries. Countries that high-income countries would be the United States, Germany, and the United Kingdom. Countries that are middle-income would-be India, China, Russia, and Brazil. Countries that are low-income would-be Kenya, Nigeria, Saharan Africa, and Sudan. Each category of income in these countries has different reasons why there are drug shortages. As for high-income countries, their main reasons for drug shortages is due to wrongful business decisions, regulatory and government issues, and unavailability of raw materials. Middle-income countries and low-income countries face similar issues such as not having an abundant amount of funds to conduct research, enforce policies, and constant fear of drug smuggling. Due to this, countries on this level struggle to correctly put a set price on drugs and especially opioids. As for people that are unaware of one of the main issues that are happening globally, it is the severe problem of drug abuse. One of the most notable drugs that have been either abused or needed in areas but are unavailable is opioids. Opioids are considered narcotic drug that is used to relieve pain but for some time, it has been overused in some parts of the world and underused in others. Lots of individuals from certain countries have the luxury of having this drug availability when needed for critical medical procedures and helping to lower pain when necessary. But in these countries, opioids become open to the public and are usually mixed with other dangerous substances such as fentanyl which is the reason why so many become addicted and lose their lives to it. In then there are other countries where medical procedures will happen, and the patient will have to either deal with the pain if possible or surgeries won’t happen because of the chance that the pain might be too much for the patient. Other countries are surrounded by countries that create opioids for a very affordable cost and lots of individuals become independent on them which also takes a toll on their life. Social justice and fairness matter greatly in this issue because the people that need opioids to relieve pain don’t receive them and people that have opioids available at their fingertips abuse the drug which in turn ruins their lives.