Subject(s)
Drug Compounding , Nostrums , Pharmaceutical Services , Pharmacies , Humans , Pharmaceutical Services/history , Pharmaceutical Services/legislation & jurisprudence , Pharmaceutical Services/statistics & numerical data , Drug Compounding/history , Drug Compounding/statistics & numerical data , Nostrums/history , Nostrums/therapeutic use , United States/epidemiology , Pharmacy/statistics & numerical data , Pharmacies/history , Pharmacies/legislation & jurisprudence , Pharmacies/statistics & numerical data , History, 19th Century , History, 20th CenturyABSTRACT
Over a long history, the pharmacy was developed in close connection with Traditional Mongolian Medicine (TMM) as one part of it. TMM was Mongolia's only available healthcare method before Western medicine was introduced in the 19th century. The pharmaceutical sector, founded in 1923, played an essential role in the health system of Mongolia over the last hundred years. During the socialist time, the pharmaceutical sector was state-owned, and privatization started in 1990 when Mongolia transitioned to a market economy from a centrally planned economy. Mongolian current pharmaceutical sector is fully privatized except for public hospital pharmacies, and as of the end of 2021, 2822 pharmaceutical facilities were operating in Mongolia. Before the transition to the market economy, the functions of the pharmaceutical sector were mainly focused on the production, supply, compounding, and dispensing of drugs. Still, since 1990, the scope of pharmaceutical care services has changed. The pharmaceutical care service has been transferring from product-oriented to patient-centered care since the mid-1990s (AU)
Subject(s)
Humans , Pharmaceutical Services/history , Drug Industry/history , MongoliaABSTRACT
Abstract The University Pharmacy Program (FU), from the Federal University of Rio de Janeiro (UFRJ), was created based on the need to offer a curricular internship to students of the Undergraduate Course at the Faculty of Pharmacy. Currently, it is responsible for the care of about 200 patients/day, offering vacancies for curricular internships for students in the Pharmacy course, it has become a reference in the manipulation of many drugs neglected by the pharmaceutical industry and provides access to medicines for low-income users playing an important social function. Research is one of the pillars of FU-UFRJ and several master and doctoral students use the FU research laboratory in the development of dissertations and theses. As of 2002, the Pharmaceutical Care extension projects started to guarantee a rational and safe pharmacotherapy for the medicine users. From its beginning in 1982 until the current quarantine due to the COVID-19 pandemic, FU-UFRJ has been adapting to the new reality and continued to provide patient care services, maintaining its teaching, research, and extension activities. The FU plays a relevant social role in guaranteeing the low-income population access to special and neglected medicines, and to pharmaceutical and education services in health promotion.
Subject(s)
Pharmacy/classification , Education, Pharmacy , COVID-19/classification , Patients/classification , Pharmaceutical Services/history , Teaching/ethics , Pharmaceutical Preparations/supply & distribution , Patient Care/ethicsABSTRACT
Objetivos: Recopilar y comentar los artículos más relevantes publicados en la Revista OFIL/ILAPHAR durante los 30 años desde creación, comparándolos con las publicaciones actuales, remarcando su importancia y aplicación.Material y métodos: Se trata de una revisión del total de los artículos disponibles en la página Web www.revistadelaofil.org, tomándose en cuenta los artículos clasificados como editoriales, cartas al editor, originales, revisiones y casos clínicos.Resultados: Se clasificaron los artículos por temas, sugiriéndose la lectura de algunos artículos por cada tema. Se pudieron encontrar artículos publicados en los inicios de la revista y que aún siguen siendo vigentes en su contenido y aplicación. Es también significativo el aporte de líderes farmacéuticos de Ibero Latinoamérica quienes dejaron asentados en sus artículos sus experiencias pero principalmente su pasión por la profesión farmacéutica.Conclusión: La revisión realizada ha servido para poder conocer cómo ha evolucionado la Revista OFIL/ILAPHAR pero también para conocer cuál ha sido la transición de los conocimientos en el mundo farmacéutico en los últimos 30 años. Recomendamos su lectura para conocer nuestra historia científica, la misma que debemos seguir engrosando con rigurosidad. (AU)
Objectives: Compile and comment on the most relevant articles published in the OFIL Magazine during the 30 years of its creation, comparing it with current publications, highlighting its importance and application.Material and methods: This article is a review of all the articles available on the OFIL Journal website www.revistadelaofil.org, considering articles classified as editorials, letters to the editor, originals, reviews, and clinical cases.Results: Articles were classified by topic, suggesting the reading of some articles for each topic. Articles published in the early days of the journal and that are still current in its content and application. The contribution of pharmaceutical leaders from Ibero Latin America is also significant, who left their experiences but mainly their passion for the pharmaceutical profession in their articles.Conclusion: The review carried out has served to be able to know how the OFIL Magazine has evolved but also to know what the transition of knowledge has been in the pharmaceutical world in the last 30 years. We recommend reading it to learn about our scientific history, the same one that we must continue to rigorously increase. (AU)
Subject(s)
Humans , Periodicals as Topic/history , Pharmaceutical Services/history , Pharmaceutical Services/trends , Pharmacy Service, Hospital , Review Literature as Topic , Pharmacology , PharmacovigilanceABSTRACT
The study covers the period of World War II after shift of occupational powers in Latvia when Soviet occupation was replaced by the occupation regime of Nazi Germany in the summer of 1941 and retained until first half of 1945. Due to this shift gradually Latvia, Lithuania, Estonia and Belarus were merged into a single administrative area and designated as "Ostland". Soviet officials left the pharmaceutical industry, which they had tried to apply to the communist ideology from June 1940 to June 1941 creating confusion and chaos. The renewed Pharmacy Board of Latvia had to deal with the restoration of supervision and a partial return from the communist to the capitalist regime. The research provides an insight to adaptation and development of the pharmaceutical industry in Latvia during Nazi Germany occupation regime, highlighting as essential indicators the administrative operation of Pharmacy Board of Latvia and its cooperation with German authorities, the availability of medicines, process of reprivatisation of pharmacies and changes in the number of pharmaceutical employees. The research issue raised is topical, since it is this period that reflects the industry's ability to adapt and perform work in fundamentally different and severe circumstances, which include both resource deficits and the transition from one regime to another. The collected evidence shows the efforts to stabilize the pharmaceutical industry in many terms. One example was the attemptions to ensure the rational dispensing of medical products to the pharmacies and hospitals, with the greatest degree of austerity, because the supply and consumption of medication was extremely complex issue throughout the war.
Subject(s)
Drug Industry/history , National Socialism/history , Pharmaceutical Services/history , History of Pharmacy , History, 20th Century , Humans , Latvia , World War IIABSTRACT
On November 5th, 1808, D. João de Bragança issued a license about the practice of druggists and the price of drugs and ordered the creation of a regulation to tax the cost of medicines marketed in Brazil. First published on 1809, the Regimento dos preços dos medicamentos... gained new editions in the following years and became an indispensable working tool for those involved in the making and trading of drugs at this time. This paper situates historically and sheds light on a document briefly explored by the researchers of the history of the Brazilian pharmacy, taking into account that it was one of the first initiatives of the Luso-Brazilian government in line with the pharmaceutical activity in Brazil in the nineteenth century.
Em 5 de novembro de 1808, dom João de Bragança promulgou um alvará sobre o exercício dos boticários e o preço das drogas e ordenou a criação de um regulamento para taxar o custo dos medicamentos comercializados no Brasil. Publicado pela primeira vez em 1809, o Regimento dos preços dos medicamentos... ganhou novas edições nos anos subsequentes e tornou-se um indispensável instrumento de trabalho para os envolvidos com a feitura e o comércio dos remédios. Este texto situa historicamente e destaca esse documento brevemente explorado pelos pesquisadores da história da farmácia brasileira, visto ter sido uma das primeiras iniciativas do governo luso-brasileiro condizentes com a atividade farmacêutica no Brasil no século XIX.
Subject(s)
Fees, Pharmaceutical/history , Pharmaceutical Services/history , Pharmacies/history , Taxes/history , Brazil , Fees, Pharmaceutical/legislation & jurisprudence , Government Regulation/history , History, 19th Century , Pharmaceutical Services/economics , Pharmaceutical Services/legislation & jurisprudence , Pharmacies/legislation & jurisprudence , Taxes/legislation & jurisprudenceABSTRACT
Managed care pharmacy has a relatively short history, but one that is defined by significant achievements. Since the late 1960s, managed care pharmacists have applied their unique skills to formulary management, clinical programs, benefit design, and contract negotiations to support patient access to life-saving therapies, while also ensuring cost-effective use of limited health care resources. Key milestones include establishing the pharmacy benefit as an essential component of the U.S. health care system, launching the Medicare Part D program, and expanding medication therapy management services. The year 2020 brings another milestone-the 25th anniversary of AMCP's flagship publication, the Journal of Managed Care + Specialty Pharmacy. This year also serves as an inflection point. As managed care pharmacy professionals prepare for change and the challenges ahead-including the imperative to address the rising costs of health care and health disparities-the use of evidence, utilization management strategies, and innovation will support our continued success. DISCLOSURES: No funding supported the writing of this commentary. The authors have nothing to disclose.
Subject(s)
Managed Care Programs , Pharmaceutical Services , Anniversaries and Special Events , Drug Costs , Forecasting , History, 20th Century , History, 21st Century , Humans , Managed Care Programs/economics , Managed Care Programs/history , Managed Care Programs/trends , Medicare Part D , Medication Therapy Management , Periodicals as Topic , Pharmaceutical Services/economics , Pharmaceutical Services/history , Pharmaceutical Services/trends , United StatesABSTRACT
Resumo Em 5 de novembro de 1808, dom João de Bragança promulgou um alvará sobre o exercício dos boticários e o preço das drogas e ordenou a criação de um regulamento para taxar o custo dos medicamentos comercializados no Brasil. Publicado pela primeira vez em 1809, o Regimento dos preços dos medicamentos... ganhou novas edições nos anos subsequentes e tornou-se um indispensável instrumento de trabalho para os envolvidos com a feitura e o comércio dos remédios. Este texto situa historicamente e destaca esse documento brevemente explorado pelos pesquisadores da história da farmácia brasileira, visto ter sido uma das primeiras iniciativas do governo luso-brasileiro condizentes com a atividade farmacêutica no Brasil no século XIX.
Abstract On November 5th, 1808, D. João de Bragança issued a license about the practice of druggists and the price of drugs and ordered the creation of a regulation to tax the cost of medicines marketed in Brazil. First published on 1809, the Regimento dos preços dos medicamentos... gained new editions in the following years and became an indispensable working tool for those involved in the making and trading of drugs at this time. This paper situates historically and sheds light on a document briefly explored by the researchers of the history of the Brazilian pharmacy, taking into account that it was one of the first initiatives of the Luso-Brazilian government in line with the pharmaceutical activity in Brazil in the nineteenth century.
Subject(s)
History, 19th Century , Pharmacies/history , Pharmaceutical Services/history , Taxes/history , Fees, Pharmaceutical/history , Pharmacies/legislation & jurisprudence , Pharmaceutical Services/economics , Pharmaceutical Services/legislation & jurisprudence , Taxes/legislation & jurisprudence , Brazil , Government Regulation/history , Fees, Pharmaceutical/legislation & jurisprudenceABSTRACT
The Pharmacy Division of the Vilnius Medical Society was founded in 1819. It was the first and only pharmacy organization in Lithuania until the beginning of the 20th century. At the time of its founding, there were only three other pharmacy organizations in the Russian Empire: the Riga Chemical-Pharmaceutical Society (1803), the Mitau (now Jelgava) Pharmacy Society (1808) and the St. Petersburg Pharmacy Society (1818). The Division did much to improve the practice of pharmacy, enhance pharmaceutical knowledge and education, support and encourage pharmaceutical research, as well as provide a forum for discussion of all matters of interest and concern to the pharmacy profession. Through its publications, rich library and study collections, pharmacists in Vilnius and the Vilnius governorate stayed abreast of all the major developments and discoveries in the medical and pharmaceutical sciences. After the closing of Vilnius University in 1832 and of the Vilnius Medical-Surgical Academy in 1842, the Vilnius Medical Society, and hence its Pharmacy Division, lost its academic base. Pharmaceutical chemistry suffered especially. Pharmacists turned their attention to their practices and business interests. Their interest in the Society waned and their membership dwindled. In the beginning of the 20th century, especially after Lithuania regained its independence in 1918, other organizational opportunities opened up to them.
Subject(s)
Pharmaceutical Services/history , Pharmacists/history , Societies, Pharmaceutical/history , Chemistry, Pharmaceutical/history , Education, Pharmacy/history , History, 19th Century , History, 20th Century , Humans , Lithuania , Societies, Medical/historyABSTRACT
DISCLOSURES: No funding was received for the writing of this reflection. Avey is a member of the AMCP Foundation and has recently retired from MedImpact Health Systems, where he served as Vice President of Specialty Clinical Solutions.
Subject(s)
Formularies as Topic/history , Managed Care Programs/organization & administration , Pharmaceutical Services/organization & administration , Drug Costs/history , History, 20th Century , History, 21st Century , Managed Care Programs/economics , Managed Care Programs/history , Pharmaceutical Services/economics , Pharmaceutical Services/history , Prescription Drugs/economics , Prescription Drugs/history , United StatesABSTRACT
Objective: To review specific literature that aimed to predict the future of US pharmacy, beginning in the late 1980s. Data Sources: Articles were identified from searching MEDLINE, CINAHL, Google Scholar, and references of relevant articles. The following combinations of search terms were used: future, pharmacy, prediction, and forecast. Study Selection and Data Extraction: The following inclusion criteria were applied: (1) full-text commentary, review, or original research and (2) focused predominantly on the pharmacy in the United States. Data on predictions for the future of pharmacy were extracted. Data Synthesis: We selected 3 articles published between 1988 and 2006, with each aiming to project the future for the following decade. We examined each prediction in light of the current knowledge. Relevance to Patient Care and Clinical Practice: Educators, practitioners, and other stakeholders should consider reflecting on the changes in pharmacy for the past 3 decades and applying both historical and emerging trends to improve patient care and sustain practice in the third decade of the 21st century and beyond. Conclusion: Most of the predictions for the future of pharmacy from the past 3 decades materialized, with some still in progress (reimbursement for pharmacy services), whereas others manifested in unexpected ways (transition from shortage to excess of pharmacists). Current forces shaping pharmacy include, but are not limited to, growing spending and use of specialty drugs, automation of pharmacy operations, growth of pharmacy in the digital health enterprise, and growing consumer interest in the use of analytical pharmacy that tests drugs before dispensing.
Subject(s)
Pharmaceutical Services , Pharmacy/trends , History, 20th Century , History, 21st Century , Humans , Patient Care/standards , Patient Care/trends , Pharmaceutical Services/history , Pharmaceutical Services/trends , Pharmacies/history , Pharmacies/trends , Pharmacists/standards , Pharmacists/trends , United StatesABSTRACT
The first period of the independent state of Latvia lasted from 1918 to 1940. During this period, pharmacy in Latvia had reached a high level of development. The study covers the period after the loss of independence, when the beginning of World War II marked a major crisis in the development of pharmacy in Latvia. The aim of the study was to compile and systematize information available in published and unpublished sources on the impact of the Soviet occupation (1940-1941) on pharmacy in Latvia, which has not been studied before. The main idea of the study was to find evidence that the Soviet occupation decreased the development capacity of Latvian pharmaceutical industry and narrowed its development opportunities. At the same time, the study reflects part of the general political, ideological and economic environment in Latvia over that period. The study is retrospective and descriptive. Materials from Latvian State Historical Archives and the National Archives of Latvia, and publications from the 20th century press of Latvia were used in the study. In one year, the Soviet system attempted to aggressively transform Latvian pharmaceutical industry to match the USSR standards. This meant the destruction of the capitalist system and the free market, as well as the introduction of centralised management. The radical changes were poorly organised and unsuitable candidates were appointed to positions of responsibility. There is evidence that pharmacy in Latvia experienced complete chaos during that period: private enterprises were nationalised, the number of pharmacy professionals decreased, and medical products from abroad were not supplied to the Latvian market. The Latvian population was rescued from total lack of medications by the last major medication purchase from Germany and the Netherlands shortly before the occupation. All the USSR actions in the pharmaceutical industry were coercive. With the occupation of Nazi Germany in the summer of 1941, the Soviet functionaries left the industry. However, in 1945, during the second occupation, the previous procedures were renewed and their results strengthened. It leads to the conclusion that the Soviet political system had an adverse effect on the development of pharmacy in Latvia.
Subject(s)
History of Pharmacy , Pharmaceutical Services/history , Drug Industry , History, 20th Century , Humans , Latvia , Occupations , Retrospective Studies , USSRSubject(s)
Ethics, Professional , Pharmaceutical Services/history , Pharmacies/history , Societies, Pharmaceutical/history , History of Pharmacy , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Pharmaceutical Services/ethics , Pharmacies/ethicsABSTRACT
Introducción: Este estudio intenta dar una visión global del quehacer profesional y de la relevancia económica, política, social y de salud pública de los boticarios de Cataluña, desde su constitución, en el siglo XIII, hasta su extinción, a finales del siglo XVIII. Previamente es necesario hacer referencia al contexto histórico, al desarrollo de la salud pública durante el periodo de estudio y al origen de la profesión de boticario. Objetivo: Exponer la evolución de los boticarios en Cataluña durante el periodo de estudio. Métodos: Revisión bibliográfica, sobre la evolución de los boticarios en Cataluña, así como sobre el desarrollo de la salud pública y el contexto histórico durante el periodo de estudio. Resultados: El desarrollo de la profesión de boticario en Cataluña se puede dividir en tres etapas bien diferenciadas: el nacimiento de la profesión (siglos XIII-XV), la consolidación de la profesión (siglos XVI- XVII) y la decadencia de la profesión (siglo XVIII)
Introduction: This study tries to give a global vision of the professional task and of the economic, political, social and public health relevance of the Apothecaries of Catalonia, from its constitution, in the XIII century, until its extinction, at the end of the XVIII century. Previously it is necessary to refer to the historical context, the development of public health during the period of study and the origin of the apothecary profession. Objective: To present the evolution of apothecaries in Catalonia during the study period. Methods: Bibliographic review on the evolution of apothecaries in Catalonia, as well as on the development of public health and the historical context during the study period. Results: The development of the apothecary profession in Catalonia can be divided into three distinct stages: the birth of the profession (XIII-XV centuries), the consolidation of the profession (XVI-XVII centuries) and the decline of the profession (XVIII century)
Subject(s)
Humans , History, Medieval , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , Pharmacists/history , Pharmaceutical Services/history , Public Health/history , Health Behavior , Pharmaceutical Services/historyABSTRACT
The pharmacy world was a mandatory crossing point and active player in the establishment of hormonal contraception in Brazil. Through an analysis of articles published in A Gazeta da Farmácia from 1960 to 1981, the study explores little-known aspects of the birth control pill's biography and the construction of its Brazilian market. For pharmacy professionals, oral contraceptives were "opportunity pills" in two senses: they provided profits and they restored the prestige of these professionals within the scientific, clinical-therapeutic, and political realms. The pathways of the pill and the pharmacy world intersected as both wove their biographies under the patronage of industry. Pharmacists and the pill were co-constructed, and each was an important crossing point for the other.
O artigo analisa matérias sobre pílulas anticoncepcionais publicadas em A Gazeta da Farmácia, entre 1960 e 1980, examinando aspectos pouco conhecidos da biografia desses medicamentos e da constituição do seu mercado. Para os profissionais de farmácia, os anticoncepcionais orais se apresentaram como "as pílulas da oportunidade", seja no sentido dos lucros, seja no sentido de resgatar seu prestígio no campo científico, clínico-terapêutico e político. As trajetórias das pílulas anticoncepcionais e do mundo da farmácia se interseccionaram, quando ambos buscavam tecer sua biografia, apadrinhados pela indústria. Farmacêuticos e pílulas se coconstituíram, um sendo importante ponto de passagem para outro.
Subject(s)
Contraceptives, Oral/history , Periodicals as Topic/history , Pharmaceutical Services/history , Brazil , Commerce , Gonadal Steroid Hormones , History of Pharmacy , History, 20th Century , Pharmacists , Professional Role , Sociological FactorsABSTRACT
Resumo O artigo analisa matérias sobre pílulas anticoncepcionais publicadas em A Gazeta da Farmácia, entre 1960 e 1980, examinando aspectos pouco conhecidos da biografia desses medicamentos e da constituição do seu mercado. Para os profissionais de farmácia, os anticoncepcionais orais se apresentaram como "as pílulas da oportunidade", seja no sentido dos lucros, seja no sentido de resgatar seu prestígio no campo científico, clínico-terapêutico e político. As trajetórias das pílulas anticoncepcionais e do mundo da farmácia se interseccionaram, quando ambos buscavam tecer sua biografia, apadrinhados pela indústria. Farmacêuticos e pílulas se coconstituíram, um sendo importante ponto de passagem para outro.
Abstract The pharmacy world was a mandatory crossing point and active player in the establishment of hormonal contraception in Brazil. Through an analysis of articles published in A Gazeta da Farmácia from 1960 to 1981, the study explores little-known aspects of the birth control pill's biography and the construction of its Brazilian market. For pharmacy professionals, oral contraceptives were "opportunity pills" in two senses: they provided profits and they restored the prestige of these professionals within the scientific, clinical-therapeutic, and political realms. The pathways of the pill and the pharmacy world intersected as both wove their biographies under the patronage of industry. Pharmacists and the pill were co-constructed, and each was an important crossing point for the other.
Subject(s)
History, 20th Century , Periodicals as Topic/history , Pharmaceutical Services/history , Contraceptives, Oral/history , Pharmacists , Gonadal Steroid Hormones , Brazil , Commerce , Professional Role , Sociological Factors , History of PharmacyABSTRACT
Analizamos la actividad botánica y profesional de Benito-José Estébanez Mazón (1852-1931), un farmacéutico rural, establecido en Soncillo (Burgos) y sus relaciones con la Universidad Central a través de Blas Lázaro e Ibiza (1858-1821). Se analiza su participación en dos proyectos fallidos: la constitución de la Federación Regional de los Colegios de Farmacéuticos del Norte de España (1917) y el la propuesta de fundar una estructura estatal dedicada al cultivo y recolección de plantas medicinales (1923)
We analyzed the botanical and professional activities of Benito-José Estébanez Mazón (1852-1931), a rural pharmacist, established in Soncillo (Burgos) and his relations with the Central University through Blas Lázaro (1858-1821). We analyzed his participation in two failed projects: the constitution of a Regional Federation of the Pharmaceutical Colleges of Northern Spain (1917) and the proposal to create a state structure dedicated to the cultivation and collection of medicinal plants (1923)
Subject(s)
History, 19th Century , Botany/history , Botany/methods , Plants, Medicinal , Pharmacists/history , Pharmaceutical Services/history , Societies, Medical/history , Societies, Medical/organization & administration , Pharmacies/historyABSTRACT
The statute of the National Institute of Hygiene from 1923 apart from research and diagnosing of infectious diseases, their sources, ways of spreading and fighting defined: "production and research of sera, vaccines, cowpox and other bacterial products". These targets were realized since 1919 along as the technology of production developed and the demand in prevention and fighting of infectious diseases increased. Sera and bacterial strains were investigated in Department of Bacteriology and Experimental Medicine in NIH and controlled Department of Sera and Vaccines. The technology of production was coordinated with foreign scientific centers and commissions of League of Nations. Since 1925 Department produced 10 species of medical sera and 32 species of various vaccines. Production was relocated to Warsaw Manufacture of Sera and Vaccines in the year 1951.
Subject(s)
Academies and Institutes/history , Vaccines , Government Agencies/history , History, 20th Century , Humans , Pharmaceutical Services/history , PolandABSTRACT
The article describes the phenomenon of a pharmacy in the Jewish ghetto in Terezín (Theresienstadt) in connection with the local healthcare system and the history of this ghetto. It lists the names of the Czechoslovak Jewish pharmacists who passed through this ghetto, including their fates, whether they survived or were murdered in extermination concentration camps or died as a result of the cruel living conditions in the ghetto. The article discusses the fate of the so-called Mischlingskinder ("mixed children", i.e., persons deemed to have both "Aryan" and Jewish ancestry) and "Aryan" men and women from the so-called "mixed" marriages. In a separate section, the attention is also paid to the fate of Jewish pharmacists from Germany and Austria. In all chapters, the data illustrated by the fate of some pharmacists are stated. Key words: Jews pharmacy Terezín ghetto pharmacist shoah.
Subject(s)
Jews , Pharmaceutical Services/history , Pharmacists/history , Poverty Areas , Czechoslovakia , History, 20th Century , HumansABSTRACT
The availability of affordable medicines is a major barrier to providing high-quality health care in many countries. Fatima Suleman talks to Fiona Fleck.