GHPI Publications
Citation: Mackey TK, Liang BA. A United Nations Global Health Panel for Global Health Governance. Soc Sci Med. 2013;76(1):12-15.
Abstract: The World Health Organization now relies upon voluntary contributions tied to specific projects, underwriting 75% of operations. A resulting cacophony of non-governmental, foundation, and private sector actors have emerged overlapping and fractionating WHO programs. In this expanding world of “global health organizations,” WHO’s role must be redefined... click here to link to article.
Citation: Mackey TK, Novotny TE. Improving United Nations Funding to Strengthen Global Health Governance: Amending the Helms-Biden Agreement. Global Health Governance. 2012;6(1).
Abstract: Global health governance is widely considered fragmented after more than a decade of inconsistent support for multi-lateral organizations and faced with the emergence of many new global health donors... click here to link to article.
Citation: Mackey TK, Liang BA. Combating Healthcare Corruption and Fraud with Improved Global Health Governance. BMC Intl Health Hum Rights. 2012;12:23.
Abstract: Corruption is a serious threat to global health outcomes, leading to financial waste and adverse health consequences. Yet, forms of corruption impacting global health are endemic worldwide in public and private sectors, and in developed and resource-poor settings alike... click here to link to article.
Citation: Mackey TK, Liang BA, Kohler JC, Attaran A. Health Domains for Sale: The Need for Global Health Internet Governance. J Med Internet Res. 2014;16(3):e62.
Abstract: A debate on Internet governance for health, or “eHealth governance”, is emerging with the impending award of a new dot-health (.health) generic top-level domain name (gTLD) along with a host of other health-related domains. This development is critical as it will shape the future of the health Internet... click here to link to article.
Citation: Mackey TK, Liang BA. Improving Global Health Governance to Combat Counterfeit Medicines: A Proposal for a UNODC-WHO-Interpol Trilateral Mechanism. BMC Medicine. 2013;11:233.
Abstract: Perhaps no greater challenge exists for public health, patient safety, and shared global health security, than fake/falsified/fraudulent, poor quality unregulated drugs, also commonly known as “counterfeit medicines”, now endemic in the global drug supply chain... click here to link to article.
Citation: Kohler JC, Mackey TK, Ovtcharenko N. Why the MDGs need Good Governance in Pharmaceutical Systems to Promote Global Health. BMC Public Health. 2014;14(63) doi:10.1186/1471-2458-14-63.
Abstract: Corruption in the health sector can hurt health outcomes. Improving good governance can in turn help prevent health-related corruption. We understand good governance as having the following characteristics: it is consensus-oriented, accountable, transparent... click here to link to article.
Citation: Mackey TK, Liang BA. The Global Counterfeit Drug Trade: Patient Safety and Public Health Risks. J Pharm Sci. 2011;100(11):4571-4579.
Abstract: Counterfeit drugs are a global problem with significant and well-documented consequences for global health and patient safety, including drug resistance and patient deaths. This multibillion-dollar industry does not respect geopolitical borders, and threatens public health in both rich and resource-poor nations alike. The epidemiology of counterfeits... click here to link to article.
Citation: Mackey TK, Liang BA. Oncology and the Internet: Regulatory Failure and Reform. J Onc Prac. 2012;8(6);341-343.
Abstract: Drug shortages have emerged as a serious patient safety and public health crisis and are affecting a variety of drug classes. This includes a number of generic sterile injectables that are used to treat various forms of cancer... click here to link to article.
Citation: Liang BA, Mackey TK. Sexual Medicine: Online Risks to Health-The Problem of Counterfeit Drugs. Nature Rev Urol. 2012;9:480-482.
Abstract: Counterfeit medicines sold online are a global scourge. Although erectile dysfunction drugs are well known to be heavily counterfeited, illicit vendors are rapidly expanding to other drugs and devices in the sexual health arena. International multidisciplinary cooperation is needed... click here to link to article.
Citation: Mackey TK. Global Health Diplomacy and the Governance of Counterfeit Medicines: A Mapping Exercise of Institutional Approaches. J Health Diplomacy. 2013;1(1).
Abstract: Counterfeit medicines are a global, multi-faceted, and complex public health problem. Global health diplomacy and cooperative efforts relying on governance systems have been limited in effectively addressing proliferation of this dangerous trade... click here to link to article.
Citation: Brown M, Mackey TK, Liang BA. Global Health Diplomacy and Management Mechanisms of US- China Public Health Collaborations in China: Lessons for Emerging Markets. J Comm Biotech. 2012;18(4):44-50.
Abstract: China is the largest emerging market in the world. It is also on the front lines of health diplomacy, where the tools of diplomatic statecraft are being employed by public health professions of both the US and China to help improve the practice of public health.... click here to link to article.
Citation: Liang BA, Mackey TK. Preparing for Health Diplomacy Negotiations—Global Governance and the Case of Taiwan, WHO, and SARS. In: Ellen Rosskam & Ilona Kickbusch, eds., Negotiating and Navigating Global Health: Case Studies in Global Health Diplomacy. London: Imperial College World Scientific Press, 2012, 173-202.
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Citation: Liang BA, Mackey TK. Reforming Off-Label Promotion to Enhance Orphan Disease Treatment. Science. 2010; 327(5963):273-274.
Abstract: Once the U.S. Food and Drug Administration (FDA) approves uses for new drugs, physicians are free to prescribe them for any clinical condition they see fit. Promotion (by manufacturers) and patient use (guided by clinicians) for any indication, population, dosage, administration... click here to link to article.
Citation: Liang, BA, Mackey TK. Direct to Consumer Advertising with Interactive Internet Media: Global Regulation and Public Health Issues. JAMA. 2011; 305(8):824-825.
Abstract: Direct-to-consumer advertising (DTCA) is only in the United States and New Zealand and has been linked with drug overutilization, public health concerns, and higher costs. Despite global proscriptions, DTCA is the most rapidly increasing form of pharmaceutical marketing, with approximately $4 billion in US expenditures, outpacing physician marketingt... click here to link to article.
Citation: Liang BA, Mackey TK. Reforming Direct-to-Consumer Advertising. Nature Biotech. 2011; 29(5):397-400.
Abstract: Direct-to-consumer (DTC) advertising is the fastest growing form of drug marketing with a global reach, despite being legal only in the United States and New Zealand. One goal of DTC advertising is to provide consumers with information about marketed drugs, but its use is also correlated with an increase in drug expenditures... click here to link to article.
Citation: Liang BA, Mackey TK. Prevalence and Global Health Implications of Social Media in Direct-to-Consumer Drug Advertising. J Med Internet Res. 2011;13(3):e64 doi:10.2196/jmir.1775.
Abstract: Direct-to-consumer advertising (DTCA), linked to inappropriate medication use and higher health care expenditures, is the fastest growing form of pharmaceutical marketing. DTCA is legal only in the United States and New Zealand. However, the advent of online interactive social media “Web 2.0” technologies... click here to link to article.
Citation: Lovett KM, Liang BA, Mackey TK. Risks of Online Direct-to-Consumer Tumor Markers for Cancer Screening. J Clin. Onc. 2012;30(13):1411-1414. doi: 10.1200/JCO.2011.37.8984.
Abstract: Cancer is the leading cause of death worldwide. Given the emotional impact of a potential cancer diagnosis, patients often search for methods of early detection. Moreover, with a growing direct-to-consumer (DTC) industry advertising medical products online... click here to link to article.
Citation: Mackey TK, Yagi N, Liang BA. Prescription Drug Coupons: Evolution and Need for Regulation in Direct-to-Consumer Advertising. Res Social Admin Pharm.; In press.
Abstract: Pharmaceutical marketing in the United States had undergone a shift from largely exclusively targeting physicians to considerable efforts in targeting patients through various forms of direct-to-consumer advertising (“DTCA”)... click here to link to article.
Citation: Mackey TK, Liang BA. Physician Payment Disclosure Under Healthcare Reform: Will the Sun Shine? J Am Board Fam Med. 2013;26: 327-331. doi: 10.3122/jabfm.2013.03.120264.
Abstract: Pharmaceutical marketing has become a mainstay in U.S. health care delivery and traditionally has been directed toward physicians. In an attempt to address potential undue influence of industry and conflicts of interest that arise, states and the recently upheld health care reform act... click here to link to article.
Citation: Mackey TK, Liang BA, Kohler J, Attaran A. The Fight over dot-health: Ensuring the Future of Health Information Online. The Lancet. 2013; 382:1404.
Abstract: The future of critical health information on the internet is for sale to private bidders, who have no discernible expertise in public health or medicine. Possibly as early as November, 2013, the rights to a new website suffix dot health (.health), alongside familiar “.com” and “.org” domains... click here to link to article.
Citation: Liang BA, Mackey TK. Online Availability and Safety of Drugs in Shortage: A Descriptive Study of Internet Vendor Characteristics. J Med Internet Res. 2012;14(1):e27 doi:10.2196/jmir.1999.
Abstract: Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online... click here to link to article.
Citation: Liang BA, Mackey TK. Vaccine Shortages and Suspect Online Pharmacy Sellers. Vaccine. 2012;30(2):103-105 doi:10.1016/j.vaccine.2011.11.016.
Abstract: Vaccines represent half the products on the FDA Biologics Product Shortages list. As a result, providers and patients may purchase them online, a process rife with patient safety risks. We examined vaccine online availability by assessing up to 5 identified online sellers.... click here to link to article.
Citation: Liang BA, Mackey TK, Lovett KM. Suspect Online Sellers and Contraceptive Access. Contraception. 2012;86(5):551-556.
Abstract: Issues surrounding contraception access have been a national focus. During this debate, adolescent and adult women may seek these products online. Due to safety concerns, including potential counterfeit forms, we wished to assess whether online “no prescription” contraceptives were available... click here to link to article.
Citation: Mackey TK, Liang BA. Global Reach of Direct-to-Consumer Advertising Using Social Media for Illicit Online Drug Sales. J Med Internet Res. 2013;15(5):e105, doi:10.2196/jmir.2610.
Abstract: Illicit or rogue Internet pharmacies are a recognized global public health threat that have been identified as utilizing various forms of online marketing and promotion, including social media... click here to link to article.
Citation: Liang BA, Mackey TK, Lovett KM. Illegal “No Prescription” Internet Access to Narrow Therapeutic Index Drugs. Clin Ther. 2013;35(5):694-700.
Abstract: Narrow therapeutic index (NTI) drugs, because of proximity of therapeutic amounts to toxic amounts, require close professional oversight, particularly when switching formulations. However, safe use may be compromised by unsupervised switching through access to online “no prescription” Web sites... click here to link to article.
Citation: Liang BA, Mackey TK, Archer-Hayes A, Shinn L. Illicit Online Marketing of Lorcaserin Before DEA Scheduling. Obesity. 2013;21(5):861-864.
Abstract: Antiobesity drugs have been marketed illicitly by ‘‘no prescription’’ online pharmacies after approval and scheduling by the drug enforcement agency. We assess whether antiobesity drug BelviqVR (lorcaserin HCl) was available from illicit online vendors before DEA-scheduling when sales are unauthorized... click here to link to article.
Citation: Liang BA, Mackey TK. Stem Cells, Dot-Com. Sci Trans Med. 2012;4(151):151cm9.
Abstract: Direct-to-consumer (DTC) advertising of suspect goods and services has burgeoned because of the Internet. Despite very limited approval for use, DTC stem cell–marketed “treatments” have emerged for an array of conditions, creating global public health and safety risks. However, it remains unclear... click here to link to article.
Citation: Mackey TK, Liang BA, Strathdee SA. Digital Social Media, Youth and Non-Medical Use of Prescription Drugs: The Need for Reform. J Med Internet Res. 2013; 15(7):e143, doi:10.2196/jmir.2464.
Abstract: The tragic death of 18-year-old Ryan Haight highlighted the ethical, public health, and youth patient safety concerns posed by illicit online nonmedical use of prescription drugs (NUPM) sourcing, leading to a federal law in an effort to address this concern... click here to link to article.
Citation: Mackey TK, Liang BA. Pharmaceutical Digital Marketing and Governance: Illicit Actors and Challenges to Global Patient Safety and Public Health. Glob Health. 2013; 9(1):45.
Abstract: Digital forms of direct-to-consumer pharmaceutical marketing (eDTCA) have globalized in an era of free and open information exchange. Yet, the unregulated expansion of eDTCA has resulted in unaddressed global public health threats. Specifically, illicit online pharmacies... click here to link to article.
Citation: Mackey TK, Liang BA. Lessons from SARS and 2009 H1N1 influenza: Employing a WHO-WTO Forum to Promote Optimal Economic-Public Health Pandemic Response. J Pub Health Policy 2012;33(1):119-131 doi:10.1057/jphp.2011.51
Abstract: No formal system exists to review trade restrictions imposed during international public health emergencies rapidly. Failure to put one in place creates disincentives for surveillance and reporting, thereby undermining protection efforts... click here to link to article.
Citation: Mackey TK, Liang BA. Global Health Policy Coordination to Address Neglected Tropical Diseases. Trop Med Inter Health 2012;17(9):1053-1056.
Abstract: The GlaxoSmithKline paediatric malarial vaccine candidate RTS,S has sparked interest in innovation for infectious tropical diseases. Yet, reliance upon ad hoc partnerships and lack of adequate incentives for research and development (R&D) addressing neglected tropic diseases (NTDs) has resulted in limited progress... click here to link to article.
Citation: Mackey TK, Liang BA. Threats from Emerging and Re-emerging Neglected Tropical Diseases. Infec Ecol Epi. 2012;2(1):18667.
Abstract: Neglected tropical diseases impact over 1 billion of the world’s poorest populations and require special attention. However, within the NTDs recognized by the World Health Organization, some are also dually categorized as emerging and re-emerging infectious diseases... click here to link to article.
Citation: Mackey TK, Liang BA, Novotny T. Evolution of Tobacco Labeling and Packaging: Global Health Governance and International Legal Considerations. Am J Pub Health. 2013;103(4):e39-e43, doi:10. 2105/AJPH.2012.301029.
Abstract: Numerous national governments have recently adopted packaging and labeling legislation to curb global tobacco uptake. This coincides with the World Health Organization’s 2011 World No Tobacco Day, which recognized the extraordinary progress of the Framework Convention on Tobacco Control (FCTC)... click here to link to article.
Citation: Mackey TK, Liang BA, Pierce JP, Huber L, Bostic C. Call to Action: Promoting Domestic and Global Tobacco Control by Ratifying the Framework Convention on Tobacco Control in the United States. PLoS Med. 2014;11(5): e1001639.
Abstract: The United States is one of the few signatories that has not ratified the landmark World Health Organization Framework Convention on Tobacco Control (FCTC) public health treaty despite... click here to link to article.
Citation: Mackey TK, Liang BA. Brain Drain: Exploring Resource Allocation to Address Health Worker Migration and Promote Global Health. Health Policy. 2012;107(1):66-73.
Abstract: Global public health is threatened by an imbalance in health worker migration from resource-poor countries to developed countries. This “brain drain” results in health workforce shortages, health system weakening, and economic loss and waste, threatening the well-being of vulnerable populations... click here to link to article.
Citation: Mackey TK, Liang BA. Restructuring Brain Drain: Governance and Financing Strengthening for Health Worker Migration. Glob Health Action. 2013;6:19923.
Abstract: Health worker migration from resource-poor countries to developed countries, also known as ‘‘brain drain’’, represents a serious global health crisis and a significant barrier to achieving global health equity... click here to link to article.
Citation: Yagi N, Mackey TK, Gerlt L, Liang BA. Policy Review: Japan-Philippines Economic Partnership Agreement (JPEPA)—Analysis of a Failed Nurse Migration Policy. Inter J Nurs.; 2014; 51:243-250.
Abstract: In 2008, the bilateral Japan–Philippines Economic Partnership Agreement took effect. Contained within this regional free trade agreement are unique provisions allowing exchange of Filipino nurses and healthcare workers to work abroad in Japan. Japan’s increasing need for healthcare workers... click here to link to article.
Citation: Mackey TK, Liang BA. Integrating Biodiversity Management and Indigenous Biopiracy Protection to Promote Environmental Justice and Global Health. Am J Pub Health. 2012;102(6):1091-1095.
Abstract: Many potentially useful medicines arise from developing countries’ biodiverse environments and indigenous knowledge. However, global intellectual property rules have resulted in biopiracy... click here to link to article.
Citation: Mackey TK, *Contreras JT, Liang BA. The Minamata Convention on Mercury: Attempting to Address the Global Controversy of Dental Amalgam Use and Mercury Waste Disposal. Sci Tot Env. 2014;472:125-129.
Abstract: In October 2013, a new international binding treaty instrument called the Minamata Convention on Mercury opened for signature in Minamata City, Japan, the site of arguably the worst public health and environmental disaster involving mercury contamination. The treaty aims to... click here to link to article.
Citation: Mackey TK, Liang BA. Patent and Exclusivity Status of Essential Medicines for Non-Communicable Disease. PLoS One. 2012;7(11):e51022.
Abstract: The threat of non-communicable diseases (‘‘NCDs’’) is increasingly becoming a global health crisis and are pervasive in high, middle, and low-income populations resulting in an estimated 36 million deaths per year. There is a need to assess intellectual property rights (‘‘IPRs’’) that may impede... click here to link to article.
Citation: Mackey TK, Liang BA. Promoting Global Health: Utilizing WHO to Integrate Public Health, Innovation and Intellectual Property. Drug Disc Today. 2012;17(24-25):1254-1257.
Abstract: The appropriate role of innovation and intellectual property (IP) in global public health is a controversial issue. Discussion is one-sided, with potential benefits advocated by industry in stark contrast to condemnation by certain civil society players... click here to link to article.
Citation: Liang BA, Mackey TK. Searching for Safety: Addressing Search Engine, Web site, and Provider Accountability for Illicit Online Drug Sales. Am J Law Med. 2009;35(1):125-184.
Abstract: Online sales of pharmaceuticals are a rapidly growing phenomenon. Yet despite the dangers of purchasing drugs over the Internet, sales continue to escalate. These dangers include patient harm from fake or tainted drugs, lack of clinical oversight, and financial loss...
Citation: Liang BA, Mackey TK. Confronting Conflict: Addressing Institutional Conflicts of Interest in Academic Medical Centers. Am J Law Med. 2010;36(1):136-187.
Abstract: Individual conflicts of interest are rife in healthcare, and substantial attention has been given to address them. Yet a more substantive concern—institutional conflicts of interest (“ICOIs”) in academic medical centers (“AMCs”) engaged in research and clinical care—have yet to...
Citation: Mackey TK, Liang BA. Off Label Promotion Reform: A Legislative Proposal Addressing Vulnerable Patient Drug Access and Limiting Inappropriate Pharmaceutical Marketing. Univ Mich J Law Reform. 2011; 45(1):1-54.
Abstract: Off-label promotion occurs when pharmaceutical manufacturers engage in promotion of unapproved or “off-label” uses of their drugs. These off-label uses may lack adequate clinical data to substantiate marketing claims, have led to corporate investigations and penalties... click here to link to article.
Citation: Lovett KM, Mackey TK. Online Threats to Senior Safety: The Direct-to-Consumer Medical Marketplace and eElder Abuse. Nat Acad Elder Law Attorneys J. 2013;9(1):91-113.
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Citation: Liang BA, Mackey TK. Public-Private Partnerships to Promote Biosimilar Access, Affordability, and Patient Safety in Emerging Markets. Stanford J Law Sci Policy.: 2014; 7(1):1-9.
Abstract: Biosimilars have tremendous potential to reduce the costs of biologic therapies. Emerging markets may represent a significant fraction of future biosimilar production, development, and consumption. Yet safety concerns, price sensitivity, and lower quality standards represent challenges to public health... click here to link to article.