Mendez, Frances Nicola
Tyler St., Filinvest Homes, BiÃ±an, Laguna
Level : Bachelorï¿½s/College Degree
Major : Nutrition
University : University of the Philippines-Diliman
Graduation Date : November 2005
Licensure Examination/s Taken
2006 Nutritionist-Dietician Licensure Examination
Remarks: 4th place
Company Name : N/A
Position : Freelance Research Writer
Specialization : Essays, Research Papers
Date Joined : February 2006 Date Left : present
Company Name : Fitness First-Philippines
Position : Nutritionist-Dietitian
Specialization : Nutrition
Date Joined : September 2006 Date Left : present
APA, MLA, Harvard Citation
Member, Nutritionist-Dieticiansï¿½ Association of the Philippines
Member, Philippine Association of Nutrition-Alpha Chapter (2004-2005)
Pharmaceuticals Derived From Plants
History of Plant-based Pharmaceuticals
According to Roger Beachy, President of Donald Danforth Plant Science Center, ï¿½Plants are the most efficient producers of proteins on earth (Biotechnology Industry Organization, 2006).ï¿½ In pharmacy, proteins can be engineered to be utilized as therapeutic agents to match specific illnesses. Applying these thoughts to biotechnology, plant-based pharmaceuticals are now being considered in the treatment of illnesses. The idea is to engineer plants to become producers of therapeutic proteins that could then be extracted, refined and used in the production of pharmaceuticals.
In general, the possibility of use of biologics, including both plants and animals, to produce pharmaceuticals has been explored prior to the new millennium. Starting 2002, animal-based pharmaceuticals already represent about 7% of the pharmaceutical market. In 2006, the expected growth of the market is to 12%, with the 700 new biologics being tested in 2005, 200 of which, in its late-stage trials (McCook, 2005). The growth is expected to rise even more with researchers on plant-based pharmaceuticals, now in various stages of clinical trials of plant-based pharmaceutical production. According to Biotechnology Industry Organization (BIO) (2006), the commercialization of the first plant-based pharmaceutical is expected in at least three to five years from now.
Biotechnological breakthroughs have made possible the genetic enhancements in plants for the production of specific proteins which are very significant in the production of different varieties of pharmaceuticals. Among these specific proteins are monoclonal antibodies, enzymes and blood proteins (Biotechnology Industry Association, 2006), thus, categorizing ï¿½plant-based pharmaceuticalsï¿½ as the therapeutic agents or pharmaceutical proteins produced in live plants and not referring to the plants per se.
With this said, the production of pharmaceutical proteins in plants entails genetic modification starting from gene sequencing to gene construction of the specific plants used. This is done to transform the plants into independent producers of necessary proteins needed in the production of the specific pharmaceuticals. The plants that are used are then grown in confinement under a highly regulated environment. The production is regulated by the US Department of Agriculture (USDA), Animal and Plant Health Inspection Service (APHIS) and the Food and Drug Administration (FDA) to ensure that the manufacturing processes meet the standards on quality and safety (Biotechnology Industry Association, 2006).
The plants undergo a series of steps for the extraction, separation, purification and processing of the pharmaceutical proteins after harvest. These proteins are then used as pharmaceutical ingredients in drugs (Biotechnology Industry Association, 2006).
The conditions they treat
As of 2005, plant-based pharmaceuticals are not widely available commercially (McCook, 2005). Drugs claiming to be plant-based, today are mostly just modifications or copies of the natural substances from plants. Examples of plant-derived substances that are used to treat ailments today are Cynarin and Silymarin. Cynarin is derived from artichokes to treat hypertension, while Silymarin is derived from milk thistle to treat liver problems. But systems using plant-based products have already started. Plants such as potatoes, corn, tobacco, rice, alfalfa, barley, safflower, soy and duckweed have already received APHIS regulatory permits, and explored by scientists for genetic alteration to yield proteins which are pure and with equivalent activity to those produced in the traditional manufacturing systems. These plants are used because of the huge amounts of knowledge, understanding, and experience possessed by contemporary scientists on their agronomics, composition, production, as well as their environmental impact. This familiarity is very crucial in the development and confinement of the plants, especially since the idea and the use of plants as pharmaceutical agents is relatively new (Biotechnology Industry Association, 2006).
Some companies are now trying to invest on its use to produce possible treatments for diseases such as cystic fibrosis, pancreatitis, , obesity, geriatric and child diarrhea, iron deficiency, kidney disease, and tooth decay (McCook, 2005; Biotechnology Industry Association, 2006). The use of plants in pharmacology also shows promise for serious ailments such as Alzheimerï¿½s disease, cancer, chronic obstructive pulmonary disease, Crohnï¿½s disease, diabetes, heart disease, Hepatitis C, HIV, multiple sclerosis, spinal chord injuries and many others.
Advantages and Disadvantages
Promoters of plant-based pharmaceuticals pride on the new systemï¿½s large volume production capacity, reduced capital requirements, and freedom from potential viral and animal protein contamination (Biotechnology Industry Organization, 2006). According to them, scientific studies support that growing of plants that are relevant to the production of pharmaceuticals can be safely grown and harvested if appropriate production and handling practices are applied. (Biotechnology Industry Organization, 2006).
The use of plants as pharmaceutical agents provides promise in the field of pharmacology, with the limited options for protein production and since most proteins cannot by synthesized chemically. Aside from plants, proteins can only be synthesized from mammals and microbial cell cultures (Biotechnology Industry Association, 2006).
One of the popular advantages of using plants as pharmaceutical agents is its relatively lower cost. It is believed that because technology can be developed in plants in the most ï¿½naturalï¿½ and renewable way, there would be less need for facilities and high production costs. In addition, the growth of plants is not limited by special logistic requirements which make its production relatively easy to adjust depending on economic variations. The relative ease in production could be exploited to provide the consumers with better access to medicines (Biotechnology Industry Association, 2006). The limited abilities of the typical manufacturing technologies to produce the needed pharmaceuticals for larger populations restrict access to treatments (Robertson, 2003). According to Peter Latham, President of BioPharm Services, Inc., ï¿½Using plants to produce pharmaceuticals in the field could reduce the costs of goods by as much as fifty percent (Biotechnology Industry Association, 2006).ï¿½
Plant-based pharmaceuticals are also relatively safer to produce compared to traditional methods. According to BIO (2006), other methods have a greater risk of propagating human pathogens and other contaminants which are not so much of problem since plant-based pharmaceuticals would most likely be produced in ï¿½plant-factoriesï¿½ in regulated conditions (Biotechnology Industry Association, 2006).
Despite the said benefits from Plant-based pharmaceuticals, activists, consumer groups, farmers, trade groups and environmentalists have continued to raise their concerns on the possible effects both to the health of the people and to the environment, of producing such drugs. Michael Hansen, an ecologist and a Senior research associate at the Consumers Unionï¿½s Consumer Policy Institute in Yonkers, NY said that exposure to the genetically engineered plants could trigger food allergies and some other possible negative impacts that are still left unanswered (Winnick, 2004).
Jeff Barach, the Vice President of the National Food Processors Association said: ï¿½There\'s a lot at stake. If plant-made pharmaceuticals, proteins, monoclonal antibodies, viruses, vaccines, whatever they are producing, wind up in the food supply, then that food is adulterated, and we\'d have to go through recalls and there could be potential consumer harm, loss of brand name, and large amounts of dollars spent on recalling products.ï¿½
There had also been questions on the cost-effectiveness of producing the said pharmaceuticals. Biomanufacturers believe that plant-based pharmaceutical systems wonï¿½t become a viable and cost-effective alternative to their traditional counterparts in the near future. However, when respondents were asked when they believe pharmaceutical production using plant and animal systems could be a viable alternative to traditional production methods more than 70% believed that such is either already a viable alternative or will be available within the next ten years. The rest believe this to be unlikely in the foreseeable future (McCook, 2005).
As with other systems in its initial stages, it is agreed that barriers must be overcome before plant-based pharmaceuticals become a successful alternative to pharmaceuticals that are produced traditionally. As of this time, the problem is still the long period of conversion from gene to protein and the high costs that the production may entail. The added processes of purification, filling and finishing of proteins after production per se add up to the costs (McCook, 2005).
Plant-based pharmaceutical companies continue their struggle for recognition and acceptance from consumer groups and federal regulators. The Sacramento-based Ventnria-Biosciences had been rejected by the California Department of Food and Agriculture (CDFA) on April 9, 2004. The company applied for permission to grow 120 acres of genetically engineered rice in California (Winnick, 2004). According to Rebecca Specter of the Center for Food Safety (CFS), among the members of the commission who voted for the rejection of Ventriaï¿½s proposal, five were farmers believing in the potential contamination of crops that could result to lost markets. Similarly, the USDA refused to renew Ventriaï¿½s permit to plant the same crops in another part in California (Winnick, 2004).
Until this day, plant-based pharmaceuticals have not entered the commercial market and are undergoing clinical trials. Dow Chemical Company and Nobex Corporation collaborates to produce NLC-001, a potential appetite suppressant (Dow to produce NOBEX peptide in plant-based system, n.d.).
Biotechnology Industry Organization. (2006). Plant-based Pharmaceuticals: Frequently Asked Questions. www.bio.org. Retrieved 30 Nov 2006 from http://www.bio.org/healthcare/pmp/factsheet2.asp.
Biotechnology Industry Organization. (2006). Advantages of Plants to Therapeutic Medicine. www.bio.org. Retrieved 30 Nov 2006 from http://www.bio.org/healthcare/pmp/factsheet3.asp.
Dow to produce NOBEX peptide in plant-based system (n.d.). Retreived 30 Nov 2006 from http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=105&STORY=/www/story/02-17-2004/0002110756
McCook, Allison (2005). Manufacturing on a Grand Scale. The Scientist: Magazine of the Life Sciences. Retrieved 30 Nov 2006 from http://www.the-scientist.com/article/display/15256/#B1.
Winnick, Edward. (2004). No go on GM pharm rice and crops. The Scientist: Magazine of the Life Sciences. Retrieved 30 Nov 2006 from http://www.the-scientist.com/article/display/22114/.
Canadian Health Care System
Canadaï¿½s Health Care System has been the subject of controversies especially when compared to the Health Care System of the United States. Unlike the former, the Canadian Health Care System is a socialized structure where almost all services as well as the delivery of health care services are publicly funded and provided for by the government, that is, it is one of the most fully socialized health care system in the world. In 1990, about 98% of health care delivery was done by the public sector and only 2% was done by the private (Health Care Systems: An International Comparison, 2001). According to the OECD Health Data, one hundred percent of the Canadian population has a publicly funded insurance. This is based from the statistical data in 1997 comparing the percentage of universal publicly funded health care systems in different countries. (Health Care Systems: An International Comparison, 2001). This Health Care philosophy clashes with the United Statesï¿½ more individualized, free-trade approach.
In the United States, there is a relatively lower participation of the government, higher involvement of the private sector in the administration of health care and without a guaranteed health insurance for all the citizens. This paper aims to analyze how the health care system of Canada is more advantageous compared to that of the United States by analyzing the system itself in terms of comparative results.
Targets individual provincial needs
The Canadian Health Care System can only be described generally as there is no specific qualities characterize its universal design. The Canadian Health care system is designed from the bottom-up approach, that is, each province or territory has a unique approach to their health care system depending on the concerned province or territoryï¿½s needs, environment, culture and political philosophies. The provinces and territoriesï¿½ freedom however is limited to meet five important principles: comprehensiveness, universality, portability, accessibility and public administration. All these principles are necessary to qualify for federal support and to make sure that the system covers all essential services and every citizen benefits (Canadian and American Health Care Systems Compared 2006).
Increased Government involvement and wider coverage
In the Canadian Health Care System, there is only the government who takes care of the bills where health care workers work on a fee-for ï¿½service basis just as it is done in most countries. The difference is that bills do not go to the insurance companies or the individuals concerned but to the provincial government. The Canadian Health Care system does not have to deal with problems involving clashes between the concerns of insurers, health care providers and the public because it is basically the public or the taxpayers who own the ï¿½insurance companiesï¿½ making better service, and payment of taxes each citizenï¿½s personal concern. According to an analyst, the Canadian Health Care system is merely a matter of balancing the citizenï¿½s ï¿½desire for more and better service against their collective ability to pay for it (Kramer 2001)ï¿½.
In Canada\'s Health Care System, all citizens can have access to health coverage regardless of any history that would have disqualified the citizen in other systems. It is the public which provides almost all kinds of treatments from preventative care, physicians, hospitals, dental and other medical services (Canadian Health Care: Introduction, 2004).
Unlike in Canada where the Health Care System takes a comprehensive approach, the United States public funding for health care is only limited to the benefits provided for by the Medicare and Medicaid to the senior citizens, poor and the disabled (Kraker 2001). People who do not belong to these categories must either get employed and benefit from the employerï¿½s health insurance packages or pay for themselves through private insurance.
The structure of the health care system in Canada supports the provision of health care funding for all its individual territories. The provision of funding and the amount of support allocated for each individual province or territory is guided by a set of qualifications as imposed by the Canada Health Act. In general, this Act prohibits private entities in providing services covered by Medicare. The purpose of which is to prevent billing of end users (Canadian Health Care: Introduction 2004). While the United States has its citizens billed for individual health services, the Canadian Health Care System provides for its citizens by mandating that all health services be billed directly to the government.
Based on Canadaï¿½s Health Act, the territories must subject themselves to regular audits of records and accounts. In addition, the public must be insured of all the health services, included in which are the hospitals, physicians and surgical dentists, which are then covered by the respective territoriesï¿½ insurance policies (Canadian Health Care: Introduction 2004).
Discrimination is not allowed according to the Health Act. All insured citizens, regardless of social status have the right to be treated in the same level of health care as any other (Canadian Health Care 2004).
In relation to the citizens\' location, anyone who moves to another territory or country is not forfeited of the right to all appropriations of health care from his or her province but only within a waiting period. Every citizen must have access to health care facilities while health care workers must be reasonably compensated for their services (Canadian Health Care: Introduction, 2004).
In terms of GDP, the OECD Health Data in 2000 shows that the US spends a substantially greater percentage of their GDP on health care compared to Canada. Approximately 13.6% of the annual GDP is spent on health care in the United States while only 9.5% was spent in Canada. This percentage for America almost doubled since 1971 when the country used to consume only about 7.6 percent of its GDP. In the same year, Canada consumed a close 7.4%. This makes the rate of GDP consumption of the United States higher compared to Canada (Kramer 2001).
According to the Health Care Systems International Comparison (2001), most of the costs in the United States Health expenditure can be attributed to the higher labor costs, administrative costs, malpractice and insurance costs. About 3.1% of the Health Spending in the US comprises the Administrative costs while Canada has only 0.8% (Health Care Systems: An International Comparison, 2001). Other explanations for the differences in Health Care costs include the differences in demographics where drug abuse and violence are a more common problem in the United States compared to Canada (Canadian and American Health Care Systems Compared 2006).
Despite the high health-care expenditures in the United States, less service is provided for the citizens of the US. About 44 million of its citizens are still uninsured and is expected to grow to about 60 million by 2008. In addition, the US has to spend more on per-capita health care compared to Canada (Kraker 2001)
Canada had a substantially lower per capita health care spending compared to the United States with Canada\'s $1520 and USï¿½ $1901 from 1990 to 1997. More recently in 2003, Canadaï¿½s per-capita health care spending rose to $1886 while US also rose to $2548. This implies a higher rate of increase in per-capita health expenditures in the US with 35% increase. Canada increased by only 24% (Health Care Systems: An International Comparison 2001).
With Canadaï¿½s socialized health care system, it is important to highlight that the country still spends less than its United States counterpart which is more of privately funded. In addition to the United Statesï¿½ more expensive per capita health care, private health administrators also have to spend more. Private companies in Canada spend about $630 for health care annually while the United States spends $2719 (Health Care Systems: An International Comparison 2001).
The feature of the Canadian Health Care System that kept the per-capita expense relatively low is their Health Care Actï¿½s criterion on public administration (Kraker, 2001). Because the health care system is administered by the government and because all insurance costs are paid by the government, administrative costs through the single-payer system, are enormously reduced. The large insurance bureaucracies and multiple administrative efforts among companies, plus the marketing expenses all add up to produce a large per-capita expense. This piling up of expenses is what happens in privately funded health care systems such as the United States (Kraker 2001).
According to the New England Journal of Medicine, about $67 billion would be saved in administrative costs once the health care system in the United States is revolutionized to pattern Canadaï¿½s Health Care System (Kraker 2001). These savings are enough to insure the majority of Americans and at the same time reduce further the administrative procedures required to the health care professionals. From 1980 to 1991, the US health care expenditures excluding the administrative costs rose by 196% while administrative costs rose by 350% (Kraker 2001).
Less expensive Pharmaceuticals
However, the Canadian Health Care System does not provide public funding for some adult health services such as dental, optical and pharmaceutical. Among these, only non-cosmetic dental care is funded for only children 14-years and below. Adult health services are usually covered by the benefit packages offered to employees by private companies (Canadian Health Care System: An Introduction 2004).
If an individual is not covered by benefit packages offered by private companies because he may be unemployed or self-employed, the citizen can choose to purchase insurance packages from insurance companies. Purchasing health insurance from private companies is beneficial to Canadians because it offsets the medical expenses resulting from the lack of coverage by the public health system (Canadian and American Health Care Systems Compared 2006).
Still, it is reported that the United States expenditure for drugs is higher compared to Canada. This is because Canada is more liberal in allowing generic drugs to take over the counters with their less prohibitive acts on medical patents. Also, Canadaï¿½s centralized purchasing of drugs, that is, with the provincial governments buying pharmaceuticals in bulk, the prices of drugs are lowered. There is also consideration given to the effectiveness of the drugs which adjusts the prices. The United States decentralized structure however, prohibits negotiation of drug prices by the Medicare and Medicaid (Canadian and American Health Care Systems Compared 2006).
Increased Equity and Fairer Rates for Health Professional Services
The Canadian public health providers include the primary care physicians, specialists and hospitals. As of 2004, there are about 30000 primary care physicians in Canada. Their main role is to provide the basic medical treatments and preventative care. Specialists provide treatment for special medical cases that are outside the scope of the physicians. In some cases, say, circumcision, access to services of specialists may involve an additional fee. Hospitals provide the primary setting for all health care services. Included in hospital services is the provision of ambulatory services for those who are incapable of transportation (Canadian Health Care System: An Introduction 2004).
Because Health professional fees are paid for by the government, the rates are determined through negotiations done by both the government and the health care professionals (Canadian and American Health Care Systems Compared 2006). This is unlike the system in the United States where free market determines the rates of the health care professionals.
According to reports, physicians in the United States have a relatively higher income compared to physicians in Canada. In the United States, physicians earn about $199,000 while physicians in Canada earn an annual average of $100,781 (Health Care System: An International Comparison). The free market system in the United States allows physicians to set an advantage in determining rates. The negotiations done by the federal government and the health professionals in Canada allows for the setting of a fairer rate (Canadian and American Health Care Systems Compared 2006).
Some people do not agree with the privatization of health care in the United States because they believe it would create imbalances with only some people being given much more benefits compared to others. However, the lower compensation given to health care professionals in Canada decreases their number as they try to migrate to other countries such as the United States with much better compensation (Canadian Health Care System: Introduction 2004).
Higher Life Expectancy and Reduced Mortality Rates
In terms of machines, Canada has fewer scanners and MRI per capita compared to the United States. But despite this, Canada has more favorable life expectancy compared to the United States and in other countries (Health Care Systems: An International Comparison). Canada has an average of 80-yr life expectancy and lowest infant mortality rate compared to other industrialized countries (Canadian Health Care System: Introduction, 2004). This is confirmed by a study done by the World Health Organization, where Canada is also shown to have a higher life-expectancy compared to that in the United States. In 2005, Canadiansï¿½ life-expectancy is 80.1 years while the Americans have 77.7 years. Similarly, the United States has a higher mortality rates for infants and children compared to Canada (Kraker 2001).
In relation, death rates from certain diseases such as cancer are higher in the United States than in Canada, despite their relatively more advanced technology and liberal percentage allocation for each patient. According to the Statistical data shown by the WHO Cancer Database, the average female death rate for Canadian cancer patients is 179.2 while for the Americans, the death rate is 187.7. For the male Canadians, the rate is 212.3 while the Americans have 214.6 (Canadian and American Health Care Systems Compared 2006).
More efficient health care system
There are some critics however who do not accept the previous indices as measures of the effectiveness and quality of health care system of a country (Kraker 2001). In this regard, it is important to note how Canada and US rank in an index devised by the World Health Organization (WHO). This indices in general measure the efficiency of the health care systems in transforming expenditures into health care services (Kraker 2001).
Among the indices used is known as the average Disability Adjusted Life Expectancy (DALE) of a population measuring the peopleï¿½s health in general instead of their life expectancies. Combining the index and figures representing patient choice, health care provider autonomy and equity of health care distribution, WHO showed that Canadaï¿½s Health Care System is bettering quality with a rank of 35th compared to the US Health Care System, 72nd (Kraker 2001).
In terms of effectiveness of the Health Care System, Canada, again ranks 7th while the US ranked 5th. The measure of effectiveness that WHO used include the level of the peopleï¿½s responsiveness to the system (autonomy, confidentiality, choice of care providers, quality of amenities), the scope of distribution to all members of the society; equity in financial contribution which considers the inequality in the household level (Kraker 2001).
More satisfied citizens
A survey asked the citizens about their satisfaction in their countryï¿½s health care system According to the survey, more people are contented with the health care system in Canada with only 23% feeling that the health care system needs to be rebuilt compared to that in the United States (Health Care Systems: An International Comparison, 2001). A similar survey was done in 1998 in the Australia, Canada, New Zealand, United Kingdom and United States and the pattern of results is consistent with the former. Based on the survey, 24% of the Canadians feel satisfied with their health care system. This is higher compared to the United States satisfaction rate which is 19% (Kraker 2001).
Increased flexibility among the citizens
Because Canadaï¿½s Health Care System is funded by the government, it is the taxes imposed on the citizens and thus, the Canadian population in general, that pays for the countryï¿½s health care. In the United States, health care costs are shouldered by only the private sector and the individuals needing the health care. The Canadian system is beneficial to the general population because expenses are spread among all the taxpayers thus lowering their costs. In addition, they become more flexible because they do not become tied to their jobs which in the United States are the usual providers of health insurances. The resultant flexibility affects not only the citizens but also the economy (Kraker 2001).
One example of how the Canadian Health Care System provides its citizens flexibility is the case of Cheryl Cameron, wife of the late Bill Cameron, one of Canadaï¿½s leading journalists. When Bill Cameron died, Cheryl was already in her 50ï¿½s. But since Cheryl is under the Canadian government, she was able to go back and land a job because the costs of health care insurance did not limit her. If she were in the United States, there would be a smaller chance of going back to work because very few employers would accept an employee out of concern for the necessity of expensive medical treatments that could increase the companyï¿½s insurance premiums (Fromma 2004)
The advantages of the Canadian Health Care System over the United States Health Care System can be attributed to its socialized structure and single-pay approach. Most importantly among these advantages are the possibilities of wider coverage of health care system, reduced health service and pharmaceutical costs both nationally and privately, and increased flexibility afforded to citizens. The health care system is designed as to provide the most service with the least cost to the most number of people and so, far, Canada has been successful in these aspects if compared to the United States with the majority of the citizens insured, lower health care costs based on the GDP allocation and increased distribution of generic drugs. As for flexibility, the citizens are not tied to their jobs simply for the reason of fearing to lose their health insurances. In addition, the elderly have more chances to start again and get a job despite their age because health insurance premiums would not be a problem for the companies.
The Canadian citizens are relatively more satisfied with their health care system compared to their American counterparts and if the quality of health care systems can be judged based on the mortality rates and life expectancy, the Canadians would definitely outperform the United States. The better efficiency and quality of the health care system of Canada are confirmed by the indices of the World Health Organization.
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