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Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade

BACKGROUND: Nepal was struck by devastating earthquakes in April–May 2015, followed by the India-Nepal border blockade later that year. METHODS: We used the United Nations Commodity Trade Statistics (UN Comtrade) database to analyse exports of various health commodities from India to Nepal from Janu...

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Autores principales: Sharma, Abhishek, Mishra, Shiva Raj, Kaplan, Warren A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568715/
https://www.ncbi.nlm.nih.gov/pubmed/28830500
http://dx.doi.org/10.1186/s12992-017-0282-0
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author Sharma, Abhishek
Mishra, Shiva Raj
Kaplan, Warren A.
author_facet Sharma, Abhishek
Mishra, Shiva Raj
Kaplan, Warren A.
author_sort Sharma, Abhishek
collection PubMed
description BACKGROUND: Nepal was struck by devastating earthquakes in April–May 2015, followed by the India-Nepal border blockade later that year. METHODS: We used the United Nations Commodity Trade Statistics (UN Comtrade) database to analyse exports of various health commodities from India to Nepal from January 2011–September 2016. We used time-series regressions of trading volume vs. unit price to ask how well Nepal’s trading history with India prior to the earthquake and blockade was able to predict unit prices of health commodities imported into Nepal during and after the earthquake and the blockade. Regression residuals were used to quantify the extent to which the blockade impacted the price of healthcare commodities crossing into Nepal. RESULTS: During the blockade period (September 2015-early February 2016), the volume of all retail medicines traded across the India-Nepal border was reduced by 46.5% compared to same months in 2014–2015. For medical dressings, large volumes were exported from India to Nepal during and shortly after the earthquakes (May–June 2015), but decreased soon thereafter. During the earthquake, the difference between observed and predicted values of unit price (residuals) for all commodities show no statistical outliers. However, during the border blockade, Nepal paid USD 22.3 million more for retail medicines than one would have predicted based on its prior trading history with India, enough to provide healthcare to nearly half of Kathmandu’s citizens for 1 year. CONCLUSION: The India-Nepal blockade was a geopolitical natural experiment demonstrating how a land-locked country is vulnerable to the vagaries of its primary trading partner. Although short-lived, the blockade had an immediate impact on traded medicine volumes and prices, and provided a large opportunity cost with implications for public health. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12992-017-0282-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-55687152017-08-29 Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade Sharma, Abhishek Mishra, Shiva Raj Kaplan, Warren A. Global Health Research BACKGROUND: Nepal was struck by devastating earthquakes in April–May 2015, followed by the India-Nepal border blockade later that year. METHODS: We used the United Nations Commodity Trade Statistics (UN Comtrade) database to analyse exports of various health commodities from India to Nepal from January 2011–September 2016. We used time-series regressions of trading volume vs. unit price to ask how well Nepal’s trading history with India prior to the earthquake and blockade was able to predict unit prices of health commodities imported into Nepal during and after the earthquake and the blockade. Regression residuals were used to quantify the extent to which the blockade impacted the price of healthcare commodities crossing into Nepal. RESULTS: During the blockade period (September 2015-early February 2016), the volume of all retail medicines traded across the India-Nepal border was reduced by 46.5% compared to same months in 2014–2015. For medical dressings, large volumes were exported from India to Nepal during and shortly after the earthquakes (May–June 2015), but decreased soon thereafter. During the earthquake, the difference between observed and predicted values of unit price (residuals) for all commodities show no statistical outliers. However, during the border blockade, Nepal paid USD 22.3 million more for retail medicines than one would have predicted based on its prior trading history with India, enough to provide healthcare to nearly half of Kathmandu’s citizens for 1 year. CONCLUSION: The India-Nepal blockade was a geopolitical natural experiment demonstrating how a land-locked country is vulnerable to the vagaries of its primary trading partner. Although short-lived, the blockade had an immediate impact on traded medicine volumes and prices, and provided a large opportunity cost with implications for public health. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12992-017-0282-0) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-22 /pmc/articles/PMC5568715/ /pubmed/28830500 http://dx.doi.org/10.1186/s12992-017-0282-0 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Sharma, Abhishek
Mishra, Shiva Raj
Kaplan, Warren A.
Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade
title Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade
title_full Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade
title_fullStr Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade
title_full_unstemmed Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade
title_short Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade
title_sort trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 india-nepal border blockade
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568715/
https://www.ncbi.nlm.nih.gov/pubmed/28830500
http://dx.doi.org/10.1186/s12992-017-0282-0
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