ArticleGlobalization and health2017
Trade in medicines and the public's health: a time series analysis of import disruptions during the 2015 India-Nepal border blockade.
Article in Globalization and health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of economic sanctions on health and health systems in low-income and middle-income countries: a systematic review and narrative synthesis.BMJ global health · 2023Pooled it
- Health System Capacity and Access Barriers to Diagnosis and Treatment of CVD and Diabetes in Nepal.Global heart · 2021Pooled it
- Availability, affordability and access to essential medications for asthma and chronic obstructive pulmonary disease in three low- and middle-income country settings.PLOS global public health · 2022Article
- Earthquake Exposure and Post-traumatic Stress Among Nepalese Mothers After the 2015 Earthquakes.Frontiers in psychology · 2019Article
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3 authors.
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Abstract
backgroundNepal was struck by devastating earthquakes in April-May 2015, followed by the India-Nepal border blockade later that year.
methodsWe 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.
resultsDuring 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.
conclusionThe 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.
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