BackgroundA training physician has his first interaction with a pharmaceutical representative during medical school. Medical students are often provided with small gifts such as pens, calendars and books, as well as free lunches as part of drug promotion offers. Ethical impact of these transactions as perceived by young medical students has not been investigated in Pakistan before. This study aimed to assess the association of socio-demographic variables with the attitudes of medical students towards pharmaceutical companies and their incentives.MethodsAs part of a cross-sectional survey, a validated questionnaire previously used for assessing attitude of medical students towards pharmaceutical industry, was modified, pre-tested and distributed among consenting clinical year students at DUHS and AKU. Questions included acceptability of pharmaceutically sponsored gifts, events and tuition fee, and their impact on future prescription. Responses were graded as agree, disagree or neutral which were then scored according to the AMSA guidelines of ethical conduct.ResultsOut of a total of 353 targeted students 303 responded, corresponding to a response rate of 85.8%. Responses indicated that 42.7% students believed in no interaction with drug companies during medical school. However, 81% of students favored pharmaceutical sponsorship of student-body events/seminars at medical colleges. More than one-third of the students were comfortable receiving gifts from drug companies. Overall, the results of this study offer an interesting comparison between the students of a private medical school (AKU) and a public medical school (DUHS); AKU students exhibited a greater degree of mistrust towards drug information provided by pharmaceutical companies compared to DUHS students (p = 0.040). Furthermore, when asked if there was a need to incorporate guidelines in the undergraduate curriculum with regard to interaction with drug companies, 84.2% students at AKU agreed, compared to 54.9% at DUHS. Medical student Attitude Scores are more or less similar to each other independent of their various demographical differences.ConclusionThis study highlights that medical students in our population have a high level of acceptability towards incentives offered by pharmaceutical industry and that formal guidance regarding the subject should be incorporated into medical curriculum.

This case study explores the 2018–22 implementation of a national community-based surveillance (CBS) programme in Sudan. The programme was designed to meet critical needs of the existing health surveillance system. It aimed to empower communities to detect and contain public health threats, improve relations between communities and their local health system, and involve villages in rural areas. Federal, state, and locality (district) staff attended CBS workshops before recruiting and training community volunteers. Over 8,000 volunteers across 11 states were recruited. The volunteers alerted staff to priority syndromes for communicable diseases as well as local events with public health implications (e.g., natural disasters, conflict-induced displacement, food insecurity). Lessons learnt can be used to increase understanding of large-scale CBS programmes and to identify opportunities to strengthen new and existing programmes. For more social science guidance on CBS, see our companion: Key Considerations: Community-Based Surveillance in Public Health.