romikgosai/squad_modified huggingface dataset:
In March 2001, 40 multi-national pharmaceutical companies brought litigation against South Africa for its Medicines Act, which allowed the generic production of antiretroviral drugs (ARVs) for treating HIV, despite the fact that these drugs were on-patent. HIV was and is an epidemic in South Africa, and ARVs at the time cost between 10,000 and 15,000 USD per patient per year. This was unaffordable for most South African citizens, and so the South African government committed to providing ARVs at prices closer to what people could afford. To do so, they would need to ignore the patents on drugs and produce generics within the country (using a compulsory license), or import them from abroad. After international protest in favour of public health rights (including the collection of 250,000 signatures by MSF), the governments of several developed countries (including The Netherlands, Germany, France, and later the US) backed the South African government, and the case was dropped in April of that year.

Questions and answers:
['
Q: How much did treatment for each patient in Africa cost?
A: 10,000 and 15,000 USD per patient per year', '
Q: Who backed the South African government which caused the case to be dropped?
A: The Netherlands, Germany, France, and later the US', '
Q: Who brought litigation to South Africa?
A: 40 multi-national pharmaceutical companies', '
Q: How many signatures were collected by MSF?
A: 250,000 signatures', '
Q: When was litigation brought to South Africa?
A: March 2001', '
Q: How many companies sued South Africa for its Medicines Act?
A: 40', "
Q: South Africa's Medicines Act allowed for the generic production of what kind of drugs?
A: antiretroviral", '
Q: How much did ARV drugs cost patients yearly?
A: between 10,000 and 15,000 USD', '
Q: How many signatures were collected supporting public health rights?
A: 250,000']
Prior to the 20th century drugs were generally produced by small scale manufacturers with little regulatory control over manufacturing or claims of safety and efficacy. To the extent that such laws did exist, enforcement was lax. In the United States, increased regulation of vaccines and other biological drugs was spurred by tetanus outbreaks and deaths caused by the distribution of contaminated smallpox vaccine and diphtheria antitoxin. The Biologics Control Act of 1902 required that federal government grant premarket approval for every biological drug and for the process and facility producing such drugs. This was followed in 1906 by the Pure Food and Drugs Act, which forbade the interstate distribution of adulterated or misbranded foods and drugs. A drug was considered misbranded if it contained alcohol, morphine, opium, cocaine, or any of several other potentially dangerous or addictive drugs, and if its label failed to indicate the quantity or proportion of such drugs. The government's attempts to use the law to prosecute manufacturers for making unsupported claims of efficacy were undercut by a Supreme Court ruling restricting the federal government's enforcement powers to cases of incorrect specification of the drug's ingredients.

Questions and answers:
['
Q: What Act forbade misbranded drugs?
A: Pure Food and Drugs Act', '
Q: What caused a Tetanus outbreak?
A: contaminated smallpox vaccine and diphtheria antitoxin', '
Q: What act allowed premarket approval for drugs?
A: The Biologics Control Act of 1902', '
Q: When did the Pure Food and Drugs Act get implemented?
A: 1906', "
Q: Who restricted the federal government's enforcement powers?
A: Supreme Court", '
Q: What was the name of the law that required premarket approval for producing drugs?
A: Biologics Control Act of 1902', '
Q: What law banned the interstate distribution of mislabeled food and drugs? 
A: Pure Food and Drugs Act', '
Q: In what year was the Pure Food and Drugs Act passed?
A: 1906']
Patents have been criticized in the developing world, as they are thought to reduce access to existing medicines. Reconciling patents and universal access to medicine would require an efficient international policy of price discrimination. Moreover, under the TRIPS agreement of the World Trade Organization, countries must allow pharmaceutical products to be patented. In 2001, the WTO adopted the Doha Declaration, which indicates that the TRIPS agreement should be read with the goals of public health in mind, and allows some methods for circumventing pharmaceutical monopolies: via compulsory licensing or parallel imports, even before patent expiration.

Questions and answers:
['
Q: Who adopted the Doha Declaration?
A: World Trade Organization', '
Q: What did the TRIPS agreement accomplish?
A: countries must allow pharmaceutical products to be patented', '
Q: Why are patents criticized?
A: thought to reduce access to existing medicines', '
Q: What did the Doha Declaration do?
A: indicates that the TRIPS agreement should be read with the goals of public health in mind, and allows some methods for circumventing pharmaceutical monopolies', '
Q: When was the Doha Declaration adopted?
A: 2001', '
Q: What has been accused of reducing access to medicines in developing countries?
A: Patents', '
Q: The Doha Declaration allows for what ways for monopolies to be bypassed?
A: compulsory licensing or parallel imports', '
Q: When did the World Trade Organization adopt the Doha Declaration?
A: 2001']
Pharmaceutical fraud involves deceptions which bring financial gain to a pharmaceutical company. It affects individuals and public and private insurers. There are several different schemes used to defraud the health care system which are particular to the pharmaceutical industry. These include: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs. Of this amount $2.5 billion was recovered through False Claims Act cases in FY 2010. Examples of fraud cases include the GlaxoSmithKline $3 billion settlement, Pfizer $2.3 billion settlement and Merck & Co. $650 million settlement. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the qui tam provisions which rewards an individual for being a "whistleblower", or relator (law).

Questions and answers:
['
Q: How much money was recovered through the False Claims?
A: $2.5 billion', '
Q: What are some of the schemes used to defraud the health care system?
A: Good Manufacturing Practice (GMP) Violations, Off Label Marketing, Best Price Fraud, CME Fraud, Medicaid Price Reporting, and Manufactured Compound Drugs.', '
Q: What is pharmaceutical fraud?
A: deceptions which bring financial gain to a pharmaceutical company', '
Q: Who had the biggest fraud case settlement?
A: GlaxoSmithKline', '
Q: What provision rewards "whistle-blowers"?
A: qui tam', '
Q: What kind of fraud financially benefits a drug company?
A: Pharmaceutical fraud', '
Q: Who is affected by pharmaceutical fraud?
A: individuals and public and private insurers', '
Q: How much money lost to pharmaceutical fraud was recovered in 2010?
A: $2.5 billion', '
Q: Which act allows whistleblowers to recover money lost from pharmaceutical fraud?
A: False Claims Act']
A 2009 Cochrane review concluded that thiazide antihypertensive drugs reduce the risk of death (RR 0.89), stroke (RR 0.63), coronary heart disease (RR 0.84), and cardiovascular events (RR 0.70) in people with high blood pressure. In the ensuring years other classes of antihypertensive drug were developed and found wide acceptance in combination therapy, including loop diuretics (Lasix/furosemide, Hoechst Pharmaceuticals, 1963), beta blockers (ICI Pharmaceuticals, 1964) ACE inhibitors, and angiotensin receptor blockers. ACE inhibitors reduce the risk of new onset kidney disease [RR 0.71] and death [RR 0.84] in diabetic patients, irrespective of whether they have hypertension.

Questions and answers:
['
Q: What drugs reduce the risk of death and other events in people with high blood pressure?
A: thiazide antihypertensive drugs', '
Q: Who conducted the review on Thiazide Antihypertensive drugs?
A: Cochrane', '
Q: What were Thiazide Antihypertensive drugs used with?
A: combination therapy', '
Q: What do ACE inhibitors do?
A: reduce the risk of new onset kidney disease [RR 0.71] and death [RR 0.84] in diabetic patients', '
Q: In what year did Cochrane release the report?
A: 2009', '
Q: What reduces the risk of new onset kidney diseases and death?
A: ACE inhibitors', '
Q: What type of drugs reduced the risk of strokes and heart disease for people with high blood pressure?
A: thiazide antihypertensive drugs', '
Q: In what year was thiazide antihypertensive drugs shown to help those with heart problems?
A: 2009']
Others have argued that excessive regulation suppresses therapeutic innovation, and that the current cost of regulator-required clinical trials prevents the full exploitation of new genetic and biological knowledge for the treatment of human disease. A 2012 report by the President's Council of Advisors on Science and Technology made several key recommendations to reduce regulatory burdens to new drug development, including 1) expanding the FDA's use of accelerated approval processes, 2) creating an expedited approval pathway for drugs intended for use in narrowly defined populations, and 3) undertaking pilot projects designed to evaluate the feasibility of a new, adaptive drug approval process.

Questions and answers:
["
Q: Who put out a report in 2012?
A: President's Council of Advisors on Science and Technology", '
Q: What has been argued restricted innovation?
A: excessive regulation', "
Q: What was a recommendations brought about from the report?
A: expanding the FDA's use of accelerated approval processes", '
Q: What is one thing excessive regulations causes?
A: therapeutic innovation', '
Q: What can be used to evaluate new approval processes?
A: pilot projects', '
Q: What is excessive drug regulation said to suppress?
A: therapeutic innovation', '
Q: In what year was a report made to reduce the burdens of drug development?
A: 2012', '
Q: What was argued to be holding back new knowledge for treating diseases?
A: current cost of regulator-required clinical trials']
In 1952 researchers at Ciba discovered the first orally available vasodilator, hydralazine. A major shortcoming of hydralazine monotherapy was that it lost its effectiveness over time (tachyphylaxis). In the mid-1950s Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello of Merck and Co. discovered and developed chlorothiazide, which remains the most widely used antihypertensive drug today. This development was associated with a substantial decline in the mortality rate among people with hypertension. The inventors were recognized by a Public Health Lasker Award in 1975 for "the saving of untold thousands of lives and the alleviation of the suffering of millions of victims of hypertension".

Questions and answers:
['
Q: Who discovered Hydralazine?
A: researchers at Ciba', '
Q: Why were the researchers recognized in 1975?
A: the saving of untold thousands of lives and the alleviation of the suffering of millions of victims of hypertension', '
Q: Who developed Chlorothiazide?
A: Karl H. Beyer, James M. Sprague, John E. Baer, and Frederick C. Novello of Merck and Co', '
Q: What is  Chlorothiazide used to treat?
A: hypertension', '
Q: What was the main shortcoming in the drug Hydralazine?
A: lost its effectiveness over time', '
Q: What was the name of the first oral vasodilator?
A: hydralazine', '
Q: What is the most used antihypertensive drug today?
A: chlorothiazide', '
Q: Beyer, Sprague, Baer, and Novello received what award in 1975?
A: Public Health Lasker Award', '
Q: In what year was hydralazine discovered?
A: 1952', '
Q: Chlorothiazide helped reduce the mortality rate among those with what disease?
A: hypertension']
In the U.S., a push for revisions of the FD&C Act emerged from Congressional hearings led by Senator Estes Kefauver of Tennessee in 1959. The hearings covered a wide range of policy issues, including advertising abuses, questionable efficacy of drugs, and the need for greater regulation of the industry. While momentum for new legislation temporarily flagged under extended debate, a new tragedy emerged that underscored the need for more comprehensive regulation and provided the driving force for the passage of new laws.

Questions and answers:
['
Q: What act needed provisions?
A: FD&C', '
Q: Who led the congressional hearings?
A: Senator Estes Kefauver', '
Q: What were the major issues that needed to be addressed?
A: advertising abuses, questionable efficacy of drugs, and the need for greater regulation of the industry', '
Q: What caused a need for more regulation?
A: a new tragedy emerged', '
Q: When did this push occur?
A: 1959', '
Q: Congressional hearings emerged addressing revisions to what act?
A: FD&C', '
Q: Who led the Congressional hearings in 1959?
A: Senator Estes Kefauver', '
Q: Did the US Congress call for more or less regulation of pharmaceuticals?
A: greater']
Other notable new vaccines of the period include those for measles (1962, John Franklin Enders of Children's Medical Center Boston, later refined by Maurice Hilleman at Merck), Rubella (1969, Hilleman, Merck) and mumps (1967, Hilleman, Merck) The United States incidences of rubella, congenital rubella syndrome, measles, and mumps all fell by >95% in the immediate aftermath of widespread vaccination. The first 20 years of licensed measles vaccination in the U.S. prevented an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths.

Questions and answers:
["
Q: What did the first measles prevent in it's first 20 years?
A: an estimated 52 million cases of the disease, 17,400 cases of mental retardation, and 5,200 deaths", '
Q: Who originally created the measles vaccine?
A: John Franklin Enders', '
Q: How much did the occurrence of serious diseases shortly after the release of the measles vaccine?
A: >95%', '
Q: When did the Rubella vaccine come out?
A: 1969', '
Q: Who recreated the measles vaccine?
A: Maurice Hilleman', '
Q: In what year was the measles vaccine made?
A: 1962', '
Q: Who helped refine the measles vaccine?
A: Maurice Hilleman', '
Q: In what year was the mumps vaccine made?
A: 1967', '
Q: How much did rubella, measles, and mumps infections drop after vaccination?
A: >95%', '
Q: Measles vaccinations helped prevent how many estimated cases of the illness?
A: 52 million']
The thalidomide tragedy resurrected Kefauver's bill to enhance drug regulation that had stalled in Congress, and the Kefauver-Harris Amendment became law on 10 October 1962. Manufacturers henceforth had to prove to FDA that their drugs were effective as well as safe before they could go on the US market. The FDA received authority to regulate advertising of prescription drugs and to establish good manufacturing practices. The law required that all drugs introduced between 1938 and 1962 had to be effective. An FDA - National Academy of Sciences collaborative study showed that nearly 40 percent of these products were not effective. A similarly comprehensive study of over-the-counter products began ten years later.

Questions and answers:
['
Q: When did the Kefauver-Harris Amendment become a law?
A: 10 October 1962', '
Q: What did this new law require?
A: all drugs introduced between 1938 and 1962 had to be effective', "
Q: What did the National Academy of Science's study discover?
A: nearly 40 percent of these products were not effective", "
Q: How long after the National Academy of Science's study did a study on over the counter drugs occur?
A: ten years later", '
Q: What brought up enhancement of drug regulations?
A: The thalidomide tragedy', '
Q: When did the Kefauver-Harris Amendment became law?
A: 10 October 1962', '
Q: What federal agency regulated the advertising of prescription drugs?
A: FDA', '
Q: Drugs made between which years had to be tested before going to market?
A: 1938 and 1962', '
Q: What percentage of drugs were shown to be ineffective after an FDA study?
A: 40 percent']
The firm continued to pressure Kelsey and the agency to approve the application—until November 1961, when the drug was pulled off the German market because of its association with grave congenital abnormalities. Several thousand newborns in Europe and elsewhere suffered the teratogenic effects of thalidomide. Though the drug was never approved in the USA, the firm distributed Kevadon to over 1,000 physicians there under the guise of investigational use. Over 20,000 Americans received thalidomide in this "study," including 624 pregnant patients, and about 17 known newborns suffered the effects of the drug.[citation needed]

Questions and answers:
['
Q: How many Americans were given the drug Kevadon?
A: Over 20,000', '
Q: When was the drug taken off shelves in Germany?
A: November 1961', '
Q: How many newborns were born with issues due to Kevadon?
A: about 17', '
Q: How was Kevadon distributed to doctors?
A: under the guise of investigational use', '
Q: Why was this drug pulled off shelves?
A: association with grave congenital abnormalities', '
Q: In what year was thalidomide banned in Germany?
A: 1961', '
Q: What adverse effect was thalidomide associated with?
A: congenital abnormalities', '
Q: Thalidomide was distributed in the USA by what name?
A: Kevadon', '
Q: About how many Americans received thalidomide in a supposed study?
A: Over 20,000', '
Q: How many newborn American babies were affected by thalidomide?
A: 17']
Prior to the second world war, birth control was prohibited in many countries, and in the United States even the discussion of contraceptive methods sometimes led to prosecution under Comstock laws. The history of the development of oral contraceptives is thus closely tied to the birth control movement and the efforts of activists Margaret Sanger, Mary Dennett, and Emma Goldman. Based on fundamental research performed by Gregory Pincus and synthetic methods for progesterone developed by Carl Djerassi at Syntex and by Frank Colton at G.D. Searle & Co., the first oral contraceptive, Enovid, was developed by E.D. Searle and Co. and approved by the FDA in 1960. The original formulation incorporated vastly excessive doses of hormones, and caused severe side effects. Nonetheless, by 1962, 1.2 million American women were on the pill, and by 1965 the number had increased to 6.5 million. The availability of a convenient form of temporary contraceptive led to dramatic changes in social mores including expanding the range of lifestyle options available to women, reducing the reliance of women on men for contraceptive practice, encouraging the delay of marriage, and increasing pre-marital co-habitation.

Questions and answers:
['
Q: What law prohibited birth control?
A: Comstock laws', '
Q: When was Enovid first approved?
A: 1960', '
Q: What increased due to the availability of birth control?
A: pre-marital co-habitation', '
Q: Who created the first oral birth control?
A: E.D. Searle and Co', '
Q: In 1965, how many women were on the birth control pill?
A: 6.5 million', '
Q: Discussing contraception sometimes led to prosecution under what laws?
A: Comstock laws', '
Q: What was the name of the first oral contraceptive?
A: Enovid', '
Q: By 1965, about how many American women were taking Enovid?
A: 6.5 million', '
Q: When did the FDA approve Enovid?
A: 1960', '
Q: Birth control was prohibited in most countries before what war?
A: second world war']
In April 1994, the results of a Merck-sponsored study, the Scandinavian Simvastatin Survival Study, were announced. Researchers tested simvastatin, later sold by Merck as Zocor, on 4,444 patients with high cholesterol and heart disease. After five years, the study concluded the patients saw a 35% reduction in their cholesterol, and their chances of dying of a heart attack were reduced by 42%. In 1995, Zocor and Mevacor both made Merck over US$1 billion. Endo was awarded the 2006 Japan Prize, and the Lasker-DeBakey Clinical Medical Research Award in 2008. For his "pioneering research into a new class of molecules" for "lowering cholesterol,"[sentence fragment]

Questions and answers:
['
Q: Who received the Laser-Debakey Clinical Medical Research Aware?
A: Endo', '
Q: How much money did Merk make in 1995?
A: over US$1 billion', '
Q: How many patients received Zocor?
A: 4,444', '
Q: What study did Merk sponsor in 1994?
A: Scandinavian Simvastatin Survival Study', '
Q: What did the study reveal after 5 years?
A: a 35% reduction in their cholesterol, and their chances of dying of a heart attack were reduced by 42%', '
Q: What was the brand name of simvastatin?
A: Zocor', '
Q: Patients treated with Zocor had their cholesterol reduced by how much?
A: 35%', '
Q: How much did Zocor reduce the chance of dying from a heart attack?
A: 42%', '
Q: How much money did Merck make from sales of Zocor and Mevacor?
A: over US$1 billion', '
Q: Endo received what award in 2008?
A: Lasker-DeBakey Clinical Medical Research Award']
Drug discovery is the process by which potential drugs are discovered or designed. In the past most drugs have been discovered either by isolating the active ingredient from traditional remedies or by serendipitous discovery. Modern biotechnology often focuses on understanding the metabolic pathways related to a disease state or pathogen, and manipulating these pathways using molecular biology or biochemistry. A great deal of early-stage drug discovery has traditionally been carried out by universities and research institutions.

Questions and answers:
['
Q: What is a drug discovery?
A: the process by which potential drugs are discovered or designed', '
Q: Who is usually responsible for early stages of drug discovery?
A: universities and research institutions', '
Q: What is used to manipulate pathways?
A: molecular biology or biochemistry', '
Q: What is involved in drug discovery?
A: isolating the active ingredient from traditional remedies or by serendipitous discovery', '
Q: What focuses on metabolic pathways?
A: biotechnology', '
Q: What is the name of the process in which possible drugs are discovered?
A: Drug discovery', '
Q: What groups carry out most early drug discoveries?
A: research institutions', '
Q: What kind of technology studies the understanding and manipulation of disease states and pathogens?
A: biotechnology', '
Q: Most drugs have been found by isolating what from traditional remedies?
A: active ingredient']