Health equity in economic and trade policies

13 countries join forces on air ticket tax for poor
USAToday/ Reuters: 1 March 2006

Thirteen countries joined forces Wednesday to adopt a tax on plane tickets to raise money to fight Aids and other killer diseases, Reuters reported, despite resistance from airlines. Brazil, Britain, Chile, Congo, Cyprus, France, Ivory Coast, Jordan, Luxembourg, Madagascar, Mauritius, Nicaragua, and Norway have now agreed to raise or started raising a sum from air tickets to help the poor, they said in a closing statement.

20 year patents threaten to end AIDS drugs for developing countries

Efforts to bring antiretroviral treatment to AIDS patients in developing countries are threatened by the looming implementation of new World Trade Organisation patent rules, the charity Médecins Sans Frontières warned in December. The organisation’s TRIPS (trade related aspects of intellectual property rights) agreement comes into force for most signatories on 1 January 2005. It requires the organisation’s members to grant 20-year patents to new pharmaceutical products. Only the least developed countries can postpone implementation until 2016.

2007 Victories: Fewer Deaths, more compulsory licenses
Baker B: Health GAP, 11 December 2007

Given India's victory against Novartis in the drug company's challenge to section 3d of the India Patent Act and given Thailand's highly publicised campaign to issue compulsory licenses on both AIDS and heart disease medicines, we are now seeing a new wave of patent withdrawals and a growing wave of compulsory licenses. This reciprocal wave action creates a wider opening for continuing access to newer and lower costs medicines. But the promise of this opening will only be realized if more countries amend their patent acts to take advantage of the TRIPS-compliant, definitional flexibilities that India has enacted and if more countries use the TRIPS compliant flexibilities for issuing compulsory licenses for generic medicines that Thailand has used.

6th Anniversary of the Marikana Massacre
Marikana Solidarity Collective; Review of African Political Economy, August 2018

This paper presents a case that six years after the Marikana Massacre, the London-based mining corporation involved (Lonmin) has decided to leave its platinum mining operation in South Africa by preparing to sell to Sibanye-Stillwater. The authors support the demands of women’s organisation Sikhala Sonke and victims’ representatives that Lonmin must fulfil a social covenant with the community, rather than to the banks. The paper reports the demands of social movements that Lonmin apologise to the South African nation and to the victims of the massacre and pay reparations to the affected parties. The authors also report the call that Lonmin join calls to release the miners in prison as a result of the massacre and to prosecute the police officers and authors of the massacre, take responsibility for the environmental destruction at Marikana and comply with the obligations of its social and labour plan and add its voice to those calling to review the Farlam Commission and finance the legal process. They reject the excuse that the company is now insolvent.

A Bitter Harvest Child Labour and Human Rights Abuses on Tobacco Farms in Zimbabwe
Wurth M; Buchanan J: Human Rights Watch, 2018

Tobacco farming is a pillar of Zimbabwe’s economy. Tobacco is the country’s most valuable export commodity—generating US$933.7 million in 2016—and the crop is particularly significant to Zimbabwean authorities’ efforts to revive the economy. However, Human Rights Watch research in 2016 and 2017 into conditions on tobacco farms in Zimbabwe revealed an industry tainted by child labour and confronted by other serious human rights problems as well. This report—based on extensive field research and interviews with 64 small-scale tobacco farmers, as well as 61 hired workers on tobacco farms in the largest tobacco-growing provinces in Zimbabwe—found several human rights problems in the tobacco sector. Children under 18 were found to work in hazardous conditions on tobacco farms in Zimbabwe, some performing tasks that threaten their health and safety or interfere with their education. Adults involved in tobacco production—both small-scale farmers and hired workers— were reported to face serious health and safety risks, with insufficient information, training, and equipment to protect themselves. Hired workers on some large-scale tobacco farms said they were pushed to work excessive hours without overtime compensation, denied their wages, and forced to go weeks or months without pay. The authors call on companies and government to prohibit children from any work involving contact with tobacco, as a policy that is both protective and straightforward for companies to communicate, implement, and monitor throughout the supply chain.

A blank cheque for abuse: the Anti-Counterfeiting Trade Agreement (ACTA) and its impact on access to medicines
Medicins Sans Frontieres: Access Campaign, February 2012

In this update to Medicins Sans Frontieres’ (MSF) November 2010 report on the Anti-Counterfeiting Trade Agreement (ACTA) - which has so far been signed by most developed nations - the impact of ACTA on access to medicines is investigated. Although a number of provisions that were harmful to access to medicines in developing countries were removed during the negotiations, the final text remains problematic, according to MSF. The agreement, for example, will undermine the ability of developing country governments to apply the Doha Declaration to protect public health. It puts medical distributors, non-governmental organisations and public health authorities at risk of severe penalties, while allowing for continued border detention of in-transit medicines destined for developing countries. ACTA undermines the role of the judiciary in protecting the right to health and balance private intellectual property rights with the larger public interest, and acts as a deterrent to the production and trade in generic medicines, as it provides for excessive punishment, shifts the risks entirely on to the generic manufacturer, and grants few protections against abuse. MSF states that it does not recognise the legitimacy of ACTA because it has been negotiated in secret with little room for public engagement. The authors conclud that ACTA is a cynical exploitation of concerns around unsafe medicines and is not a legitimate response to the problem of counterfeiting.

A call for more equitable economies and some ideas on how to get them
Chang C: CAFOD, April 2013

What can we do collectively to tackle inequality? The author of this article argues that first we need to ensure that governments are providing proper support to the livelihoods of poor men and women. At present, governments are a very long way from knowing if the money that they are spending on economic development is having an impact on poor entrepreneurs. Second, we need to ensure that the rules of the game governing our economies are not stacked against the poorest, resulting in distorted and unfair markets. These issues need to be addressed collectively by governments and included in an international setting. For example, taxing companies that operate across borders requires governments in different tax jurisdictions to cooperate. However, on these difficult, structural issues, promising first steps have been made. George Osborne led the call for a crack-down on tax-dodging multinationals at a G20 meeting last month, while in 2012 governments agreed to rethink investment rules at a United Nations conference in Doha.

A call to the 2007 G8 Summit to support African national health plans and comprehensive health workforce strategies
African Council for Sustainable Health Development (ACOSHED), African Medical and Research Foundation (AMREF)

The full call and signatories are found here to this call from African organisations to the G8 presented in the editorial section of the newsletter.

Further details: /newsletter/id/32346
A cross-sectional survey on knowledge and perceptions of health risks associated with arsenic and mercury contamination from artisanal gold mining in Tanzania
Charles E, Thomas DS, Dewey D, Davey M, Ngallaba SE and Konje E: BMC Public Health 13(74), 25 January 2013

An estimated 0.5 to 1.5 million informal miners, of whom 30-50% are women, rely on artisanal mining for their livelihood in Tanzania, and are exposed daily to mercury and arsenic. The primary objective of this study was to assess community risk knowledge and perception of potential mercury and arsenic toxicity in Rwamagasa in northwestern Tanzania, an area with a long history of artisanal gold mining. A total of 160 individuals over 18 years of age completed a structured interview. These interviews revealed wide variations in knowledge and risk perceptions concerning mercury and arsenic exposure, with 40.6% and 89.4% not aware of the health effects of mercury and arsenic exposure respectively. Males were significantly more knowledgeable (36.9%) than females (22.5%) with regard to mercury poisoning. An individual’s occupation category was associated with level of knowledge, and individuals involved in mining (73.2%) were more knowledgeable about the negative health effects of mercury than individuals in other occupations. Of the few individuals (10.6%) who knew about arsenic toxicity, most (58.8%) were miners. Overall lack of knowledge, combined with minimal environmental monitoring and controlled waste management practices, highlights the need for health education, surveillance, and policy changes, the authors conclude.

A decade of tobacco control: The South African case of politics, health policy, health promotion and behaviour change
Reddy PD, James S, Sewpaul R, Yach D, Resnicow K, Sifunda S, Mthembu Z, Mbewu A: South African Medical Journal, 103 (11):835-840, November 2013

The South African (SA) government has implemented comprehensive tobacco control measures in line with the requirements of the Framework Convention on Tobacco Control. The effect of these measures on smoking prevalence and smoking-related attitudes, particularly among young people, is largely unknown. This paper describes the impact of a comprehensive health promotion approach to tobacco control amongst SA school learners with evidence from four successive cross-sectional Global Youth Tobacco Surveys (GYTSs) in 1999, 2002, 2008 and 2011 among nationally representative samples of SA grades 8 - 10 school learners. Smoking-related attitudes and behaviours showed favourable changes over the survey period. The surveys demonstrated that the comprehensive and inter-sectorial tobacco control health promotion strategies implemented in SA have led to a gradual reduction in cigarette use amongst school learners. Of concern, however, are the smaller reductions in smoking prevalence amongst girls and black learners and an increase in smoking prevalence from 2008 to 2011. Additional efforts, especially for girls, are needed to ensure continued reduction in smoking prevalence amongst SA youth.

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