Health equity in economic and trade policies

AU takes decision on EPAs
AFROL News, 29 January 2008

The Executive Council of the African Union was reported in January to have resolved that no African region should be allowed to sign the Economic Partnership Agreements (EPAs) with the European Union "as long as the draft agreement is not submitted and discussed at the continental level". The council believed that the signing of any interim or complete EPAs will affect other regions in Africa, recommended "the need for a political intervention at the highest level to protect the interest of African countries."

Austerity: The history of a dangerous idea
Blyth M: Oxford University Press, 2013

According to this book, governments across the globe are being persuaded by economists that government spending on services like education and health is unnecessary and can only worsen the global economic crisis. To this effect they have advanced a policy of draconian budget cuts – austerity - to solve the financial crisis. However, the author of this book argues that the source of the financial crisis is not in government spending but the direct result of bailing out, recapitalising and adding liquidity to the broken banking system. Through these actions private debt was reclassified as government debt, which now is the responsibility of taxpayers to pay off, hence the proposed cuts in government spending. Blyth argues that historical evidence shows that austerity doesn't work when all states try it simultaneously: all they do is shrink the economy. He shows how austerity policies aggravated the Great Depression of the 1930s and created the conditions for seizures of power by the forces responsible for the Second World War: the Nazis and the Japanese military establishment. He concludes that the arguments for austerity are tenuous and the evidence thin. Rather than expanding growth and opportunity, the repeated revival of this dead economic idea has almost always led to low growth along with increases in wealth and income inequality.

Back to Doha: Financing for development at stake
Valot H: e-CIVICUS 413, 31 October 2008

Doha is known for having its name attached to the World Trade Organisation (WTO) Doha Development Round, the current trade-negotiation round of the World Trade Organisation which commenced in November 2001. As of 2008, talks have stalled over a divide on major issues, such as agriculture, industrial tariffs and non-tariff barriers, services, and trade remedies. Major negotiations are not expected to resume until 2009. Civil society organisations have pointed out a need for a strong regulatory framework to counter well-documented abuses, and ensure positive developmental impacts of foreign direct investment. They recommended specific mechanisms, such as country-by-country reporting to regulate transnational corporations, policies to harness the revenue from natural resource extraction and commitment to combat increasing trade and investment liberalisation.

Balancing intellectual monopoly privileges and the need for essential medicines
Martin G, Sorenson C, Faunce T: Globalization and Health 3:4, 12 June 2007

This issue of Globalization and Health presents a paper by Kerry and Lee that considers the TRIPS agreement and the recent policy debate regarding the protection of public health interest, particularly as they pertain to the Doha Declaration. This editorial considers the debate, examines issues of enacting, implementing and monitoring TRIPS provisions and identifies questions that should be considered by key stakeholders in ongoing discussions.

Behind closed doors: Secrecy at the International Financial Institutions
Musuva C: IFI Transparency, 2006

This study involved making freedom of information requests for information on IFIs in five different countries: Bulgaria; Mexico; Slovakia; South Africa and Argentina. The study found that information was difficult to obtain and there were varying degrees of disclosure across countries, with only 22 per cent of the 120 requests resulting in full disclosure and a number of requests being totally ignored by the IFIs. The Charter is the GTI's flagship statement of the standards to which IFI information disclosure policies should conform and a key advocacy tool for the promotion of more progressive policies.

Beijing Declaration of the Ministerial Forum of China-Africa Health Development
Ministers of health of the People’s Republic of China and African countries, August 2013

The ministers of health of the People’s Republic of China and African countries as well as representatives of the African Union, the World Health Organization, UNAIDS, UNFPA, UNICEF, the World Bank, the Global Fund to fight against HIV / AIDS Fund, Tuberculosis and Malaria and GAVI, met in Beijing in August 2013 to implement the Beijing Action Plan 2013-2015, adopted by the 5th China-Africa Cooperation Forum Ministerial in 2012. Under the theme of “Priorities of China-Africa Cooperation Health in the New Era”, the meeting reviewed previous health cooperation between China and Africa and reached consensus on the priorities for and ways of health cooperation. The meeting agreed on various areas of future links including on health worker training; cooperation between research institutions in China and Africa, strengthening of health information systems; prevention and control of communicable and non-communicable diseases; support for health infrastructure development donating modulated clinics to Africa, adapted to local conditions; cooperation in standard setting and inspection of medical products through capacity building and use of appropriate technology and promotion of health technology transfer to reduce the price of health commodities including pharmaceuticals, diagnostics, vaccines and equipment, and to increase their affordability.

Benefits of global partnerships to facilitate access to medicines in developing countries: A multi-country analysis of patients and patient outcomes in GIPAP
Kanavos Panos, Vandoros Sotiris and Garcia-Gonzalez Pat: Globalization and Health 5(19), 31 December 2009

Access to medicines in developing countries continues to be a significant problem due to lack of insurance and lack of affordability. Chronic myeloid leukemia (CML), a rare disease, can be treated effectively, but the pharmaceutical treatment available (imatinib) is costly and unaffordable for most patients. GIPAP is a programme set up between a manufacturer and a non-governmental organisation to provide free treatment to eligible CML patients in 80 countries worldwide. In this study, data for 13,568 patients across 15 countries, available quarterly, were analysed over the 2005-2007 period. Four waves of patients entering quarterly in 2005 were used to evaluate patient survival over the sample period. Having controlled for age, location and occupation, the analysis showed that patients were significantly more likely to move towards a better health state after receiving treatment irrespective of their disease stage at the point of entry to the programme.

Between the Rack and a Hot Place: Can we Reconcile Poverty Eradication and Tackling Climate Change?
Woodward D: Sussex Development Lecture, IDS, Sussex University, 20 February 2012

By any reasonable definition, the majority of humanity is on the rack of poverty; and a major obstacle to its eradication is the growing threat of extreme and irreversible climate change. The coexistence of a chronic crisis of serious under-consumption for most with an increasingly critical environmental crisis resulting from over-consumption in aggregate can only be explained by extreme inequality in the global distribution of income. Resolving both simultaneously, as envisaged in the Post-2015 Agenda, requires a fundamental reconsideration of the nature and objectives of economic policy, and of the global economic system. The lecture discusses the extent and implications of global inequality, before building on a number of working hypotheses to outline an alternative model of economic development more conducive to the achievement of these two most fundamental global goals.

BFTU policy position paper on globalisation: 2007
Botswana Federation of Trade Unions (BFTU): 2007

This policy paper deals primarily with the effect of globalisation on Botswana’s workforce and includes a discussion of occupational health and safety (OHS) within this framework. It notes that, in general, the effective monitoring of health standards is absent in Botswana. The Labour Inspectorate is a government unit under the Ministry of Labour and Home Affairs. It operates under the Factories Act that came into force in 1979. However, there are only a handful and overburdened of labour inspectors carrying OHS inspections to verify compliance with the relevant law. In other cases, some international labour standards ratified have not been backed up by legislation. For example, despite being a heavily mining dependent country, the International Labour Organisation’s convention 176, which deals with health and safety in the mines, has not been enacted at all, notwithstanding its ratification almost a decade ago. The government, like in many other cases continues to gloss over this very serious matter.

Bilateral trade agreements may undermine South African Constitution, says government
Davies R: South African Department of Trade and Industry, 24 September 2012

While bilateral investment treaties (BITs) can make a positive contribution to sustainable development, the benefits to host countries are not automatic, according to this speech by South African Minister of Trade and Industry, Rob Davies. He says BITs pose risks and limitations on the ability of the Government to pursue its Constitutional-based transformation agenda. As a result, Cabinet has concluded that South Africa should refrain from entering into BITs in future, except in cases of compelling economic and political circumstances. Cabinet also seeks to incorporate legitimate exceptions to investor protection where warranted by public policy considerations such as, for example for national security, health, environmental reasons or for measures to address historical injustice and or promote development. South Africa’s updated approach would aim to achieve an appropriate balance between the rights and obligations of investors, the need to provide adequate protection to foreign investors, while ensuring that constitutional obligations are upheld, and that government retains the policy space to regulate in the public interest.