The General Agreement on Trade in Services (GATS), created under the auspices of the World Trade Organisation, aims to regulate measures affecting international trade in services - including health services such as health insurance, hospital services, telemedicine, and acquisition of medical treatment abroad. The agreement has been the subject of great controversy, for it may affect the freedom with which countries can change the shape of their domestic health care systems. This article explains the rationale behind the agreement and discusses its scope. It also addresses the major controversies surrounding the GATS and their implications for the U.S. health care system.
Health equity in economic and trade policies
The General Agreement On Trade In Services: Implications For Health Policymakers
Debt for Aids swaps
Debt swaps exchange debt for some other asset or obligation. In the context of development, they normally involve countries negotiating cancellation of external debts in return for commitments on internal resource mobilization or some other government action. There has been considerable international interest in debt swaps and their potential to create a new and additional financing mechanism to help overcome long-standing barriers to development. The impact of AIDS on many developing countries, including many of the most indebted, has been severe. In the worst cases, AIDS has caused development progress to be set back by decades. There is therefore emerging interest in examining whether debt swaps are potentially useful new instruments to apply to the problem of AIDS and development. This is according to a UNAIDS policy brief on the issue.
Patam sends letter to African finance ministers
Finance Ministers that attended the World Bank spring meetings in Washington towards the end of April were urged by the Pan-African Treatment Access Movement (PATAM) to ensure that urgent attention be paid to building the internal capacity of African countries to marshal their own resources against HIV/AIDS, reject fiscal conditions that imply a decline in additional donated revenues for HIV/AIDS, demand full debt cancellation and upport efforts to highlight transparency, accountability and representation in the IMF and World Bank. PATAM send a letter to African ministers of finance which can be read by clicking on the link below.
Further details: /newsletter/id/30407
World Bank criticised for HIV/AIDS response
The World Bank failed to protect social spending during its structural adjustment operations in the 1980s and 1990s, and this led to the deterioration of basic services - including those needed for the prevention and control of HIV/AIDS. And instead of focusing on HIV/AIDS, the World Bank sought improvements in the way goods and services were provided and financed through health sector reforms, such as user fees, privatisation, decentralisation and integration of services. These reforms frequently had the unintended effect of reducing access to effective health care, including services aimed at the prevention and control of HIV/AIDS. This is according to a paper Produced by ActionAid that evaluates the response to the HIV crisis by the World Bank.
Globalisation, the international poverty trap and chronic poverty
This paper argues that the dollar-a-day poverty is pervasive and persistent in most Least Developed Countries because they are caught in an international poverty trap. It highlights the fact that poverty is perpetuated by vicious domestic circles through which the high incidence and severity of poverty constrain national economic growth, and that the current form of globalisation is tightening rather than loosening the international poverty trap. In response to this, the author states that policies underlying international development cooperation, focusing on Poverty Reduction Strategy Papers (PRSPs) have not changed sufficiently to enable countries to escape the trap and realise the opportunity for fast poverty reduction through economic growth.
Issues and suggestions in trade and development
The Monterrey Consensus recognises the strong links between trade, finance and development issues. The challenge is to make trade, trade policy and trade rules work for development. This is a big challenge because many trade rules, for example in the WTO, and many trade policies, for example in structural adjustment conditionalities, are not yet aligned with development needs in the South, says a discussion paper submitted by the Third World Network to an informal meeting on financing for development.
MDG report on Zambia justifies more social sector involvement
Civil Society for Poverty Reduction (CSPR) has said the glaring failure revealed in the Millennium Development Goal (MDG) report on Zambia justifies the call for more investment in the social sector. Commenting on the contents of the MDG report that was released recently, CSPR assistant co-ordinator Gregory Chikwanka said the report's revelations heralded the need for the government to revisit the resource allocation procedures. The report states that of the 10 MDG targets, Zambia could probably achieve one while possessing the potential to achieve only six others.
Poor Countries Fail To Take Advantage of WTO Accord on AIDS Drugs
Poor countries that fought to be able to import generic prescription drugs have failed to use changes to the WTO rules on intellectual property rights, reviving a row over who is to blame for the lack of treatment for millions of AIDS sufferers, reported Agence France Presse in March. According to Daniela Bagozzi, spokeswoman for the World Health Organisation in Geneva, "nothing much has changed since August," when a compromise between the 146 members of the WTO broke an eight-month deadlock over the changes. "From what we know and what we've heard, no country has issued a demand for a compulsory license as authorized within the agreement," she said.
Robbing the poor to pay the rich
This paper argues that the government of the United States is contravening its commitment under the "Doha Declaration" of 2001by using technical assistance, bilateral and regional trade agreements, and the threat of trade sanctions to ratchet up patent protection in developing countries. The paper states that the U.S. is pressuring developing countries to implement patent laws which go beyond TRIPS obligations and do not take advantage of its public-health safeguards in order to benefit the influential U.S. pharmaceutical industry.
US AIDS Czar Undermines WHO Initiative
Sanjay Basu
In May 2003, at its annual World Health Assembly, the World Health Organisation (WHO) announced a modest proposal: that it would provide the technical and organisational support to provide 3 million people in poor countries with antiretroviral treatment by the year 2005. This "3-by-5 initiative" was minor in one sense, in that it would provide treatment to only about 5 percent of those in need. But in another sense, it was a major step forward, particularly because the WHO proposed a novel manner of delivering the anti-HIV medicines: combining the drugs into a "fixed-dose regimen", a combination pill containing three drugs in one capsule, allowing an infected person to take only one pill twice per day for a complete HIV-treatment regimen. Fixed-dose combinations are cheaper and easier to take than the existing HIV treatment protocol; taking two fixed-dose combination pills a day for a year costs $140 per patient, compared to about $600 per year for the normal regimen of six pills per day.
Further details: /newsletter/id/30350