Health equity in economic and trade policies

Assessing regional integration in Africa III
Economic Commission for Africa: 2009

Macroeconomic stability, monetary and financial integration are crucial for successful regional cooperation and integration. Both processes make decisive contributions to the creation of a conducive environment for economic growth, promotion of trade and boosting of investor confidence, hence the importance of pursuing prudent fiscal, monetary, exchange rate and debt policies at the national level and of harmonising these policies at the subregional and regional levels. Arguably, these policies should be situated within the socio-political, technological and international development setting of the countries, and indeed of the continent at large. The strengthening and deepening of the financial sector, including the establishment of vibrant capital markets, will also greatly facilitate the flow of funds and help anchor macroeconomic policies. Moreover, strong national and subregional capital markets would play a catalytic role in attracting foreign direct investment and promoting cross-border investment flows. This report also provides a brief ‘progress report’ on the developments in Africa’s regional integration.

AU Health Ministers Meeting speaks out on TRIPS

An AU Health Ministers meeting was held in Gaborone, Botswana 13-14 October 2005. On TRIPS, the final statement of the meeting said:
- UNDERTAKE to pursue, with the support of our partners, the local production of generic medicines on the continent and to making full use of the flexibilities in the Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPs) and the Doha Declaration on TRIPS and Public Health;
- CALL UPON our Ministers of Trade to seek a more appropriate permanent solution at the WTO that revises the TRIPS agreement and removes all constraints, including procedural requirements, relating to the export and import of generic medicines;
- CALL UPON Member States and Regional Economic Communities to ensure that TRIPS plus provisions which go beyond TRIPS obligations are not introduced in bilateral / regional trade agreements or in economic partnership agreements.

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.

BAT faces landmark legal case over Malawi families' poverty wages
Boseley S: The Guardian, October 2019

Human rights lawyers are reported to be preparing to bring a landmark case against British American Tobacco on behalf of hundreds of children and their families forced by poverty wages to work in conditions of gruelling hard labour in the fields of Malawi. Leigh Day’s lawyers are seeking compensation for more than 350 child labourers and their parents in the high court in London, arguing that the British company is guilty of “unjust enrichment”. Leigh Day says it anticipates the number of child labourer claimants to rise as high as 15 000. While BAT claims it has told farmers not to use their children as unpaid labour, the lawyers say the families cannot afford to work their fields, because they receive so little money for their crop. Many of the families are from Phalombe, one of the poorest regions in the south of the country. Children as young as three are involved in tobacco farming, the letter of claim says, often during harvest when the work can be especially hazardous. Children are particularly vulnerable to the effects of toxic pesticides, fertiliser and green tobacco sickness, from nicotine absorption while handling the leaves. Symptoms include breathing difficulties, cramps and vomiting. BAT is one of the most profitable companies in the world, making an operating profit last year of £9.3bn on sales of £24.5bn. Like other big tobacco companies, it has distanced itself from the farmers by commissioning a separate company to buy a stipulated amount of tobacco leaf each year.

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.