Health equity in economic and trade policies

Unequal partners: How EU–ACP Economic Partnership Agreements could harm the world’s poorest countries
Oxfam International: Oxfam Briefing note, 27 September 2006

The Doha ‘Development’ Round of trade talks has stalled, but the world’s poorest countries remain under pressure to open up their markets with potentially disastrous consequences. The EU wants to forge new free trade agreements with 74 of its former colonies in Africa, the Caribbean, and the Pacific (ACP). These imbalanced negotiations of ‘Economic Partnership Agreements’ (EPAs) between the two regions, pit some of the world’s most advanced industrial economies against some of the poorest nations on earth. The EU has an opportunity to develop fairer trading relations with ACP countries, but such extreme disparities in negotiating power could all too easily produce unfair results. The proposed EPAs are a serious threat to the future development prospects of ACP countries, and the forthcoming review of the EPA negotiations must be used to force a radical rethink.

UNITAID warns against measures to restrict access to medicines in EU-India FTA
UNITAID: 9 February 2012

In the lead-up to Free Trade Agreement (FTA) discussions during the European Union-India Summit in New Delhi on 10 February 2012, UNITAID has urged both parties to ensure that access to medicines, and particularly AIDS medicines, is not hampered by trade interests via provisions that could undermine the production, registration and availability of generic medicines. The agreement coincides with a delicate time for access to treatment efforts - the suspension of grants by the Global Fund and diminishing resources for health and development, said UNITAID, calling on the European Union to safeguard the right of millions of people in developing countries to continue accessing affordable life-saving medicines produced by the Indian generic industry. AIDS treatment has experienced startling progress over recent years, with almost seven million people starting treatment between 2003 and 2011, largely due to India's ability to produce low-cost, quality-assured generic medicines and to healthy competition among India's producers. However, such provisions as data exclusivity, patent term extensions and border measures could severely legally restrict manufacturers' ability to produce recently developed medicines and patient adapted formulations at low cost and to export those medicines to other developing countries.

Unity in diversity: Governance adaptation in multilateral trade institutions through South-South coalition building
Yu VPB: South Centre, 2008

This paper from the South Centre is concerned with the widening development gap in the setting of new international policy regimes and a changing global economic environment. It discusses participation and developing country governance adaptation issues in the WTO and in the UN Conference on Trade and development (UNCTAD). It concludes that developing country group action should be an essential component in global trade governance. Inclusive governance will require clear policy issue and agenda articulation from shared understanding, institutionalised coordination and group leadership mechanisms, good working relationships between individual country delegates and other developing country delegates, and full and continuous institutional support of high professional quality.

Unlocking the potential of migration for inclusive development
Börje EA: Migration Policy Practice III(1), February–March 2013

In this article, the author argues that migration has a role to play in inclusive development and addressing the Millennium Development Goals (MDGs) for poverty, gender equity and health. Remittances sent to family back home usually help to cover the daily consumption needs, which helps to reduce poverty and hunger. Remittances are, in addition, often invested in health, education and accommodation. Such investments often come with important impacts on the MDGs linked to education and health, particularly where women decide on the use of remittances. Sectors with critical skills shortages can benefit from the transfer of skills through circular migration and return (so-called ‘brain gain’ and ‘brain circulation’). The migration experience can empower women, both as individuals and as a group, by helping them to enter the labour market and earn higher incomes. The transfer of values and ideas brought about by migration (so-called ‘social remittances’) may also facilitate the gender equity goals of the MDGs.

Untangling the web of Antiretroviral Price Reductions
Médecins Sans Frontières (MSF): July 2013

According to the latest edition of MSF’s report on HIV treatment price and access issues, the price of first- and second-line anti-retrovirals have declined due to increased generic competition, while third-line regimens remain “exorbitantly priced”. For newer HIV medicines, including integrase inhibitors, generic competition is mostly blocked because of patents, and these drugs are more expensive as a result. MSF finds that patents remain a barrier on newer drugs and in middle-income countries, but some countries are using World Trade Organisation-sanctioned flexibilities to issue compulsory licences to increase access to the medicines. Flexibilities are built in to the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). MSF has proposed patent opposition (when applications do not meet a country’s patentability requirements) and the issue of compulsory licences in the interest of public health, as ways to bring prices down further. Additionally, MSF claims that free trade agreements continue to pose a threat to access, pointing to the European Union-India Free Trade Agreement and the Trans-Pacific Partnership Agreement as examples of agreements with “harmful provisions”.

Updating economic partnership agreements to today’s global challenges: Essays on the future of economic partnership agreements
Jones E and Marti DF: GMF Economic Policy Programme, 19 November 2009

African and Pacific countries continue to negotiate the challenging Economic Partnership Agreements (EPAs) with the European Union. These new agreements have the potential to help African countries accelerate their economic growth and develop more resilient economies. However, the presence of negotiating deadlocks or a sense of fatigue as well as the lack of real appetite for these agreements among many African, Caribbean, and Pacific (ACP) negotiators, raise legitimate questions regarding their structure and content, as well as their ability to constitute instruments to leverage economic growth.

Updating the economic partnership agreements to match today’s global challenges

German Marshall Fund of the United States: 19 November 2009
This document is a collection of seventeen essays on economic partnership agreements (EPAs) authored by recognised trade experts and senior policy-makers. Their responses constitute a mix of positive and negative elements, reflecting the complexity of the EPA processes. The negative message here is that EPAs are not useful or, at least, that these agreements are not necessarily relevant in light of the challenges faced by poor and vulnerable states, such as the African, Caribbean and Pacific (ACP) countries. The positive message is that all stakeholders continue to strongly believe that the EPAs should and can make a positive difference and that it is therefore possible to shape them for a truly positive outcome. The views expressed here reflect great convergence over the fact that there continues to be a huge trust gap in the negotiations. Whether perceived or observed, there is a persistent impression among ACP negotiators that EPAs are about European interests. Without trust among negotiating parties, chances are scant that negotiations will actually lead to genuine partnerships, as implied by the term ‘economic partnership agreement’.

Urban Health Initiative in Accra: Workshop on planning for climate action, improved air quality and health
Accra Metropolitan Assembly: Ghana, May 2019

The World Health Organisation, Accra Metropolitan Assembly, Ghana Health Service, Environmental Protection Agency, UN-Habitat and ICLEI hosted a two-day workshop with the Accra Metropolitan Assembly in May 2019 to support action towards healthier urban environments and to engage other municipalities to jointly act on air quality, public health and the reduction of short-lived climate pollutants. With representatives from several assemblies and municipalities, ministries and other relevant institutions, the workshop took participants through working sessions to discuss the health and economic impacts of sectoral policies, to inform the development of Accra’s Climate Action Plan and control of air pollution.

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
US free trade agreements block access to medicines
Oxfam International: 16 August 2006

At the International AIDS Conference in Toronto, US efforts to introduce stronger intellectual property rules in bilateral trade agreements were noted to undermine the fight against AIDS by limiting ability of developing countries to access affordable medicines. 'Under the name of free trade, the US is pushing for monopoly on new medicines, thus driving up the cost for some of the world’s poorest people,' said Rohit Malpani, policy advisor for Oxfam International. 'Neither patients nor governments will be able to afford the new antiretroviral medicines essential to address the pandemic.'