According to this article, the developing countries of the South should seek to establish trade and financial arrangements between themselves. Instead of seeking alliances with the United States or China, they could construct regional arrangements independently from the rules governing the global system. In this way, the economies of emerging countries will not have to be contingent on the problems experienced by the economies of these superpowers. A regional currency basket is also proposed, to build local capacity and independence. These various arrangements in different parts of the South could eventually be inter-related at the level of a global South. The article points to the failure of the G20 to reach consensus on a number of issues, including trading in health services, as indication that there is no possible global consensus. The author suggests that the way forward for countries of the South is to take independent initiatives among themselves.
Health equity in economic and trade policies
Based on the outcome of a meeting that took place from 22-26 November in Switzerland, the World Intellectual Property Organization (WIPO) has initiated an intellectual property (IP) project aimed at developing countries. The New Platform for Technology Transfer and IP Collaboration addresses WIPO Development Agenda recommendations 19, 25, 26 and 28 regarding developing countries. These recommendations require WIPO to facilitate access to knowledge and technology for developing countries and least-developed countries, to promote the transfer and dissemination of technology to benefit developing countries, and to foster research co-operation between developed and developing countries. The project consists of five phases: the organisation of five regional technology transfer consultation meetings, the commissioning of peer-reviewed analytic studies, the organisation of a High-Level International Expert Forum, the creation of a web forum on technology transfer and IP, and ‘the incorporation of any adopted set of recommendations resulting from the above activities into the WIPO programmes’.
This report includes the draft version of the Joint Africa-Europe Strategy (JAES) Action Plan 2011-2013 for the Partnership on the Millennium Development Goals (MDG), which commits the European Community and African Union (AU) partnership to several health actions and goals, focused on implementing the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA), increasing human resources for health in Africa and ensuring that governments meet their Abuja commitment to allocate 15% of spending on health. Certain goals are provided. By 2013, CARMMA must have been launched in all 53 AU Members States and its strategy implemented in at least 25 Members States. By 2013, more AU Member States should have improved access to HIV and AIDS, tuberculosis and malaria services by implementing the ‘Abuja Call’ with its new set indicators aligned with those of MDG 6. Finally, by 2013, more Member States must have strengthened their health systems through improved human resources for health strategies.
This resolution was adopted by the African Caribbean and Pacific (ACP) Council of Ministers during their meeting in Brussels on 8-10 November 2010. It makes no explicit references to health, but the inclusion of health may be inferred by references to the Millennium Development Goals (MDGs), food insecurity and development aid. The Council re-affirmed the need to develop objective criteria that will be used to determine the parameters to enable the conclusion and implementation of the economic partnership agreements (EPAs). These criteria may be linked to a number of areas, including the Millennium Development Goals (MDGs), agricultural production, and the level of official development aid. The Council calls on the European Union to demonstrate maximum flexibility on all the outstanding contentious issues, with a view to resolving them and thereby affording the ACP States and regions the opportunity to grow economically, particularly in the context of south-south trade, and allow for maximum use of policy space for development purposes. The Council requests that the EU include a specific safeguard clause for agriculture in the framework of the EPAs while maintaining the possibility of resorting to the Special Safeguard Mechanism during WTO negotiations, to help protect small farmers and maintain food security in the ACP regions.
This report calls for the creation of a new international development architecture (NIDA) for least-developed countries (LDCs) that will reverse their marginalisation in the global economy and help them catch up, while supporting a pattern of accelerated economic growth and diversification that will improve the general health and well-being of all their people. It argues that these objectives can be achieved if there is a paradigm shift that supports new, more inclusive development paths in LDCs and outlines alternative policy scenarios to accelerate growth and reduce poverty. The NIDA will consist of formal and informal institutions, rules and norms, including incentives, standards and processes, which would shape international economic relations in a way that is conducive to sustained and inclusive development. It will be supported by reforms of the global economic regimes that directly affect development and poverty reduction in LDCs, as well as the design of a new generation of special international support mechanisms (ISMs) for LDCs aimed at addressing their specific structural constraints and vulnerabilities. Increasing South-South cooperation could also play an important role.
Health is not mentioned much in this report, with its focus on trade and development, but a few links are made. The report argues that, in developing countries, as in developed countries, the ability to achieve sustained growth of income and employment on the basis of productivity growth depends critically on how the resulting gains are distributed within the economy, how much additional wage income is spent for the consumption of domestically produced goods and services, and whether higher profits are used for investment in activities that simultaneously create more employment, including in some service sectors, such as the delivery of health and education. In most developing countries there is a pressing need to increase public sector provision of essential social services, especially those concerned with nutrition, sanitation, health and education, according to the report. This is important not only for the obvious direct effects in terms of improved material and social conditions, but also for macroeconomic reasons. The public provision of such services tends to be labour-intensive, and therefore also has considerable direct effects on employment.
Medical tourism involves patients intentionally leaving their home country to access non-emergency health care services abroad. This article reviewed academic articles, grey literature, and media sources extracted from 18 databases to examine what is known about the effects of medical tourism in destination and departure countries. It found that most of the 203 sources accepted into the review offer a perspective of medical tourism from the Global North only, focusing on the flow of patients from high-income nations to lower- and middle-income countries, biasing the findings. Five interrelated themes emerged: medical tourism was promoted as a solution to health system problems and a revenue-generating industry offering patients higher standard of care, but some studies criticised it for using scarce public resources and causing health inequity. The study concluded that what is currently known about the effects of medical tourism is minimal, unreliable, geographically restricted and mostly based on speculation. Additional primary research on the effects of medical tourism is needed if the industry is to develop in a manner that is beneficial to citizens of both departure and destination countries.
European governments have promised to fix laws that caused generic medicine seizures in the Netherlands, the Indian Minister of Commerce and Industry announced. He added that seizures were illegal under the Trade-Related Aspects of Intellectual Property Rights agreement. Minister Anand Sharma pointed to significant savings in buying Indian-made generics for developing countries, for example by reducing the price of treatment for one patient for one year of antiretroviral medicines from US$12,000 to $400. He cautioned against confusing generic medicines with counterfeits, arguing that India was fully TRIPS compliant. India has had meetings with the Directorate-General for Trade at the European Commission, and European Union (EU) Trade Commissioner Karel De Gucht and his predecessor Catherine Ashton in this regard. Some were expecting India to call for formation of a panel in the dispute case after several months of consultations, but the Minister said that he has received ‘clear assurance [from] the EU trade commissioner that the notification under which actions were taken was misinterpreted and will be amended to plug all loopholes’.
According to the authors of this article, the exchange of South-South knowledge and experience has an enormous potential role in the emerging global development architecture. Many current answers to development challenges come from developing countries. For example, developing countries have designed and implemented solutions that have no precedent in the developed world, such as microfinance models in countries like Bangladesh and Indonesia, or the use of mobile technologies for all kinds of services in Africa and elsewhere, including health. Those same developing countries are building strong and reputable academic institutions and development think tanks, with implications for the diversity, sources, and availability of development knowledge and experience. The article proposes greater investment in a more demand-driven model of co-operation that promotes horizontal relationships, invests in local capacity and moves away from a one-size-fits-all solution. For this new approach to work, regional and global multilaterals should mainstream South-South approaches in their business lines and develop funding and brokering mechanisms for low-and middle-income countries, as well as for short-term and long-term projects. Traditional external funders need to be made aware of the win-win opportunity that lies in developing capacity in one country to promote sustainable change in another, and they need to adapt their co-operation strategies accordingly. Parliamentarians and civil society organisations can ensure that governmental peer learning fosters democratic ownership and human rights. Academia and the private sector can help enrich the agenda and engage more with governments and other stakeholders.
This report summarises the main themes, ideas and discussion points from the G20 Conference, held on 30 June 2010. The purpose of this conference was to explore options for the future for the G20 in advancing key issues in global health and development, set against a background of a G8 legacy of contributions to global health aid and the G20’s current focus on the economic crisis. Several themes emerged. First, the Global Fund noted it cannot meet its funding promises and is looking for contributors for the next three years. The Fund needs US$10 billion to sustain current levels, and $17 billion to continue to make gains in fighting HIV and AIDS, tuberculosis and malaria. The conference heard that there is a real possibility of eradicating polio in the next ten years, as just four countries still suffer from the disease, but this requires a concerted effort and political will. While it could be expensive, the long-term savings may be huge as people will no longer need to be immunised against the disease.