This new study shows how South Africa's flagship health legislation conflicts with binding commitments the former apartheid regime negotiated under the World Trade Organization's General Agreement on Trade in Services (GATS). This trade treaty conflict threatens to undermine the much-needed legislation and, if left unresolved, would make meeting the health needs of the majority of the population far more difficult. The study explores several options that South Africa has for resolving this conflict in favour of its health policy imperatives, but each entails risk. South Africa's dilemma should serve as a world-wide warning that health policy-makers, governments and citizens need to be far more attentive to negotiations that are now underway in Geneva to expand the reach of the GATS.
Health equity in economic and trade policies
"Major changes in international trade, intellectual property (IP) protections and drug registration requirements are substantially affecting pharmaceutical markets, with significant implications for access to medicines by poor people. Within this framework, and drawing on legal, regulatory, economic and pharmaceutical industry expertise, the UK's Department for International Development (DFID) has commissioned a series of seven studies. The studies, summarised in this paper, examine the policy implications of these trends for emerging producers of generic medicines such as India and China, and for poor people in developing countries.A key question is how strengthened intellectual property protections and heightened registration standards may or may not improve access to medicines in these currently under-served markets."
Tony Blair is running out of time on achieving the third and most controversial part of the 'Marshall Plan for Africa' he promised earlier this year: trade justice. With just weeks to go before critical World Trade Organisation talks in Hong Kong, Europe and the US are in deadlock over how far they should open up their markets to farmers from poor countries - and what they will demand from the rest of the world in return.
This report traces the trends and patterns in economic and non-economic aspects of inequality and examines their causes and consequences across and within regions and countries. It focuses on the gaps between the formal and informal economies and between skilled and unskilled workers, the growing disparities in health, education and opportunities for social, economic and political participation as well as analysing the impact of structural adjustment, market reforms, globalisation and privatisation on economic and social indicators.
The World Bank's annual World Development Report this year focuses on equity, arguing that inequality of opportunity is holding back prosperity and economic growth. This article from the Institute for Development Studies argues that the report fails to get to grips with what inequality really means: "The World Development Report for 2006 on Equity and Development (WDR 2006) has been described by Sanjay Reddy from Columbia University as reflecting the most progressive face of the World Bank. This is because it argues strongly on ethical and efficiency grounds for the need to tackle the gross disparities in opportunity for children born in different parts of the world. Reddy also finds that the theoretical construction of the report is 'rather clunky and appears to be the product of political compromise…but is workable'."
Bowing to huge international pressure, major pharmaceutical companies have made significant efforts to make their patented antiretroviral drugs available in Africa while ensuring that they – not generic manufacturers – maintain market control in the continent. Globally, the ARV market accounts for less than 3% of pharmaceutical sales worldwide and Africa’s portion of this has been negligible. However, with the World Health Organisation’s campaign to get three million people on ARV treatment by the end of this year (the 3-by-5 campaign), there has been a scramble to ensure improved supplies.
"This paper describes a conceptual framework for the health implications of globalisation. The framework is developed by first identifying the main determinants of population health and the main features of the globalisation process. The resulting conceptual model explicitly visualises that globalisation affects the institutional, economic, social-cultural and ecological determinants of population health, and that the globalisation process mainly operates at the contextual level, while influencing health through its more distal and proximal determinants. The developed framework provides valuable insights in how to organise the complexity involved in studying the health effects resulting from globalisation."
"We deplore the worsening conditions of health experienced by many of the world's people and we denounce their cause - neo- liberalism. Neo-liberal polices imposed by the G8, transfer wealth from the South to the North, from the poor to the rich, and from the public to the private sector. Corporate profits increase while poor people, indigenous peoples and the victims of war and occupation, suffer. Economically and politically generated health inequalities have increased, yet these root causes of avoidable disease and death are not effectively addressed by current policies or programs."
"The General Agreement on Trade in Services (GATS) seeks to expand international trade in a wide range of services ranging from tourism to telecommunications and education. In recent years, it has come under attack from civil society organizations in both the North and the South for having a detrimental impact on poor people's right to basic services. This article explores some of these controversies, using the example of water services. It focuses specifically on the impact of the GATS on poor people's right to water and national governments' ability to safeguard the interests of poor people through regulation."
This year people in bars and at football matches were asking about the Group of 8 (G8) nations summit in Gleneagles, Scotland. Such unprecedented popular interest was prompted by Bob Geldof's Live 8 concerts and the Make Poverty History campaign. These initiatives were organised to raise awareness about African poverty and to pressure politicians into tackling the preventable global burden of disease afflicting billions of people living in low-income settings. When asked if his lobbying had paid off, Geldof said, “A great justice has been done”. He should have said “No”. (requires registration)