As poor countries face a possible swine flu pandemic with only enough Tamiflu to treat a tiny fraction of their populations, some experts are calling for a simple but contentious solution: massive production of generics. Indian pharmaceuticals giant Cipla said it would charge about $12 per course of a generic Tamiflu. One course of Roche Tamiflu can sell for up to $100. That has led critics to question why the World Health Organization (WHO) hasn't ordered up batches of generic Tamiflu or encouraged poor countries to do so Some suspect WHO is reluctant to anger drug companies, which supply the agency with stockpiles of drugs, by encouraging the use of generics. Despite WTO rules, Western pharmaceuticals have long fought to keep generics out of the market in all circumstances. There needs to be a better system in place so that WHO does not have to rely on the goodwill and charity of drugmakers to get medicines for poor countries.
Health equity in economic and trade policies
The United Nations is the only existing legitimate forum through which the financial crisis can be resolved. The Stiglitz Commission provides a good basis on which new models can be built. In the current financial context, any decrease in aid will push more people into poverty, in particular in the most vulnerable least-developed countries. The cutbacks of aid by some EU member states are already signs that this is happening. It is imperative, therefore, that the fundamental reform of the international financial system must take place in reference to the needs of developing countries. The world’s richest Nations agreed a financial stimulus package amounting worth 832 billion Euros (1.1 trillion US dollars) yet barely one quarter will be given to developing countries. And the money destined for developing countries will be channelled through the IMF, whose loan conditionalities have been central in spreading misery around the developing world. Recent changes in IMFs policies have not resolved this problem.
The Indian government's efforts to bring in affordable patented medicines for chronic and lifestyle ailments, may hit a roadblock with multinational companies trying to stall the move. The mechanism would have increased affordability of drugs like Tarceva, Herceptin, Pegasys and Januvia used for treatment of chronic ailments, which at present are exorbitantly priced. Government put forth a model to multinational pharmaceutical companies, which has not met with much enthusiasm from the industry. It asked them to ensure that patented drugs introduced in the country are priced cheapest here than anywhere in the world. Significantly, the recommendations say that patented block-buster drugs that have no substitute in the market and offer substantial therapeutic benefit should be offered at prices 40% to 70% cheaper than the maximum retail price through the public health system.
After their workshop, participants made a number of recommendations. They wanted governments to meet their obligations in the Abuja Declaration to spend at least 15% of its budget on the health sector, in addition to any donor aid the country may receive for the same purpose. A process should be initiated to review and amend all patent legislation, especially to ensure maximum use of TRIPS flexibilities that promote access to medicines. The implications of ratifying the 30 August 2003 decision on licenses for exports to countries with insufficient manufacturing capacity need to be considered. An improvement is required in the monitoring, transparency and participation of all interested stakeholders in the negotiation of free trade agreements and economic partnership agreements to ensure no eroding of flexibilities and no further enforcement processes to patents.
The World Trade Organization’s 2009 Global Monitoring Report notes that the deepening global recession, rising unemployment, and volatile commodity prices in 2008 and 2009 are seriously affecting progress toward poverty reduction. The recent food crisis has thrown millions into extreme poverty. Deteriorating growth prospects in developing countries will further slow the pace of poverty reduction. Recovery prospects depend on effective policies that restore confidence in the financial system and counter falling global demand. While the responsibility for restoring global growth lies largely with rich countries, emerging and developing countries have a key role to play in improving the growth outlook, maintaining macroeconomic stability, and strengthening the international financial system. Financing the health sector may be negatively impacted by the recession.
Is there a link between the financial crisis dominating the front pages of newspapers and the health stories on the inside? The Commission on Social Determinants of Health certainly believed so. Its starting point was that the economic and social features of society are closely linked to the distribution of health within and between countries. The social determinants of health are the conditions of daily life and its structural drivers will be influenced by the financial crisis. As social determinants are affected by the financial crunch, so will health outcomes be affected as well.
This paper is an unprecedented collaboration between a wide spectrum of civil society organisations in the United Kingdom (UK). the civil society organisations in the UK called on the UK government to initiate an economic system that that seeks to work for people and for the planet. The civil society statement makes recommendations to world leaders to chart a path out of recession in a way that builds an equitable global economy. It prioritises tax reforms to end poverty, accountable and transparent processes for the international finance system and calls for reforms to be implemented through the United Nations in consultation with governments, trade unions and civil society organisations.
The auhtor argues that there are several issues that the G20 Summit failed to resolve, besides the biggest omission – failure to reform IMF policies. First, it failed to produce anything tangible on a coordinated fiscal stimulus policy. Secondly, it did not come up with a plan of action to clean up the crisis-hit banking systems. Thirdly, there was no plan for regulating cross-border activities of financial institutions or cross-border financial flows, nor an acknowledgement that a framework should be created that facilitates developing countries’ ability to regulate the flow of cross-border funds. Fourthly, there was no move to assist developing countries to avoid wrenching debt crises. Without this, they would be deprived of the kinds of schemes by which banks or companies in trouble pay back only a portion of their loans whose market values would have fallen.
This compilation consists of short essays from a broad range of experts to provide proposals on immediate trade priorities in the context of the economic crisis and provide a forward-looking agenda for global trade governance. The essays focus special attention on the needs of developing countries and sustainable development considerations. Some conclusions drawn from the compilation include the recommendation to establish a working group of experts to propose WTO reforms. Immediate action should be taken to implement those areas of the Doha Development Agenda where agreement exists. The World Trade Organisation's capacity needs to be expanded and a trade-and-development ombudsman should be appointed at the WTO to whom third-party complaints about trade impacts can be brought.
The draft G20 Communiqué recognises explicitly in its opening paragraph, that 'a global crisis requires a global solution'. But at no point does it recognise any need for a global process to decide what that global solution should be. The G20 members appear determined that they, and they alone, should determine the future course of the global economy – and that it should be designed to protect their financial interests, with only token efforts to limit the damage to the rest of the world. They are trying to seize control of the global economy but, in doing so, the author argues that they are amply demonstrating why they must not be allowed to succeed.