Health equity in economic and trade policies

Calling for a New Global Economic Order
PHM, Wemos: Astana, November 2018

In 1978, the Alma-Ata International Conference on Primary Health Care stated, in its final declaration, that “economic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all.” In Astana at the Cafe Session this video shares why this call is still relevant today and why it should be recalled and renewed now the world celebrates the 40th Anniversary of the Alma-Ata Declaration at the Global Conference on Primary Health Care in Astana, on 25-26 October. The film reminds that Primary Health Care is more than basic health care and some sort of financial protection but rather a radical comprehensive concept based on economic justice. The video calls for a new economic global order as was called for in 1978.

Seeds of Resistance, Harvests of Hope: Farmers halt a land grab in Mozambique
Wise T: Food Tank, 2018

On July 26, 2018, farmers in Xai-Xai, Mozambique, achieved a milestone. They met to formalize their new farmers’ association, elect leaders, and prepare a petition to the local government for land. The association, christened Tsakane, which means “happy” in the local Changana language, was the culmination of six years of resistance to a Chinese land grab that had sparked protest and outrage. The association now has a request pending for its own land. The difference between a large-scale agricultural development project and a land grab is consultation and consent, and this one had neither. Some 7,000 farmers had moved onto the irrigated lands along the Lower Limpopo River in the 1980s after a state farm ceased operations. Farmers reported that they were encouraged to do so by the local government. Mozambique’s Land Law is one of the most progressive in Africa, recognizing the land rights of peasant farmers whether or not they can show formal title, as long as they have been farming the land for 10 years or more. That applies not only to community or village land, it applies to estate land for which the government holds the formal land title. Instead of giving all the best land and infrastructure—particularly irrigation—to foreign investors who then displace local farmers, they ask why not give the land to those farmers? Help them organize into marketing cooperatives, water use associations, and credit unions. With the formal recognition of the Tsakane Farmers’ Association, the Xai-Xai farmers are planning to do just that. They hope to get collective land title to 750 acres of good land for their 300 members.

Calling for a New Global Economic Order
Peoples Health Movement; Medicus Mundi International; G2H2: Astana 2018

In 1978, the Alma-Ata International Conference on Primary Health Care stated, in its final declaration, that “economic and social development, based on a New International Economic Order, is of basic importance to the fullest attainment of health for all.” This video raises why this call is still relevant today and why it should be recalled and renewed now we celebrate the 40th Anniversary of the Alma-Ata Declaration at the Global Conference on Primary Health Care in Astana, on 25-26 October 2018.

The causes of the growth of 'populism'
Navarro V: Other News, October 2018

In this article (original in Spanish) the author analyses current movements termed 'populist'. He notes that they have some points in common. One of them is their clear opposition to globalization and economic integration and to the cultural and political homogenization that they entail and that is perceived as a threat to their national identity. A desire to recover identity and national control conditions is a nationalist sentiment based primarily (though not exclusively) on globalization being identified with a decline in the quality of life and well-being of the social classes behind this populism, even while this was due to the enormous increase in the wealth and welfare of wealthy minorities at the expense of the great decline in welfare and standard of living of the majority of the population The author asserts that socialist movements that have an opposition and alternative to a neoliberal conservative establishment differs from most populisms, which have an anti-establishment dimension but lack a proactive dimension . At the same time he argues that the failure of socialist or social democratic parties to develop an effective response to neoliberalism has been one of the main causes of the growth of right wing populist movements. The author argues for responses that recognise that the different sectors of the population have elements and conditions in common, that also provides more radical proposals for how to address these conditions.

Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps?
Nkosi V; Wichmann J; Voyi K: Environmental Health 14(33), doi:, 2015

This study investigated the association between proximity to mine dumps and prevalence of chronic respiratory disease in people aged 55 years and older. Elderly persons in communities 1-2 km (exposed) and 5 km (unexposed), from five pre-selected mine dumps in Gauteng and North West Province, in South Africa were included in a cross-sectional study. Structured interviews were conducted with 2397 elderly people, using a previously validated questionnaire from the British Medical Research Council. Exposed elderly persons had a significantly higher prevalence of chronic respiratory symptoms and diseases than those who were unexposed., Results from the multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma, chronic bronchitis, chronic cough, emphysema, pneumonia and wheeze. Residing in exposed communities, current smoking, ex-smoking, use of paraffin as main residential cooking/heating fuel and low level of education emerged as independent significant risk factors for chronic respiratory symptoms and diseases. This study suggests that there is a high level of chronic respiratory symptoms and diseases among elderly people in communities located near to mine dumps in South Africa.

Why India’s IP policy needs a South African tweak
Syed S: The Hindu BusinessLine, July 2018

South Africa recently adopted a new Intellectual Property Policy, which seeks to align IP with the country’s national development plan. What works for the new SA policy is that it addresses the interface between IP and public health. In facilitating local production and export of pharmaceuticals in line with its industrial policy, the new policy recommends the following changes: introduction of substantive patent search and examination, introduction of patent opposition, strengthening of patentability criteria, incorporation of disclosure requirements, parallel importation, exceptions, provisions to regulate voluntary licensing, compulsory licences, use of IP and competition law. All these provisions use flexibilities provided in the TRIPS (Trade related aspects of IP Rights) Agreement to safeguard development objectives. The South African policy mentions that it must engender the ethos of the South African Constitution and also reflect the country’s broader social economic development objectives. In contrast, India’s IP policy fails to take notice of obligations under Fundamental Rights and Directive Principles of the right to health in its Constitution while promoting IP rights. Instead it focuses on enhancing the protection and enforcement of IP rights, which goes beyond its international obligations (referred as ‘TRIPS-plus’) without taking into consideration their negative implications. Despite being at the forefront of international fora in defending the TRIPS flexibilities, the author observes that India ignores their use for itself at the domestic level, and recommends following the South African approach.

6th Anniversary of the Marikana Massacre
Marikana Solidarity Collective; Review of African Political Economy, August 2018

This paper presents a case that six years after the Marikana Massacre, the London-based mining corporation involved (Lonmin) has decided to leave its platinum mining operation in South Africa by preparing to sell to Sibanye-Stillwater. The authors support the demands of women’s organisation Sikhala Sonke and victims’ representatives that Lonmin must fulfil a social covenant with the community, rather than to the banks. The paper reports the demands of social movements that Lonmin apologise to the South African nation and to the victims of the massacre and pay reparations to the affected parties. The authors also report the call that Lonmin join calls to release the miners in prison as a result of the massacre and to prosecute the police officers and authors of the massacre, take responsibility for the environmental destruction at Marikana and comply with the obligations of its social and labour plan and add its voice to those calling to review the Farlam Commission and finance the legal process. They reject the excuse that the company is now insolvent.

BRICS-Johannesburg simultaneously disappoints and threatens
Bond P: Pambazuka News, August 2018

The author asks whether the Brazil-Russia-India-China-South Africa (BRICS) bloc can rise to the talk in Johannesburg about counter-hegemonic prospects during the BRICS summit held in the last week of July. However he also notes that their ideological diversity means that an excellent opportunity for this was lost and that the unity came rather from a support for mercantilist-neoliberalism. This he notes points to progressive international reform being practically impossible at present. He noted that the BRICS further distorted the International Monetary Fund (IMF) during its 2015 vote restructuring. Four of the five countries took much greater shares for themselves (aside from South Africa which lost 21 percent of its vote) at the expense mainly of poorer countries. He argues that the main site to consider antidote analysis and news is “brics from below,” a tradition of counter-summit critique begun in Durban five years ago, and also witnessed in Fortaleza in 2014, Goa in 2016 and Hong Kong in 2017. and as found in a protest led by four Goldman Environmental Prize winners and their organisations and allies: Makoma Lekalakala of Earthlife Africa, Bobby Peek of groundWork, Thuli Makama of OilChange International and Des D’Sa of the South Durban Community Environmental Alliance. As one outcome the largest proposed mega-project made at prior BRICS summits in 2014 and 2015 on US $100 billion worth of nuclear energy reactors as a deal between former South African president Jacob Zuma and Putin, is now on indefinite hold.

Countries Pressured to Drop Language on Protecting Access to Affordable Meds from TB Summit Declaration Negotiations
Medicins Sans Frontieres; Doctors Without Borders: July 2018

Countries negotiating the final declaration text for the first-ever UN High-level Meeting on Tuberculosis in September were put under significant pressure to drop references to protecting countries’ rights to take fully-legal actions to access affordable medicines for their people, Médecins Sans Frontières reports. One of the final sticking points in the negotiations in New York was language on public health safeguards enshrined in the World Trade Organization’s (WTO) Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS). This allows governments, among other things, to issue ‘compulsory licenses’ to override patents in the interest of public health, so that they can allow generic versions to be produced or imported and more people can receive needed treatment. The ‘Group of 77’ bloc of developing countries has been under pressure to drop all references to the WTO’s 2001 Doha Declaration that enshrined public health flexibilities and safeguards in the TRIPS agreement. This led to a call by Leena Menghaney, South Asia Head for MSF’s Access Campaign for all countries, including those in the Group of 77, and Brazil, Russia, India, China and South Africa, that have a high burden of TB, to urgently stand up right now against what they refer to as 'bullying', that aims to keep medicines out of the hands of people who need treatment.

Social support under siege: An analysis of forced migration among women from the Democratic Republic of Congo
Wachter K; Gulbas L: Social Science & Medicine (208) 107-116, 2018

The authors aimed to develop theory to explain how women who migrated from the Democratic Republic of the Congo recreate social support post-resettlement in the United States. An interpretive approach informed by postcolonial feminist perspectives guided the grounded theory methodology. Upon arrival to the United States, women experienced partitioned lives through changing relationships in space and time, which contributed to women being alone and impacted on their well-being. Converging processes propelled women towards learning to stand alone, through which they developed a sense self-reliance, but not without consequences for themselves and their relationships. The analysis contributes to the knowledge of how resettlement is a life altering event that sets into motion psychosocial processes with implications for well-being and health.