Health equity in economic and trade policies

Africa’s trade in services and economic partnership agreements
Poverty Reduction and Economic Management (PREM), Africa Region: 28 June 2010

According to this paper from the World Bank, an Economic Partnership Agreement (EPA) is unlikely to offer much in terms of improved access to European Union services markets, especially for temporary movement of unskilled workers, a key issue for African countries. The main impacts of a services EPA for African countries would come from locking in openness to trade, providing precedents for regulation in key sectors, cooperation on competition policy and support for regional integration. According to the Bank, many of these goals could be pursued through a more cooperative approach with interested African countries, without necessarily negotiating and signing a broad EPA agreement.

Economic partnership agreements and food security
Matthews A: Trade Negotiations Insights 9(5), June 2010

The African, Caribbean and Pacific (ACP) countries face a massive challenge in tackling hunger and under-nutrition, but many critics have argued that the commitments required of ACP countries under Economic Partnership Agreements (EPAs) will make this more difficult. This article investigates the threat to food security posed by these agreements. While some observers blame trade liberalisation for these problems, the article identifies the lack of investment to improve productivity and address supply-side constraints as the major limiting factor. It argues that the debate around the issue of EPAs and food security distracts from the more important question of what domestic initiatives ACP countries need to take to ensure that agriculture can play its role as an engine of economic growth and poverty reduction. Government should invest in agriculture rather than rely on trade restrictions for food security. The potential of EPAs to improve food security can only be realised by a focus on greater agricultural investment and improved institutions. Resources can be made available from the EU budget, the EU’s European Development Fund and bilateral external funders, but the prerequisite is that these requirements are prioritised by ACP countries.

Millennium Development Goal 8: The Global Partnership for Development at a critical juncture
MDG Gap Task Force: United Nations, 2010

This report by the United Nations assesses global progress towards meeting Millennium Development Goal (MDG) 8: Develop a global partnership for development. According to the report, only five member countries of the Development Assistance Committee have met their pledge, made in 2005, to pay 0.7% of their gross national as official development assistance, representing a major shortfall in funding. Market access (trade) has not improved, for developing countries, with no reductions in tariffs and no agreements having yet been reached at the Doha negotiations. The debt situation of many developing and transition economy countries deteriorated during the financial and economic crisis owing to the slowing down of the global economy and the fall in trade, remittances and commodity prices. In terms of access to affordable essential medicines, the report urges countries without significant pharmaceutical manufacturing capacity to take advantage of flexibilities in the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to import affordably priced essential medicines or, if they have the capacity, to produce generic pharmaceuticals and promote foreign investment to acquire new technologies for producing the medicines. With regard to new technologies, disparities between developed and developing countries remain. Large regional disparities in the use and uptake of information and communication services also persist. For instance, access to the Internet at broadband speeds remains very low in developing countries and is practically negligible in less-developed countries.

One MDG that can be achieved now: Market access for the poorest countries
Elliott KA: Trade Negotiations Insights 9(5), June 2010

This article explains how trade preference programmes can be made more effective for poorer countries. It is based on five principles put forward by the Center for Global Development (CGD) to make trade preferences more effective for less-developed countries: expand coverage to all exports from all least developed countries; relax restrictive rules of origin; make trade preference programmes permanent and predictable; promote co-operation between countries giving and receiving preferences; and encourage advanced developing countries to implement trade preference programmes that adopt the other four principles. It argues that extending full duty-free, quota-free market access to all least developed countries would have far more power if it is a project of the G-20, not just the G-8, and Brazil, China, India and Turkey are already showing the way. The author urges the G-20 to show its leadership on global development issues and to realise the Millennium Development Goal of using trade as a tool for development.

Restoring hope: Reinvigorating the Millennium Development Goals
International Monetary Fund: September 2010

This collection of essays assesses how the world is doing in meeting the Millennium Development Goals (MDGs). The lead essay, 'Regaining Momentum,' notes that, while several of the MDGs are within reach, the global economic crisis has set back progress toward a number of the targets, especially those related to health. Developing countries will need the support of advanced economies in to get back on track. In other essays, economist Jagdish Bhagwati calls into question the premise of the MDGs and economists Arvind Panagariya and Rodney Ramcharan debate on how important it is to fight inequality.

The impact of the global financial crisis on the budgets of low-income countries
Development Finance International: 2010

This report, written for Oxfam, examines the impact of the global financial crisis on the budgets of low-income countries, especially their spending to reach the Millennium Development Goals (MDGs). It points out that the current global economic crisis has created a huge budget revenue hole of US$65 billion, of which aid has filled only one-third. As a result, after some fiscal stimulus to combat the crisis in 2009, most low-income countries (LICs) – including those with International Monetary Fund (IMF) programmes – are cutting MDG spending, especially on education and social protection. They have also had to borrow expensive domestic loans, and increase anti-poor sales taxes. The report argues that almost all LICs could absorb much more aid without negative economic consequences (whereas they have much less space to borrow or to raise taxes). It urges the international community to make strong new aid commitments at the Millennium Summit in September 2010, funded by financial transaction taxes or other innovative financing. The IMF should encourage LICs to spend more on MDG goals and on combating climate change and to report regularly on such spending, and LIC governments should increase spending on social protection and education, and bolster efforts to fight tax avoidance.

AIDS activists denounce European Commission’s actions in trade
Act Up-Paris: 21 July 2010

Act-Up Paris made this speech via the European Commission's (EC) satellite to the International AIDS Conference, held from 18 – 23 July in Vienna, Austria. It denounces the EC’s actions, such as its decision to take a trade-based and not a health-based approach to access to medicines, and accuses the body of duplicity in its Free Trade Agreement negotiations with India, its negotiations regarding the proposed All Censorship Trade Agreement (ACTA), which aims to govern global intellectual property rights, and seizures of allegedly counterfeit generics being transported from India to South America and Africa. Act-Up Paris asserts that the EC is working to make medicines more expensive, while at the same time freezing its contributions to the Global Fund. It urges the EC to respect the Doha Declaration and to embark on a global rights-based approach to dealing with HIV and AIDS.

Further details: /newsletter/id/35257
Coverage of anti-counterfeit policy debate varies widely across global media
Mara K: Intellectual Property Watch, 2 August 2010

Are counterfeit products first and foremost a threat to human health and safety or is provoking anxiety just a clever way for wealthy nations to create sympathy for increased protection of their intellectual property rights? This article indicates that coverage of this issue in the world’s news media varies greatly. Some argue that attempts to fight fake drugs are as much a risk to access to the real medicines as the fakes themselves. Legitimate, low-cost generics – often the only medicines the poor can afford – can get caught in the crossfire of anticounterfeiting enforcement measures. In addition, they say, there is need to combat not only medicines that violate trademarks (as counterfeit is often defined) but also medicines of general low quality (harder to spot and often, some say, a greater problem). The article examines a variety of news items that have recently appeared in the international media. Sources in American media have focused on organised crime in drug counterfeiting without considering the problems of access to medicines in developing countries. On the other hand, India’s newspapers are concerned with the impact of new legislation on the production of generics and the United Kingdom’s BBC has acknowledged the problems of access to medicine.

Gates Foundation buys shares in Goldman Sachs and Monsanto
Borzo J: Dow Jones, 16 August 2010

The Bill and Melinda Gates Foundation, known for concentrating on vaccines and AIDS in its charitable work, has added Ecolab and Monsanto to its portfolio. Monsanto is the world largest biotechnology company dealing in genetically modified organisms.

HIV generics under threat from tighter patenting rules
Plus News: 2 August 2010

Most of the estimated 5.2 million people worldwide on antiretroviral (ARV) treatment are taking generic versions manufactured primarily in India, but tighter global intellectual property rights and trade rules could shut down this trade. While the patents on many older, first-line ARVs have expired, leaving generic manufacturers free to produce them, newer, less toxic and more effective drugs are patented and priced out of reach of less developed nations. The main way generics manufacturers can produce newer drugs is to obtain a ‘voluntary licence’ from the patent holder. This usually sets quality requirements and defines the markets in which the licensee can sell the product. For example, pharmaceutical giant Gilead has allowed the South African firm, Aspen Pharmacare, to manufacture and distribute branded and generic versions of tenofovir, one of the newer first-line ARV drugs. However, civil society activists say voluntary licences skew the balance of power too far in favour of patent-holders and present a way to control generic competition by creating dependency on the innovator companies, according to this article. The United States and the European Union have been accused of pressuring developing countries by using trade threats to coerce these countries into adopting intellectual property laws that will increase the cost of medicines. By jeopardising generics, especially those from India, this article argues that they are effectively putting millions of lives at risk.

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