Health equity in economic and trade policies

Letter supporting proposal by India and South Africa on waiver from certain provisions of the TRIPS agreement for the prevention, containment and treatment of COVID-19
Civil society signatories: 2020

This open letter calls on WTO Members to strongly support the adoption of the text proposed by India and South Africa in their proposal for “Waiver from certain provisions of the TRIPS Agreement for the prevention, containment and treatment of COVID19” (Waiver Proposal), recognising the consensus that curbing the spread of COVID-19 demands international collaboration to speed and scale up development, manufacturing, and supply of effective medical technologies, with calls including from several Heads of State for medical products for COVID-19 to be treated as global public goods. Seven months into the pandemic, there is no meaningful global policy solution to ensure access, inequality in access to critical technologies, rejection by the pharmaceutical industry of the COVID-19 Technology Access Pool (C-TAP) launched by WHO to voluntarily share knowledge, IP and data, has been rejected by the pharmaceutical industry and intellectual property infringement disputes. While the TRIPS Agreement contains flexibilities that can promote access, many WTO Members may face challenges in using them promptly and effectively. The signatories argue that unless concrete steps are taken at the global level to address intellectual property and technology barriers, the above mentioned failures and shortcomings will replay as new medicines, vaccines and other medical products are rolled out.

Over 80 per cent of IMF Covid-19 loans will push austerity on poor countries
Oxfam: Oxfam UK, United Kingdom, 2020

Over 80% of the International Monetary Fund’s (IMF) Covid-19 loans recommend that poor countries hit hard by the economic fallout from the COVID-19 pandemic adopt tough new austerity measures in the aftermath of the health crisis. Since the pandemic was declared in March, 76 out of 91 IMF loans – 84% – negotiated with 81 countries push for belt-tightening that could result in deep cuts to public healthcare systems and social protection. Government failure to tackle inequality ―through support for public services, workers’ rights and a fair tax system― left them woefully ill-equipped to tackle the Covid-19 pandemic. The authors argue that the IMF has contributed to these failures by consistently pushing a policy agenda that seeks to balance national budgets through cuts to public services, increases in taxes paid by the poorest, and moves to undermine labour rights and protections. As a result, when Covid-19 hit, only one in three countries, covering less than a third of the global workforce, had safety nets for workers to fall back on if they lost their job or became sick. The analysis also found that just 8 out of 71 World Bank health emergency response projects approved between April and end of June this year aim to eliminate healthcare fees, which are prohibitive in at least 56 of these countries.

Recovering Better from COVID-19 Will Need a Rethink of Multilateralism
Kozul-Wright R: Development (2020) 1-5, doi:, 2020

The world economy is experiencing a deep recession amid a still unchecked pandemic. The author argues that the commitment to recovering better will not materialize if, as happened after the global financial crisis, high income countries resort to a policy mix of austerity, liberalization and quantitative easing. Such an approach will only worsen a whole set of pre-existing conditions and in particular, high inequality, excessive debt (both public and private and weak investment—that will lead to a lost decade, particularly for low income countries. What is proposed to be needed instead is an expansionary plan for global recovery, that can return even the most vulnerable countries to a stronger position than before the crisis. This paper sets out some of the key elements of such a plan and argues that its implementation will require systematic reforms to the multilateral trade and financial system if a more resilient recovery is to turn into a sustainable and inclusive future.

Thandika Mkandawire: A ‘young’ African economist’s appreciation
Chelwa G: Journal of African Studies, doi: 10.1080/00020184.2020.1836913, 2020

At the invitation of African Studies, Grieve Chelwa reflects on Thandika Mkwandawire’s life and work and impact on the social and economic sciences in Africa. Mkwandawire’s career spanned over four decades with a long and diverse list of publications. Chelwa refers to five specific publications that have helped to make sense of Africa’s place and the place of African economists in the seemingly never-ending debates about the continent’s prospects for economic development. Chelwa calls these his favourite things, ‘because Thandika was African development scholarship’s saxophonist.’

What Does the Seventy-third World Health Assembly Mean For Socio-economic Survival of Countries, Food Security, and International Cooperation in the COVID-19 Pandemic
Ssemakula M: People’s Health Movement (PHM) and Human Rights Research Documentation Centre (HURIC) –UGANDA, 2020

COVID-19 has underpinned unprecedented economic instability and global food supply disruptions in Africa. This has put global cooperation (aid, partnerships and concession finance) on test after the economic downturn in the world economy performance. This article provides a discourse on damaging interruptions caused by the pandemic on socio- economic survival of countries and food security, and how that relates to the gaps in interventions in IHR core principles reported by WHO member states and UN agencies at seventy-third World Health Assembly, which PHM closely followed through its WHO Watch programme.

Conclusions and outcomes from SATUCC seminars during the 16th Southern African Civil Society Forum
SATUCC: Botswana, August 2020

The 16th Southern African Civil Society Forum (CSF) was held remotely in late August due to the challenges posed by COVID-19. In seminars at the forum hosted by SATUCC, and with evidence presented from studies implemented for SATUCC, it was noted that the pandemic has amplified a number of challenges that workers were already facing before COVID-19, such as increase of insecure and informal work, lack of social protection and rising unemployment, exacerbating poverty and inequalities. Youth were found to be more vulnerable due to high youth working poverty rates and because the youth are over-represented in vulnerable and informal employment. Young women are facing an increasing double burden to manage both paid work and unpaid care and household work due to widespread school closures. The sessions identified that trade unions should be actively involved in the formulation and implementation of responses to COVID-19 at both national and regional level and that the issues facing workers should be addressed in social dialogue and in the collective bargaining agreements. Trade unions should be pro-active in bringing alternative proposals for building sustainable economies after the pandemic.

COVID-19: South Africa, India call for enabling technology transfer in TRIPS
Third World Network: TWN Info Service on Health Issues, August 2020

At the WTO’s TRIPS Council meeting on 30 July, members discussed South Africa’s proposal (IP/C/W/665) for members to come up with proposals, share information and national experiences, pointing out how the 2030 SDGs may be achieved through an effective framework for technology transfer. India reminded the TRIPS Council that any discussion on “E-Commerce will lack meaning if the gaping digital divide, partly arising out of lack of access to technologies and furthered by the pandemic, continues to exist.” In conclusion, India said that “it is of utmost importance for developing countries to adopt e-commerce and IP policies that are mutually supportive and in line with their developmental goals and policy specificities.”

Fostering local production of essential medicines in Nigeria
Fatokun O: Bulletin of the World Health Organisation 98, doi:, 2020

Consistent availability and access to medicines in low- and middle-income countries is a challenge. As a result, the governments in these countries have shown increasing interest in local pharmaceutical production as a means of promoting technology transfer, building capacity and improving access to essential medicines. In Nigeria, the Five Plus Five-Year Validity (Migration to Local Production) policy aims to reduce the number of pharmaceutical products imported into Nigeria and encourage local production of essential medicines. The Five Plus policy follows a fiscal policy measure implemented since 2016 which reduced the import adjustment tax under the Economic Community of West African States Common External Tariff on pharmaceutical raw materials from 5–20% to 0% and imposed a 20% import adjustment tax on four groups of imported drugs that can be produced by local manufacturers, including antimalarials, antibiotics, alkaloid derivatives and vitamins. While local pharmaceutical production in some low-income countries is not viable because of limited local technical expertise or low economies of scale, this issue may not be the case in Nigeria, given its large population, huge potential market and local expertise and experience for the manufacture of essential medicines.

Lessons from COVID-19: Pharmaceutical Production as a Strategic Goal
Correa C: South Centre, South Views 202, 2020

The economic and financial crisis generated by COVID-19 has deepened initiatives - which are not entirely new - to sustain local production of pharmaceuticals through a variety of mechanisms aimed at recovering 'strategic autonomy'. The pharmaceutical industry (including biotechnological products) can be one of the axes in new policy frameworks oriented to local production. A UNCTAD study concluded that in many developing countries companies have achieved the economies of scale required to produce medicines competitively and will expand over the next decade. Taking advantage of these opportunities to strengthen a pharmaceutical/ biotechnology industry may require the reformulation of industrial policies, to promote the sector as a generator of value added, employment and foreign exchange, as well as an instrument for achieving health autonomy to address public health needs. The author argues that this requires the deployment of well-articulated instruments, in line with the concept of 'mission-oriented industrial strategy'.

An assessment of workers’ rights in the mining sector during the COVID-19 Lockdown
Mlevu S: Centre for Natural Resource Governance, Zimbabwe, May 2020

This situation update from the Centre for Natural Resource Governance Zimbabwe looks at how the mining companies have been handling labour concerns as they have been operating during the lockdown. The authors report from various mines that companies have been making piecemeal commitments to health and safety of the employees, with some ignoring stipulated health measures. It also identifies only one company in Mutoko that invested time and money towards the health and safety of their employees during the lockdown. During the lockdown, the authors report that some workers have failed to get their salaries, while some workers have gone for 3 months without pay. The authors recommend that government convene a Tripartite Negotiating Forum to discuss the conduct of employers and their employees during the lockdown, that the Labour Act be revised to provide for the conduct of employers and employees during emergencies; that companies provide decent accommodation to their employees to minimise staff movements and contact with community members and protective equipment for all workers despite rank or grade who are working during the pandemic.