In the run-up to the United Nations (UN) Climate Change Conference, hosted in South Africa from 28 November-9 December 2011, the author of this article points to the ‘David and Goliath’ nature of the Conference as civil society faces the industrial giants of the first world, with the poor of the developing world on the sidelines. The failure of Durban’s COP17 is certain, the author agues. Binding emissions-cutting commitments under the Kyoto Protocol are impossible, given Washington’s push for an alternative global architecture that is inequitable to developing countries. The author expressed concern about plans for climate finance and technology, which include an extension of private-sector profit-making opportunities at public expense. Politically, the author argues that global climate policy makers, especially from the United States State Department and the World Bank, will aim to distract global attention from any potential overall UN solution to the climate crisis, from the severe global power imbalance between nations and from the progressive demands and solutions by civil society, which include demands for a better environment in townships, including increased housing, electricity, water and sanitation, and improved waste removal, healthcare and education. ‘Connecting the dots’ to climate will be the primary challenge for all attendees at the Conference, the author notes.
Health equity in economic and trade policies
According to the CIDSE, a coalition of Catholic welfare organisations in the North, the much-anticipated G20 London Summit has ended in an anti-climax. CIDSE’s presents four main criticisms of the G20 outcomes. First, the International Monetary Fund (IMF) will continue to regulate global finance and has been given a US$500 billion boost to continue to be the guardian of the global financial system, a role it has failed at so far. Although the G20 outcome acknowledges the need to reform global financial institutions, to take steps (unspecified though they be) to make these institutions more accountable and credible and to appoint the heads and senior management on merit through open and transparent process, CIDSE argues this is unlikely to have much impact on low-income countries. Second, tax havens will continue to flourish so long as they sign bilateral agreements that have proven not to be effective. The black-listing measures that the G20 has announced will do little to return the millions of euros that have been illegally taken out of developing countries and deposited in secret European bank accounts. Third, the announced US$50 billion in aid for low-income countries is little more than a repackaging of existing resources, as many countries in the European Union – the largest external funder in the world – are set to default on their aid commitments, having not yet made concrete allocations to their development budgets. The G20 communiqué is also vague regarding the modalities and the timeline for the disbursement of these funds. Fourth, a balanced and development-friendly system for international monetary stability remains elusive. The call by China to review the current monetary system based on a single reserve currency is not reflected in the communiqué. The adverse impacts of currency exchange rate instability on developing countries’ terms of trade also remain unaddressed, while the recommendation of the Expert Commission of the United Nations General Assembly President to adopt a new Global Reserve System does not appear on the agenda of the G20.
This document provides responses to the concerns expressed by the International Treatment Preparedness Coalition (ITPC) regarding the Gilead-Pool licences issued by the Pool in October 2011. The ITCP was concerned that the licences might undermine TRIPS flexibilities that would allow developing countries to manufacture and purchase cheaper generic medicines, but the Pool refutes this, arguing that one of the core principles of the Pool is to ensure that the terms and conditions it negotiates do not undermine the use of other mechanisms that can improve access to affordable medicines. Least-developed countries (LDCs) still have the option of not introducing patent protection for pharmaceuticals until 2016, the Pool notes. The licences do not require countries to apply to Gilead for ‘prior permission’ for use of a compulsory licence (CL), as countries retain their sovereign rights under the TRIPS Agreement to issue CLs for any reason, and licensees are expressly required to supply countries that do so. Further, the Pool argues that the licences do not block the ability of excluded countries to parallel import generic medicines – countries that have adopted appropriate provisions in their national laws may still be able to purchase the patented product at a lower price in a different country. In addition, the Gilead-Pool licences do not prevent licensees from challenging the validity of any of the licensed patents. Generic companies and civil society groups are free to oppose the grant of any patents they feel do not meet the requirements of patentability. Although the Pool does not have the authority to set patentability criteria or to grant patents (this rests with national governments), it can play a role in ensuring they do not block access to medicines.
According to this article, economic growth is not constitutively the same thing as development, in the sense of a general improvement in living standards and enhancement of people’s well-being and freedom. Growth, of course, can be very helpful in achieving development, but the authors argue that this requires active public policies to ensure that the fruits of economic growth are widely shared, as well as making good use of the public revenue generated by fast economic growth for social services, especially for public healthcare and public education. Yet it is also important to recognise that the impact of economic growth on living standards is crucially dependent on the nature of the growth process (for instance, its sectoral composition and employment intensity) as well as of the public policies - particularly relating to basic education and healthcare - that are used to enable common people to share in the process of growth. There is also an urgent need for greater attention to the destructive aspects of growth, such as environmental degradation and involuntary displacement of communities that have strong roots in a particular ecosystem.
At a formal meeting of the regular session of the TRIPS Council on 24-25 October 2011, Member States conducted their annual review of the implementation of the ‘Paragraph 6’ solution in respect of the TRIPS Agreement and public health. The solution aims to help developing countries with insufficient or no pharmaceutical manufacturing capacities to import cheaper generic medicines produced under compulsory licensing. Ecuador and Venezuela continued to argue that, since the system has only been used once, it is too complicated to be effective, while other Member States questioned whether it is working and said they need more information. Members also agreed to extend the period for acceptance of the protocol amending the TRIPS Agreement (of 2005) for a further two years – till 31 December 2013 – until two thirds of World Trade Organisation (WTO) Members accept the amendment, which is required for it to take effect. Discussions were also held on the Anti-Counterfeiting Trade Agreement (ACTA), during which India, the world’s largest generic manufacturer, stressed that ACTA border measures constituted a grave threat to trade in generics. India argued that ACTA is not legitimate, as it bypasses the multilateral processes of WTO or the World Intellectual Property Organisation and goes far beyond the enforcement levels laid down in the TRIPS Agreement. It noted that ACTA proposals that are underway could undermine the provisions and flexibilities in the TRIPS Agreement by requiring patentability of new uses and minor variations of older known drugs, resulting in indefinite lengthening of the patent life and undermine the generics industry.
According to this press release by the Treatment Action Campaign (TAC), a South African coalition of HIV and AIDS treatment activists, South Africa currently provides patent protection beyond what is required by the international TRIPS agreement, which regulates patents, including those governing production of medicines. Flexibilities in TRIPS allow developing countries to produce or procure affordable generics and countries like India, Brazil and Thailand have used these flexibilities to curb excessive patenting of pharmaceuticals and promote public health. Yet South Africa has not followed their example, argues TAC, having granted 2,442 pharmaceutical patents in 2008 alone, while Brazil only granted 278 pharmaceutical patents between 2003 and 2008. Although President Jacob Zuma has signed on to a joint declaration with India and Brazil recognising the urgent need to scale up production of generic medicines by using TRIPS flexibilities, TAC argues that government has not yet taken the concrete steps needed to fulfill this commitment.
Chinese economic success is not the product of free market accidental coincidence, according to this article – rather, it is orchestrated by the State through a mixture of nationalism (‘big think’) and pragmatic decisions (disjointed incrementalism) in agriculture, finance and industry. By following the Chinese example, the author argues for Pan-Africanism, a form of ‘big think’. The main obstacle to development in Africa, he argues, may well be how to align the vested, narrow interests of territorially bound rulers with their citizens, whose languages and cultures tend to transcend the colonially determined national boundaries and who are more likely to support development efforts if they are consonant with existing practices and values. The author argues that Pan-Africanism would allow Africa to take advantage of the economies of scale that accrue with larger markets, give Africa better leverage on its natural resources, allow for easier sharing of resources between rich and poor communities and give the continent greater international clout.
At the United Nations’ meeting on non-communicable diseases (NCDs) in September 2011, heads of state were told that cancers, heart disease and mental health issues were critical to the future of the global economy: NCDs are forecast to cost $47 trillion, or 4% of global gross domestic product (GDP), over the next 20 years. This, the author of this article points out, was the only figure put forward to contextualise NCDs, as the meeting failed to produce any concrete targets, funds and action plan. Although the UN General Assembly called on the World Health Organisation (WHO) to develop a global monitoring framework over the next twelve months, the framework will contain only voluntary targets and there is little in the declaration that is specific on international co-operation or coordination. Most action is for sovereign interpretation and subject to domestic interests. Health system development, the regulation of industry and key interventions across sectors such as education, environment, agriculture, and transport remain areas for intervention at the national level only. While trade issues concerning access to medicines, food regulation and tobacco control are affected by global policy, governments remained divided in their interpretation of such policies. On the one hand, health ministries now recognise the human and economic cost of overt protection of industries but on the other hand, commerce officials continue to promote consumption of goods domestically and internationally with simplistic assumptions about individual and social impacts.
In this paper, the author argues that, in order to ensure food security for everyone, all aspects of the food security supply chain, global governance, investment and trade will need to be addressed simultaneously. For improving global governance, full support should be given to the work of the reformed Committee on World Food Security (CFS). This may involve merging the United Nations (UN) High Level Task Force with the Committee. At the same time, the Committee may need to work more independently of the Rome-based agencies and report to the UN Economic and Social Council with more coordination than has existed so far. To ensure a functional global food supply system, World Trade Organisation members should consider alternative mechanisms for adjusting trade rules and expanding the mandate of the Committee on Agriculture according to the changing global requirements, the article notes. Thanks to many positive developments such as having a reformed CFS, the Global Partnership on Food Security, substantial new funding and a much more coordinated approach, the global community is in a much better position to reduce global hunger. Unfortunately trade rules are not keeping up with other developments the author concludes.
The Medicines Patent Pool, which negotiates voluntary licences for lower pharmaceutical prices, has announced the signing of an agreement with Indian generics producer Aurobindo Pharma Limited to manufacture antiretroviral (ARV) medicines. The Patent Pool has recently come under criticism from AIDS activists concerned about its July 2011 licence agreement with drug company Gilead, and it remains to be seen if this action will address their concerns. The Medicines Patent Pool said that the agreement will enable Aurobindo to manufacture ARVs licensed to the Pool by Gilead Sciences in July. The uptake of the listed ARVs by generic manufacturers will help close the gap between the arrival of new medical technology in developed country markets and its often delayed arrival in developing countries, according to the Pool. In particular, Aurobindo took advantage of a key provision negotiated by the Pool so it can sell the ARV, tenofovir, to a larger number of countries without paying royalties. The arrangement is expected to make it possible for Aurobindo to sell tenofovir to a larger number of countries than before.