Health equity in economic and trade policies

Gender justice in trade policy: The gender effects of economic partnership agreements
One World Action: 2010

This study provides the first detailed economy-wide analysis of the likely gender effects of economic partnership agreements (EPAs) based on the goods tariff liberalisation schedules agreed by Tanzania, Mozambique and Jamaica. The study found that the employment and production effects of trade liberalisation on women will depend on the extent to which women are employed in the sectors sensitive to import competition, but most importantly, their ability to relocate to an expanding sector of production. It predicts that, under an EPA, women’s employment is likely to be minimally affected in Jamaica, Mozambique and Tanzania. Findings suggest that the consumption effect of trade may be regressive: imports, such as washing machines in Mozambique or gas cookers in Tanzania, will most likely benefit the wealthier, as they are not consumed by poorer households. For example, increasing availability of household appliances could reduce the workload of women with access to electricity, but only 7% of Mozambican households have access and an indirect effect could be a drop in demand for domestic workers, most of whom are women. The loss of government revenue from tariff removal constitutes the most immediate and significant impact, estimated at 2% of revenue, with too little time to compensate for lost revenue. The study urges that further monitoring of the implementation of trade liberalisation is required from a gender perspective. The gender-aware framework and analytical approach developed could be used to examine other EPAs and other trade agreements.

Latecomer development: Innovation and knowledge for economic growth
Oyelaran-Oyeyinka B and Sampath PG: Routledge, 2010

This book is based on a macro analysis of 79 countries and micro-surveys in different sectors and countries, spanning seven years. In it, the authors argue that rich countries have built strong institutions to complement to their production systems, which has allowed them to build up strong production and the exportation of high quality goods and services, a path followed by emerging economies. However, poor countries continued to produce raw materials for the richer countries. Central to the production activities of all countries that became rich is a set of industrial and innovation policies, which are discussed in the book. ‘Latecomer countries’ are defined as countries that are late in developing, and which do not innovate at the 'global frontier,' which is occupied by the top industrialised countries. They need industrial and innovation policies that shift attention from commodities to development of productive capacities. Innovation is not research and development, it is about knowledge that countries acquire, according to the book.

Mercury exposure in a low-income community in South Africa
Oosthuizen MA, John J and Somerset V: South African Medical Journal, 100(6): 366–371, June 2010

This study aimed to establish whether a specific community in a gold mining area, with potentially associated small-scale gold mining activities, was exposed to mercury. Thirty respondents completed a questionnaire and mercury levels were determined in 28 urine and 20 blood samples of these respondents. Three (15%) of the blood samples exceeded the guideline for individuals who are not occupationally exposed, while 14 (50%) of the urine samples exceeded the guideline for mercury in urine for those not exposed occupationally. The cause of these elevated levels is unknown, as only 20% of respondents indicated that they used coal as an energy carrier. Furthermore, nobody from the community was reportedly formally employed in a goldmine. Nineteen (63%) respondents consumed locally caught fish, while 20 (67%) drank water from a river. The study concluded that some individuals in this study may be occupationally exposed to mercury through small-scale gold mining activities. As primary health facilities will be the first point of entry for individuals experiencing symptoms of mercury poisoning, South African primary health care workers need to take cognisance of mercury exposure as a possible cause of neurological symptoms in patients.

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

This article outlines how trade preference programmes can be made more effective for low income 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.

Our common strategic interests: Africa's role in the post-G8 world
Cargill T: Chatham House, June 2010

The author argues that global players that develop greater diplomatic and trade relations with African states will be greatly advantaged. For many countries, particularly those that have framed their relations with Africa largely in humanitarian terms, this is argued to require a shift in public and policy perceptions. Without this shift, many of Africa's traditional partners, especially in Europe and North America, will lose global influence and trade advantages to the emerging powers in Asia, Africa and South America. The author argues that economic fortunes across Africa are diverging, making it less meaningful to treat Africa as a single entity in international economic negotiations. He claims that it is in the global interest that the African Union should be granted a permanent place at the G20 and that in turn, a more focused, sophisticated and strategic African leadership is needed.

Reconsidering regional integration in sub-Saharan Africa
McCarthy C: Tralac and Danida, 2010

This paper explores regional integration in Africa. The author observes that fragmentation of countries has led to the absence of scale in the production of goods and services. Industrialisation and regional integration policies were proposed to overcome this. For some communities, such as the Southern African Development Communities, there were also political objectives. None of the regional integration arrangements are yet fully fledged customs unions. The author notes the limits to intraregional trade by virtue of the low industrial capacity of the countries in the region. However regional integration provides in theory the economies of scale that attract investment and protects producers within a common market. He argues that these benefits of regional integration have not been achieved. As regional integration is argued to be important, the author argues that it needs to be more strongly based on national strategies for enhancing production capacities.

Regional economic outlook: Sub-Saharan Africa: Back to high growth?
International Monetary Fund: April 2010

According to this report, the current economic slowdown in sub-Saharan Africa may soon be over. Output is projected to expand by 4¾% in 2010, compared to 2% in 2009. Most countries in the region are now bouncing back from the growth slowdown or contraction in output experienced during the global recession. The brevity of the slowdown owes much to the relative strength of the region’s economies heading into 2008–2009, the expansionary macro-economic stance then adopted by most countries, and the relatively quick recovery in global economic activity. The report predicts that prospects for 2011 and beyond look good. Output growth is projected to accelerate to 5¾% in 2011, playing off the expected continued improvement in global economic conditions. Over the medium term, growth rates in most sub-Saharan African countries are expected to be only marginally below those enjoyed in the mid-2000s. In the meantime, most countries have been able to shield pro-poor and pro-growth public spending. According to preliminary budget out-turn numbers, health and education spending increased in real terms in 20 of the 29 low-income countries in the region in 2009. In a similar vein, government capital spending also looks to have held up in 2009, increasing in real terms in more than half of the countries in the region.

Supporting regional integration in east and southern Africa
McCarthy C, Cronjé JB, Denner W, Fundira T, Mwanza W, Bursvik E: Trade Law Centre for Southern Africa and the Royal Danish Embassy, 2010

This collection of papers reviews select issues on the regional integration agenda in east and southern Africa. It starts by assessing the African Paradigm of Regional Integration, as well as the broader AU integration agenda. It also reflects on the impact of the global economic crisis on Africa. This is followed by a review of progress on regional integration in the Southern African Development Community (SADC). It then considers country-specific issues, including the trade policy choices of several countries, the role of new generation trade issues, such as services on the regional integration agenda, and assesses the status of protectionism, trade remedies and safeguards in regional trade agreements, both intra- and extra-regional. Finally, it presents a review of the developments in the negotiations concerning SADC’s economic partnership agreements, specifically focusing on concerns raised within the SADC group.

The EU-Africa partnership: At a strategic crossroads
Bello O: FRIDE policy brief 47, May 2010

The Joint Africa-EU Strategy (JAES) launched by European and African leaders at the Lisbon summit of 2007 is argued to have so far failed to deliver on its key promise to fundamentally transform development and political cooperation between the continents. Three years of uncertain implementation reveals just how wide a gap separates the rhetoric and reality of the new strategic partnership. This policy brief shows how the Joint Africa-EU Strategy has struggled to integrate some pre-existing frameworks and transform the logic of elevated partnership. Both sides admit difficulties in the face of unfulfilled expectations of additional European Union (EU) funding. At the same time implementation of the agreement is clouded by dissonant discourses from both sides of the negotiation table. To complicate matters further, institutional complexity in Europe is met by an embryonic process of continental integration in Africa.

Veil of secrecy on anti-counterfeit bill
Mpaka C: Malawi News, 12 June 2010

Health activists in Malawi have expressed concern at what they call government’s ‘secret conduct’ on the proposed anti-counterfeit law, which they fear could legislate against the generic drugs on which Malawi’s health care system heavily relies. In keeping with World Trade Organisation (WTO) and international trade agreement terms, countries in East and Southern Africa are introducing laws reportedly to crack down on infringement of trademark and intellectual property rights. According to this article, Malawi’s proposed law to that effect has already been examined by Cabinet on its way to becoming law. However, health activists have expressed concern that the law may cause drug stock-outs if generic medicines are treated as counterfeits, as has been raised in East African versions of counterfeit law. Government is allegedly denying health civil society access to the document, saying it is not for public consumption. Executive Director for the umbrella body Malawi Health Equity Network (MHEN), Martha Kwataine, said enacting a law against generic medical products will reverse Malawi’s efforts in improving health care and worsen drug stock outs in hospitals. ‘Once we have the new laws, it means we will be forced to buy the most expensive brand-name drugs,’ she added. ‘The big companies that are owners of the patents will be making huge profits at the expense of the lives of poor people in Malawi.’

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