Health equity in economic and trade policies

Genuine partnership or a marriage of convenience? India-Africa relations in the 21st century
Cheru F and Obi C: Fahamu Books and Pambazuka Press, 2011

While China's relationship to Africa is much examined, knowledge and analysis of India's role in Africa has until now been limited but, as a significant global player, India's growing interactions with various African countries call for detailed analysis of the Asian giant's influence and its relations with the African continent. In this book, which enables readers to compare India to China and other 'rising powers' in Africa, expert African, Indian and western commentators draw on a collection of accessibly written case studies to explore inter-related areas including trade, investment, development aid, civil society relations, security and geopolitics.

Land deals in Africa: What is in the contracts?
Cotula L: International Institute for Environment and Development (UK), March 2011(revised)

As world market prices for crops such as grain and soybeans have risen, governments in countries that import food have realised they can no longer depend on the market for supplies. At the same time, predictions that food and water shortages are being exacerbated by climate change and expanding populations have convinced countries such as China, South Korea, Saudi Arabia and others to buy large amounts of land in poor countries in Africa, according to this paper. Agribusinesses, government agencies, and investment funds alike have been acquiring long-term leases for more than 50 million hectares of land in countries such as the Democratic Republic of Congo, Madagascar and Mozambique. But in many cases the contracts are just a few pages long, and the land is sold for less than US$1 per hectare. These so-called “land grabs” are water acquisitions as well; some contacts include turning over water rights without a fee. And since most of the leases are for up to 100 years, the local population often loses the rights to its land and water for generations. Why are the governments in these African countries signing such fragile deals? Poor African nations hope to gain jobs and infrastructure development, the author concedes. Yet many local farmers living on land sold to foreign entities stand to lose much as most of the contacts to acquire the land were completed without local participation or notification.

Proposed EU customs regulation may not dispel fear of wrongful drug seizures
Saez C: Intellectual Property Watch, 31 May 2011

The European Commission has issued a new draft customs regulation that it says addresses past concerns over wrongful seizures of generic drug shipments transiting through European ports. But the new regulation does not substantively change existing rules, it said, and civil society groups say it does not go far enough. The proposal does not explain that the customs regulation is of a procedural nature, and it does not change or add to the rules defining what an intellectual property rights (IPR) infringement is. In 2008, shipments of legitimate generic medicines transiting through Europe were detained by customs authorities on allegation of IPR rights infringement. This triggered the filing of disputes at the World trade Organisation (WTO). On 11 May 2010, India requested consultations at the WTO with the European Union and the Netherlands about seizures of generic drugs coming from India and travelling via the Netherlands to developing countries in Africa and elsewhere. India said those seizures were inconsistent with the obligations of the European Union and the Netherlands of various provisions of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The dispute is ongoing and remains at the consultation phase.

Tax havens or financial sink holes?
Boyce JK: Triple Crisis, 18 April 2011

According to the author of this article, secrecy jurisdictions – or tax havens - act as financial sinkholes: places where vast sums of money flow between the legitimate world economy and the illicit underworld economy. The costs of financial sinkholes are borne by ordinary citizens throughout the world, not only by taxpayers in industrialised countries but also by many of the world’s poorest people. The author points to the flight of US$735 billion (in constant 2008 dollars) from sub-Saharan Africa from 1970 to 2008. Most of this disappeared into secrecy jurisdictions, with recorded African deposits in Western banks amounting to less than 6% of this amount. To put Africa’s capital haemorrhage into perspective, the total foreign debt of the same countries stood at US$177 billion at the end of 2008. In this sense Africa is a net creditor to the rest of the world because its external assets far exceed its external liabilities. However the assets are private and hidden, whereas the liabilities are public, owed by the people of Africa through their governments. The author points to advocacy from groups like the Tax Justice Network, Global Financial Integrity and Global Witness, who have raised public awareness of these issues.

Local pharmaceutical production in developing countries: How economic protectionism undermines access to quality medicines
Bate R: Campaign For Fighting Diseases Discussion Paper No. 1, January 2008

The author of this paper argues for public-private partnerships to help deliver locally produced generics in Africa, and against protectionism in favour of open market access. He points to promising developments, such as experienced Indian and Western pharmaceutical firms undertaking original research and development and partnering with firms in African countries. He believes this investment by reputable companies should help ensure quality drugs are produced by furnishing the technical expertise that overcomes capacity constraints. Local production enterprises in Africa will allow international companies to diversify their supply sources, the author argues, guarding against potentially disastrous shocks such as a natural disaster that would destroy an Artemisia crop and send the price of artemisinin-based malaria drugs skyrocketing. Local production partnerships could encourage trade, especially because the bulk active ingredients needed to produce them still come most efficiently from abroad. Partnerships between foreign pharmaceutical firms and African companies may also help train a pool of skilled workers, improving a country’s long-term development prospects.

Registering new drugs for low-income countries: The African challenge
Moran M, Strub-Wourgaft N, Guzman J, Boulet P, Wu L et al: PLoS Medicine 8(2), 1 February 2011

In this study, the authors argue that an optimal drug registration approach for Africa should reliably evaluate safety, efficacy, and quality of drugs for African use. It should include African expertise, contribute to building African regulatory capacity, and, ultimately, expedite African access by reducing duplicative and sequential reviews by different regulators. However they present an overview of the current situation that shows the present system of drug approval to be far from achieving these goals, with inefficiencies in the use of regulatory resources and in the uptake of capacity-building opportunities for African regulators. As a result regulatory processes and decisions may not meet current needs. The authors recommend that countries institute formal twinned regulatory reviews, fund Centres of Regulatory Excellence in each of Africa’s main regions and conduct a strategic review of WHO drug pre-qualification disease and product priorities.

The ability of select sub-Saharan African countries to utilise TRIPs Flexibilities and Competition Law to ensure a sustainable supply of essential medicines: A study of producing and importing countries
Avafia T, Berger J and Hartzenberg T: ICTSD, UNCTAD and tralac, 2006

Despite the successes in using competition law to reduce drug prices in South Africa, the prospects of other countries in the region being able to utilise competition law and policy to attain similar objectives are not high, due to a lack of institutional capacity (in some cases) and a lack of expertise, the authors of this paper argue. By taking an initial focus on domestic legislation, SADC countries may ultimately pave the way for a form of regional harmonisation for competition policy. As developments in South Africa have shown, national competition policy can ensure that national markets function efficiently, assure consumers of competitive prices and product choices, and promote other such efficiency-plus objectives. However, it is true that market developments tend to outstrip policy and regulatory developments. This region demonstrates perhaps one of the most confusing and complex arrays of overlapping membership of regional trade organisations with various countries being members either of SACU, SADC or COMESA. Given the mix of multiple memberships of regional trading organisations in the region, it is suggested that the two most viable (but by no means exclusive) options to explore for a regional competition policy are COMESA and SACU.

The Joint Africa-EU Strategy
Faria F and Laporte G: Trade Negotiations Insights 10(9), December 2010-January 2011

This article looks at the main challenges to European Union-Africa relations in light of the EU-Africa summit held in Tripoli, Libya from 29-30 November 2010. The Tripoli meeting marked the third Africa-EU Summit since 2000. In 2007, both parties to the JAES pledged to work together to implement the Africa Health Strategy, the EU Project on Human Resources for Health, the Abuja commitment to dedicate 15% of government financing for health, and the European Programme for Action to Tackle the Shortage of Health Workers in Developing Countries. President Jacob Zuma of South Africa openly expressed his concern that after ten years of the partnership, there was still too little to show in terms of tangible implementation of the undertakings made in previous summits. He cautioned the summit against committing to another action plan when commitments made in the past have not been implemented. The author noted that for example the ongoing Economic Partnership Agreement (EPA) negotiations, have become a contentious issue in EU-Africa relations, with clauses that may negatively impact on the production of affordable generic medicines for developing countries by rigorously protecting patent holders in developed countries.

An Update on Intellectual Property Claims Related to Global Pandemic Influenza Preparedness with Comments on the WIPO Patent Search Report on Pandemic Influenza Preparedness
Hammond E: Third World Network, 8 April 2011

In this report, the author found that proprietary rights on “influenza genetic sequences and the proteins they encode, used in vaccines,” get in the way of developing countries’ access to medicines. The study shows a sharp rise in patent applications in this area since 2006, shortly after the outbreak of H5N1 in late 2005. The study lists a series of examples of patent applications, such as Baxter International, for the production of influenza vaccines, published in July 2010. This patent application includes animal and human H5N1 types from China, Vietnam, Indonesia, Thailand, Cambodia, Turkey, and Singapore. According to the author, developing countries “collect and share influenza viruses with WHO’s Global Influenza Surveillance Network with the understanding that those viruses are to be used for public health.” However, proprietary claims can prevent access to technology and products produced with a given technology, he said.

Eye on the ball: Medicine regulation – not IP enforcement – can best deliver quality medicines
Oxfam: 2 February 2011

The report notes that poor-quality, or "substandard", medicines threaten patients and public health in developing countries. Prioritisation of medicines regulation by developing-country governments, with the technical and financial support of rich countries, is badly needed. Yet under the guise of helping to address dangerous and ineffective medicines, rich countries are pushing for new intellectual-property rules and reliance on police - rather than health regulatory - action. This approach will not ensure that medicines consistently meet quality standards. Worse, new intellectual property rules can undermine access to affordable generic medicines and damage public health. Developing countries must improve medicines regulation - not expand intellectual-property enforcement - in order to ensure medicine quality.

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