Health equity in economic and trade policies

Making a Killing: How tax scams are robbing poor countries of life-saving healthcare
O’Meara C; Hanna L; Gugushvili D: Save the Children, UK, 2015

The authors report that the world’s poorest countries are losing billions of potential tax revenue each year as a result of illicit financial flows and the tax dodging schemes associated with them. These complex and shadowy tax dealings are robbing developing countries of revenue they need to spend on essential public services. Making a Killing analyses one part of the web of illicit financial flows, the ‘misinvoicing’ of international trade – a way of hiding the true value of imports and exports, shifting profits and evading taxes. The figures are staggering. The sums being lost are comparable to the amounts currently missing from the health budgets of very poor countries – lost money that could boost total budgets and pay for desperately needed doctors, nurses, clinics, hospitals and medicines, and provide the basic minimum of decent healthcare to mothers and children. If the world is to meet its ambitious targets on health and child survival, let alone the broader objectives of the Sustainable Development Goals, illicit financial flows must be urgently addressed. This reports sets out recommendations for action by the international community.

Making Medicines in Africa: The Political Economy of Industrialising for Local Health
Mackintosh M; Banda G; Tibandebage P; Wamae W: Palgrave Connect, December 2015

The importance of the pharmaceutical industry in Sub-Saharan Africa, its claim to policy priority, is rooted in the vast unmet health needs of the sub-continent. Making Medicines in Africa is an open access online book that is a collective endeavour, by a group of contributors with a strong African and more broadly Southern presence, to find ways to link technological development, investment and industrial growth in pharmaceuticals to improve access to essential good quality medicines, as part of moving towards universal access to competent health care in Africa. The authors aim to shift the emphasis in international debate and initiatives towards sustained Africa-based and African-led initiatives to tackle this huge challenge. The authors argue that without the technological, industrial, intellectual, organisational and research-related capabilities associated with competent pharmaceutical production, and without policies that pull the industrial sectors towards serving local health needs, the African sub-continent cannot generate the resources to tackle its populations' needs and demands.

Rejoinder: In defence of the Alternative Mining Indaba
Capel J; Lorgat H: Pambuzuka News 763, February 2016

In a response to critiques of the 2016 Alternative Mining Indaba, the Bench Marks Foundation asserts their commitment to a popular movement of workers and poor people in contesting corporate power and elite control over mining processes. The authors define their approach as evidence or research-based activism, accompanied by community organising and monitoring of corporate conduct with the view of challenging corporate power and continuing to agitate wherever power lies. To date, they have followed an advocacy strategy built on research, community organising, building alliances with organised workers and other communities. The organisers of the Alternative Mining Indaba argue that it is a time for governments to rededicate themselves with concrete deeds to protect and prevent harm for poor people.

Promoting the use of climate information to achieve long-term development objectives in Sub-Saharan Africa: Results from the future climate for Africa scoping phase
Jones L, Carabine E, Roux JP, Tanner T: Climate and Development Knowledge Network, February 2015

The impacts of climate change are currently being felt by people and communities. However, many of the most severe impacts will be felt in the decades to come. Significant barriers emerge in an effort to achieve long-term development objectives, particularly in sub-Saharan Africa, a region with low capacity to adapt to the future impacts of climate change. Factoring medium- to long-term climate information into investments and planning decisions is therefore an important component of climate-resilient development. We know little about how climate information is used in Africa to make decisions with long-term consequences, or how effective it is. We know even less about the barriers to – and opportunities for – using climate information in decision-making. How, then, should governments, businesses and donors strive for climate information to achieve Africa’s long-term development objectives? The Future Climate For Africa (FCFA) programme explores these questions and seeks to challenge many of the assumptions that underlie them. To guide the programme, six case studies investigated how climate information was being used in decision-making in sub-Saharan Africa. These comprised four country case studies: Malawi, Rwanda, Zambia and a combined study of Accra, Ghana and Maputo, Mozambique; and two desk-based studies focused on long-lived infrastructure in the ports sector and the large hydropower sector. This report presents the results of the scoping phase.

The global financial crisis and access to health care in Africa
Mensah J: Africa Today 60(3), 2014

Just when health care financing in Africa is expected to pick up due to perceptible improvements in many economies, including those of Ethiopia, Rwanda, and Angola, the global financial crisis gathers momentum for contagion. This paper examines how the financial crisis is undermining access to health care in Africa, and offers some suggestions to help improve the situation. The paper sees access as a multifaceted concept, imbued with various social, economic, and geographic characteristics. The study found that the revenue constrictions wrought by the ongoing financial crises (e.g., through reductions in donor funding, tourist bookings, and remittance to Africa) have affected the supply of health care services, put pressure on personal finances, and compelled many households to reduce their demand for formal health care services.

The scramble for Africa: A continuing narrative
Oyateru T, Pambuzuka News, 713, February 2015

Africa is fast becoming the go-to continent for countries wanting access to the vast and rich resources. But can the continent harness its potential, negotiate effectively and have the confidence to take charge of its own future, without allowing global financial giants to ride rough-shod over it? This article discusses the current state of investment into the region, the influence of China and America and the implications for Africans.

WTO least-developed countries request waiver of IP rights on pharma products
Saez C, Intellectual Property Watch, 25 February 2015

In the World Trade Organization intellectual property committee meeting in February, least-developed countries (LDCs) submitted a request to extend a waiver allowing them not to enforce intellectual property rights on pharmaceutical products that goes to 2016. The countries have extended the waiver before, but this time they are seeking to make it indefinite, until they are no longer considered LDCs are disproportionately exposed to the health risks associated with poverty, and “patent protection contributes to high costs, placing many critical treatments outside the reach of LDCs, according to a communication by the group.

Africa Forum on Inclusive Economies 2014
Rockefeller Foundation, African Development Bank, United Nations Economic Commission for Africa: December 2014

The Rockefeller Foundation, the African Development Bank and the United Nations Economic Commission for Africa convened in December 2014 at the Africa Forum on Inclusive Economies, a Pan African convening aimed at bringing together key thought leaders and policy makers to closely interrogate and propel forward, thinking around the theme of advancing inclusive economies. The convening aimed to focus new ideas and narratives towards the advancement of an inclusive economies approach with key African institutions and influencers and to provide a platform to further enhance thinking and critical debate on the issue of inclusive economies. Reports, videos and a blog from the convening can be found on the website.

The Heretic's Guide to Global Finance: Hacking the Future of Money
Scott B: Pluto Press, 10 May 2013

The Heretic's Guide to Global Finance: Hacking the Future of Money is a friendly guide to the complex maze of modern finance but also tells us how to utilise and subvert it for social purposes in innovative ways. It sets up a framework to illuminate the financial sector and helps the reader develop a diverse DIY toolbox to undertake their own adventures in guerilla finance and activist entrepreneurialism. Part 1 (Exploring) covers the major financial players, concepts and instruments. Part 2 (Jamming) explores innovative forms of financial activism. Part 3 (Building) showcases the growing alternative finance movement - including peer-to-peer systems, alternative currencies, and co-operative economies - and shows how people can get involved in building a democratic financial system.

The International Monetary Fund and the Ebola outbreak
Kentikelenis A, King L, McKee M, Stuckler D: The Lancet, 21 December 2014

In recent months, the International Monetary Fund (IMF) has announced US$430 million of funding to fight Ebola in Sierra Leone, Guinea, and Liberia. By making these funds available, the IMF aims to become part of the solution to the crisis, even if this involves a departure from its usual approach. As IMF Director Christine Lagarde said at a meeting on the outbreak, “It is good to increase the fiscal deficit when it's a matter of curing the people, of taking the precautions to actually try to contain the disease. The IMF doesn't say that very often.” Yet, could it be that the IMF had contributed to the circumstances that enabled the crisis to arise in the first place? A major reason why the outbreak spread so rapidly was the weakness of health systems in the region. There were many reasons for this, including the legacy of conflict and state failure. Since 1990, the IMF has provided support to Guinea, Liberia, and Sierra Leone, for 21, 7, and 19 years, respectively, and at the time that Ebola emerged, all three countries were under IMF programmes. However, IMF lending comes with strings attached—so-called “conditionalities”—that require recipient governments to adopt policies that have been criticised for prioritising short-term economic objectives over investment in health and education. Indeed, it is not even clear that they have strengthened economic performance. Here the authors review the policies advocated by the IMF before the outbreak, and examine their effect on the three health systems.

Pages