The African Union set out its vision of An Integrated, prosperous and peaceful Africa, driven by its own citizens and representing a dynamic force in the global arena. Aiming to encourage discussion among all stakeholders, Agenda 2063 is an approach to how the continent should effectively learn from the lessons of the past, build on the progress now underway and strategically exploit all possible opportunities available in the immediate and medium term, so as to ensure positive socioeconomic transformation within the next 50 years. Agenda 2063 emphasizes the importance of Pan-Africanism, unity, self-reliance, integration and solidarity that was a highlight of the triumphs of the 20th century. It highlights the need to more effectively use African resources for the benefit of people in the continent. It raises regional political, institutional renewal and financing/resource mobilization issues, as well as the changing nature of Africa’s relationships with the rest of the world. The AU is calling for input to the agenda.
Health equity in economic and trade policies
The July BRICS Summit ratified an agreement on the establishment of a $100 billion BRICS pool of currency reserves, according to a document published early May 2015. It is reported that the bank will invest primarily in infrastructure projects in both BRICS and non-BRICS countries. The establishment of its first regional office in Johannesburg will give access to the Africa, where infrastructure development needs are highest. The idea to set up BRICS bank was first proposed by India and that topped the agenda at the summit of the group in New Delhi in March 2012. India believes a joint bank would be in line with the growing economic power of the five-nation group. The bank could firm up the position of BRICS as a powerful player in global decision-making. India believes that a BRICS bank could, among others, issue convertible debt, which would arguably be top-rated and can be bought by central banks of all BRICS countries. BRICS countries would thus have a vessel for investment risk-sharing.
Agriculture has the potential not only to feed all of Africa’s people but also to earn the continent revenues for development. There are numerous practical ways in which this can be achieved. the Comprehensive Africa Agriculture Development Programme (CAADP) is a programme of African Union, which was endorsed in Maputo in 2003 with the aim of improving and promoting agriculture across Africa calls for countries to allocate 10% of their national income to agricultural development. Most countries have poor storage facilities and transportation systems which have led to post-harvest losses in both grains and vegetables. Maize has been affected by aflatoxin. There has been persistent price fluctuation of agricultural products which makes it almost impossible to plan for the earnings. The foreign income is minimal since most countries engage in primary exports, where the market is saturated. The author indicates that it is time Africa embraced the concept of value addition, exporting finished products will give an upper hand in the global market. Enhancing tariff barriers will make imports expensive boosting the demand for local products.
The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security—its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including World Health Organization reform, it will be important to distil lessons learned from the Ebola outbreak. Prof. Heymann led a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for the next steps. The paper describes some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed but their common goal is a more sustainable and resilient society for human health and wellbeing.
This study was carried out to understand the role social determinants and health seeking behavior among rice farming and pastoral communities in Kilosa District in central Tanzania. The study involved four villages; two with rice farming communities while the other two with pastoral communities. In each village, heads of households or their spouses were interviewed to seek information on livelihoods activities, knowledge and practices on malaria and its preventions. A total of 471 individuals were interviewed. Only 23.5% of the respondents had adequate knowledge on malaria. Fifty-six percent of the respondents could not associate any livelihood activity with malaria transmission. Majority (79%) of the respondents believed that most of fevers were due to malaria; this was higher among the pastoral (81.7%) than rice farming communities (76.1%). Cases of fever were significantly higher in households with non-educated than educated respondents. Women experienced significantly more episodes of fever than men. Fever was reported more frequently among pastoral than rice farming communities. Treatment seeking frequency differed by the size of the household and between rice farming and pastoral communities. In conclusion, education, sex, availability of health care facility and livelihood practices were the major social determinants that influence malaria acquisition and care seeking pattern in central Tanzania. The authors argue for an ecohealth approach to address the links of livelihoods and malaria transmission among rural farming communities.
As pharmaceutical firms experience increasing civil society pressure to act responsibly, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. The author’s sought to understand how multinational pharmaceutical companies currently engage in CSR activities in developing countries and their motivations for doing so. They conducted a small-scale, exploratory study combining (i) in-depth review of publicly available data on pharmaceutical firms’ CSR with (ii) interviews of representatives from 6 firms, purposively selected, from the highest earning pharmaceutical firms worldwide. Corporate social responsibility differed for each firm. Across the firms studied, the common CSR activities were: differential pharmaceutical pricing, strengthening developing country drug distribution infrastructure, mHealth initiatives, and targeted research and development. Primary factors that motivated CSR engagement were: reputational benefits, recruitment and employee satisfaction, better rankings in sustainability indices, entrance into new markets, long-term economic returns and improved population health. CSR strategies ranged from philanthropic donations to integrated business models. The authors indicate that the study points to the need to (i) develop clearer definitions of CSR in global health (2) strengthen indices to track CSR strategies and their public health effects in developing countries and (iii) undertake more country level studies that investigate how CSR engages with national health systems.
Modern trade negotiations have delivered a plethora of bilateral and regional preferential trade agreements (PTAs), which involve considerable risk to public health, thus placing demands on governments to strengthen administrative regulatory capacities in regard to the negotiation, implementation and on-going management of PTAs. In terms of risk management, the administrative regulatory capacity requisite for appropriate negotiation of PTAs is different to that for the implementation or on-going management of PTAs, but at all stages the capacity needed is expensive, skill-intensive and requires considerable infrastructure, which smaller and poorer states especially struggle to find. It is also a task generally underestimated. If states do not find ways to increase their capacities then PTAs are likely to become much greater drivers of health inequities. Developing countries especially struggle to find this capacity. In this article the authors set out the importance of administrative regulatory capacity and coordination to manage the risks to public health associated with PTAs, and suggest ways countries can improve their capacity.
The author argues that the outcome of the last WTO Ministerial, the 'Nairobi Package', was in fact a slap in the face for the peoples of the South. He observes it to be especially egregious that the US used the 10th Ministerial, with the help of the Kenyan leadership, to undermine the future of Pan-African trading relations and to drive a wedge between the BRICS societies and those that the US wants to manipulate in the poor countries. He further argues that the 10th Ministerial has hastened the demise of the WTO in an article which charts the various trade agreements and roles played by state actors in the North and South in achieving unfair and unequal global agreements.
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.
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.