In this paper, the authors discuss the various aspects of occupational cancer in developing countries, focusing on the conditions of informal workers and firms. They found that estimating the burden of cancers attributable to occupational exposures is difficult as occupational cancers are usually clinically indistinguishable from those unrelated to occupation. Lack of reliable data is an obstacle to establishing the place for cancer prevention in public policies, particularly in poor regions. Workplaces are argued to be a substantial source of carcinogen exposures, together with psychosocial stressors that mediate exposure to cancer risk factors such as smoking and alcohol consumption. Enforcement of hazard control in workplaces is weak and workers’ organisations are not strong enough to ensure compliance with standards required for healthy and safe work environments. This situation is even more intense in the informal economy, where firms are beyond state control. There are reports of increased risks of cencer among informal workers compared to formal workers.
Health equity in economic and trade policies
In this article, the author argues that regional integration and regional agricultural markets are particularly important for African agriculture, since national markets and institutions are too small to bring about the needed transformation of African agriculture. Great opportunities exist, with Africa having 60% of the world's total amount of uncultivated arable land and therefore an immense potential for agricultural productivity growth. However, the author believes more attention should be dedicated to increase the productivity of small-scale farmers, who contribute around 90% of Africa's agricultural production but remain largely locked out of trade dynamics. Regional integration and agriculture development, and in particular intra-African agricultural trade, offer a great potential for food security and pro-poor growth in Africa, if they can work in synergy, especially at the regional level. Various independent processes are under way to promote agricultural development and encourage regional trade in Africa, such as the Comprehensive Africa Agriculture Development Programme (CAADP) and the development of trade corridors. However, weak communication across the agriculture and trade sectors/communities and the parallel - and at times competing - policy frameworks hamper the creation of much needed synergies.
In the lead-up to Free Trade Agreement (FTA) discussions during the European Union-India Summit in New Delhi on 10 February 2012, UNITAID has urged both parties to ensure that access to medicines, and particularly AIDS medicines, is not hampered by trade interests via provisions that could undermine the production, registration and availability of generic medicines. The agreement coincides with a delicate time for access to treatment efforts - the suspension of grants by the Global Fund and diminishing resources for health and development, said UNITAID, calling on the European Union to safeguard the right of millions of people in developing countries to continue accessing affordable life-saving medicines produced by the Indian generic industry. AIDS treatment has experienced startling progress over recent years, with almost seven million people starting treatment between 2003 and 2011, largely due to India's ability to produce low-cost, quality-assured generic medicines and to healthy competition among India's producers. However, such provisions as data exclusivity, patent term extensions and border measures could severely legally restrict manufacturers' ability to produce recently developed medicines and patient adapted formulations at low cost and to export those medicines to other developing countries.
An intellectual property (IP) conference for government ministers, to be held in April 2012 in South Africa, has stirred controversy among civil society advocates. Entitled “Africa Intellectual Property Forum: Intellectual Property, Regional Integration and Economic Growth in Africa”, the event is being organised by the United States government, and is being touted as the first Africa-wide ministerial-level event of its kind. The authors observe that the focus of the conference appears however to be stricter enforcement of IP rights, as most panels are concerned with enforcement and protection, and most speakers originate in developed country governments and industry. Non-governmental organisations who have worked on intellectual property rights have expressed disappointment, as they expected the conference would consider the 2007 World Intellectual Property Organisation Development Agenda, which consisted of 45 agreed recommendations intended to more fully incorporate the development dimension into WIPO activities, including technical assistance. They critique the agenda and an apparent underlying motive of encouraging strong IP legislation in those countries, at the expense of development and universal access to affordable medicines.
The World Health Organisation (WHO) Executive Board has agreed to propose to the May 2012 World Health Assembly the establishment of a mechanism for international collaboration on counterfeit and substandard medical products, but with the exclusion of trade and intellectual property issues. The Executive Board resolution would “establish a new Member State mechanism for international collaboration among Member States, from a public health perspective, excluding trade and intellectual property considerations, regarding substandard/spurious/falsely-labelled/falsified/counterfeit medical products”. The next Assembly in May will decide on this resolution. The mechanism would be reviewed by the World Health Assembly after three years, and countries will submit a progress report after one year. A contentious issue around counterfeits has been the suspicion on the part of some developing countries that concerns about counterfeit and substandard medicines are being purposely confused with trade in legitimate generic medicines from those countries. Removing intellectual property and trade from WHO discussions is intended to minimise the possibility of confusion.
Inter-African trade, which is high on the agenda at the upcoming African Union (AU) summit, will not remain the AU’s only priority in 2012. According to this report in Africa Review, the ambitious list of priorities consists of efforts to boost the continent’s global role, and plans to review the AU’s international partnerships in order to ensure they bring greater benefits to Africa. Peace and security continue to be a major concern, and AU intends to push its member states to strengthen democracy and good governance, an area closely linked to security concerns. The AU will take steps to establish food reserves and to secure access to markets and competitive prices for farmers. A free trade zone across the continent is envisaged to boost commerce between countries. At present, less than 15% of African trade stays on the continent - the rest is sold abroad.
This paper describes the contemporary contours of protest in South Africa, and the dominance of the Tripartite Alliance and its embrace of neoliberal policies. It discusses the development of a strategic impasse among South African social movements. The authors present and critique several theoretically informed alternative routes out of or around the apparent cul-de-sac. They pose the strategic questions for an agency-centred South African left.
The Deputy Chairperson of the African Union (AU) Commission, Erastus Jarnalese Onkundi Mwencha, says the structure of the economic partnership agreement between the continent and the European Union is not to Africa’s advantage, arguing instead for regional integration. He explained that regional integration will help develop larger markets, foster greater competition and improve the policy stance in many areas of the development agenda. Progress towards increased intra-African trade as a major objective of an economic integration agenda has been less than impressive, he added. The structures of African economies have been intended to produce raw materials for export. Mwencha argues that African countries need to add value to their raw materials and use the rest of the continent as a base for industrialisation and trade.
India has one of the best patent laws in the world that still gives some space to its producers to make generic drugs. But international health organisations such as UNAIDS, UNITAID and Medicins Sans Frontieres have raised serious concerns that recent trends may threaten India’s role as the chief supplier of affordable medicines to Africa and other developing countries. The old policy space has been eroded because many new drugs since 2005 have been patented by multinational companies which are selling them at exorbitant prices. Indian companies can no longer make their own generic versions of these new medicines unless they successfully apply to the government for compulsory licences, and that is quite cumbersome; or unless they obtain a licence from the patent-owning multinational, and that usually comes with stringent conditions, especially for export. Another worry is that India is negotiating a free trade agreement with the European Union. Such agreements usually contain provisions such as data exclusivity and extension of the patent term, which prevents or hinders generic production. Finally, six Indian companies have recently been bought up by large foreign firms. If this trend continues, the Indian drug market may be dominated by multinationals again. It is uncertain whether they will continue to supply the developing world with cheap generic medicines when this may be in conflict with their own branded products.
Least developed countries (LDCs) have used the 2016 transition period for TRIPS and have demonstrated the value of the flexibility provided by the extension. There remains opportunity to further enhance the benefits of this transition period through the end of the period in 2016. LDCs and other stakeholders, like civil society, can all play a role in maximising opportunities to improve access to HIV-related medicines in least developed countries during this period. By January 2016, the patenting situation of HIV-related medicines, particularly second and third-line treatments, as well as diagnostics, will be even more complex than it was in 2001 when the Doha Declaration was adopted. Therefore LDCs will continue to need maximum flexibility beyond January 2016 with respect to their TRIPS obligations in order to address their public health needs. There are clear parameters and rationale for granting LDCs further extension before full pharmaceutical patenting is required. The case for extension should be made clearly and in timely manner by LDCs with the support of other WTO Members and international organisations, such as UNAIDS. It is key that a coherent legal, political and practical case is presented, complying with TRIPS procedures, in order to ensure success.