The emergence of an increasingly global economy suggests that the ability of individual countries to shape their own destinies is becoming more difficult. International trends and pressures now influence national, and even local, health care policy making. Researchers from the University of the Witwatersrand, South Africa, together with Oxford University, looked at the effect of globalisation on health issues in South Africa and assessed its influence compared to national and local forces.
Health equity in economic and trade policies
What factors most affect health policy in South Africa?
Who should pay for debt cancellation?
Proposals by the US government to re-divert aid funding to pay for the debt cancellation for the world's poorest countries have been criticized by the Catholic Agency for Overseas Development (CAFOD). It is understood that the US Treasury Department is going to call for 100% debt cancellation for highly indebted poor countries. However the American proposal calls for the debt relief to be offset against new aid funding for the poverty-stricken countries. Henry Northover, Public Policy Analyst, CAFOD, said: "It's not so much a 100% debt cancellation as a 100% debt makeover. Debt cancellation for the worlds poorest must be paid for by the world's richest."
Evaluating economic change
In recent years there have been enormous changes in our technology, our economy, and our society. But has there been progress? asks economist Joseph Stiglitz. In the countries that have been less successful, globalization is often viewed with suspicion. "As I have argued elsewhere, there is a great deal of validity to the complaints of those who are discontent. In much of the world, there has been in recent years a slowing of growth, an increase in poverty, a degradation of the environment, and a deterioration of national cultures and of a sense of cultural identity."
Health in an Age of Globalization
Disease has travelled with goods and people since the earliest times. Armed globalization spread disease, to the extent of eliminating entire populations. The geography of disease shaped patterns of colonization and industrialization throughout the now poor world. Many see related threats to public health from current globalization. Multilateral and bilateral trade agreements do not always adequately represent the interests of poor countries, the General Agreement on Trade in Services may restrict the freedom of signatories to shape their own health delivery systems, and it remains unclear whether current arrangements for intellectual property rights are in the interests of citizens of poor countries with HIV/AIDS.
HIPC sunset clause - Haven't we been there before?
The World Bank and IMF have produced a paper entitled "Enhanced HIPC Initiative - Possible Options Regarding the Sunset Clause", dealing with the sunset clause of the Highly Indebted Poor Countries Initiative (HIPC). The paper provides a brief background to the sunset clause and discusses the implications of its expiry at the end of the year before going on to discuss four possible policy options and concluding remarks. Eurodad, the European Network on Debt and Development, comments that any extension would: "...embarrassingly for the WB and IMF, represent the fourth extension to the initiative. We argue that this demonstrates the severe technical shortcomings (and therefore credibility) of the initiative."
Pushing the boundaries: health and the next round of PRSPs
Wemos and Medact have prepared this report to fuel the discussion on how PRSPs can be used to improve the health of the poor. The report builds on the materials from seven country studies, prepared by NGOs to gain insight into the possible added value of PRSPs for health in their countries. Based on these and other sources, the report highlights a number of issues that in our view are crucial for achieving equitable health systems and which should receive much more attention in PRS processes than they do so far. These include the coordination of development aid and international health initiatives, the debt burden and other macroeconomic constraints to increased health spending, and policy initiatives to make health care markets more socially-inclusive in low-income countries.
World Development Report 2006
The average level of real income in the richest countries is 50 times that of the poorest. The richest tenth of the South African population enjoy levels of consumption per person almost 70 times those of the poorest tenth. Citizens of the world also experience profound differences in influence, access to legal systems, power and social status, whether at the level of individuals, between men and women, or between groups. Acute inequality in incomes, in health status, in educational outcomes and in other dimensions of welfare is a stark fact of life. The 2006 World Development Report will explore the relationship between equity and development strategy.
Doha round must be about development
In the last two months we have seen concerted attempts at reviving global trade talks which collapsed in Cancun, Mexico last year. This article from the SEATINI bulletin argues that the Doha round cannot be about anything other than development. At any rate, the Marrakesh Agreement which established the WTO speaks of a “need for positive efforts designed to ensure that developing countries and especially the least developed countries among them secure a share in growth in international trade commensurate with the needs of their economic development.” The outcome of any negotiations cannot be considered legitimate if they trash the concerns of the poor countries.
Further details: /newsletter/id/30544
U.N. Adviser Says Africa Should Refuse To Pay Debts
Jeffrey Sachs, special adviser to U.N. Secretary General Kofi Annan on anti-poverty targets, said Africa's heavy debt burden was untenable and urged the continent not to pay its debts if rich countries refused to cancel them. The U.S. economist, director of the Earth Institute at Columbia University, spoke at a conference in Addis Ababa, Ethiopia, on hunger on the eve of a summit of the heads of state of the African Union, which estimates sub-Saharan Africa's foreign debt at $201 billion.
Patents, access to medicines and the role of NGO's
One-third of the world’s population lacks access to the most basic essential drugs. For the destitute sick in the developing world, the price of medicines can determine whether they will be treated. Patents drive drug prices up, the resultant monopoly status allowing the producer to charge whatever price the market will bear. The World Trade OrganizationTrade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement, which provides 20 years’ patent protection for pharmaceuticals, also includes safeguards such as compulsory licensing, to ensure that countries can override patents whenever they are a barrier to access to medicines. Experience from South Africa, Thailand, Kenya and Guatemala shows the enormous pressures countries face in implementing theTRIPS Agreement in a manner that protects public health and underscores the vital role played by civil society in defending the right to access affordable medicines.