Health equity in economic and trade policies

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.

Slow motion robbery: The WTO and developing countries

Developing countries are being shackled by regulations formulated and enforced by international organisations. Policies to nurture domestic industry, which were used in Europe, north America and more recently the successful East Asian 'tiger' economies, are becoming illegal. The three major agreements which emerged from the World Trade Organisation (WTO) Uruguay Round of international trade talks - on investment measures (TRIMS), trade in services (GATS) and intellectual property rights (TRIPS) - are narrowing the powers of states. Governments now find it difficult to combine profit-oriented actions of companies within their borders with complementing national development strategies.

The WTO Global Agreement on Trade in Services (GATS) and Health Equity in Southern Africa

PART I of this paper provides a brief introduction of the link between trade and development as related to health in general. The history of the World Trade Organisation (WTO) is also briefly introduced as it relates to the General Agreement of Trade in Services (GATS). Then a brief outline of the contents of GATS is given focusing on those areas relevant to public health generally, to health services and to their financing. PART II presents opportunities and threats posed by GATS for public health and health equity goals and policies in southern Africa, in terms of both general obligations and specific commitments across all modes of supply.

** Globalisation, Trade and Health
Abstract of paper presented at the Equinet conference, Durban, 8-9 June 2004, by R Tayob SEATINI, EQUINET theme co-ordinator

This paper posits that the International Trading System (ITS) is biased in favour of richer northern states. It argues that greater circumspection is required by developing countries within the ITS if they want to maintain their sovereign right to meet the needs of their people. The inequitable system of “globalisation” is imposed through the ideology of neo-liberalism, which the developed countries present as a “natural” form of globalisation. It is a very particular type of globalisation that is being imposed on the world by the major economic powers, i.e. neo- liberal globalisation. This form of globalisation has worsened material conditions in developing countries.

Further details: /newsletter/id/30457
How Do Patents And Economic Policies Affect Access To Essential Medicines

This paper studies the relationship between patents and access to essential medicines. It finds that in sixty-five low- and middle-income countries, where four billion people live, patenting is rare for 319 products on the World Health Organisation’s Model List of Essential Medicines. Only seventeen essential medicines are patentable, although usually not actually patented, so that overall patent incidence is low (1.4 percent) and concentrated in larger markets. This and other results shed light on the policy dialogue among public health activists, the pharmaceutical industry, and governments that is often based on mistaken premises about how patents affect corporate revenues or the health of the world’s poorest.

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