By any reasonable definition, the majority of humanity is on the rack of poverty; and a major obstacle to its eradication is the growing threat of extreme and irreversible climate change. The coexistence of a chronic crisis of serious under-consumption for most with an increasingly critical environmental crisis resulting from over-consumption in aggregate can only be explained by extreme inequality in the global distribution of income. Resolving both simultaneously, as envisaged in the Post-2015 Agenda, requires a fundamental reconsideration of the nature and objectives of economic policy, and of the global economic system. The lecture discusses the extent and implications of global inequality, before building on a number of working hypotheses to outline an alternative model of economic development more conducive to the achievement of these two most fundamental global goals.
Health equity in economic and trade policies
This work is a review of public sources including white papers, news and peer-reviewed literature with a focus on mainstream approaches used by the pharmaceutical industry (such as unaffordable price premiums for innovative medicines) and governments (such as denial of intellectual property rights) to support their interests. The authors also explore the implications of possible approaches on pharmaceutical policy in the context of global health diplomacy. The latter is a requirement for universal health coverage given the increasing power of state and non-state actors in emerging markets. The authors conclude that evidence and due processes, through inclusive and transparent priority-setting mechanisms, offer a reconciliatory way forward for both parties. Value-based pricing, underpinned by Health Technology Assessment (HTA), could leverage global health diplomacy to set priorities and resolve the perhaps unsustainable status quo. HTA is itself a diplomatic, consensus building and evidence-based approach that can help diffuse the current tension, enhance mutual understanding and perhaps help strengthen (or even mend) the current model of product development. Value-based pricing and HTA offer a potential priority setting mechanism that can serve as a transparent, non-adversarial platform for governments and the pharmaceutical industry to engage with each other and work towards enhancing access to medicines. Further quantitative research, exploring the impact of different policy-setting approaches by governments on medicine access using HTA, would strengthen this discourse.
Genetic Engineering of crops means that recombination DNA technology is used to insert, delete, transpose and substitute new genes in plants. The author notes that new gene products may serve as allergens capable of inducing illness in consumers. Antibiotic resistance genes are reported to be used to enable the selection of bacteria harbouring the desired gene, a technique which is thought to contribute to increasing resistance of bacteria to well established antibiotics such as penicillin, ampicillin, tetracycline and numerous others. The effect of the viral vector used in gene transfers on the environment, crops and individual consumers is not known. The author calls for an active regulatory guide by the United Nation Organization to safeguard the human population, the environment and life in general.
The Geneva-based South Centre has encouraged India and other developing countries "to continue to make full use of the TRIPS flexibilities for public health and other public policy objectives," consistent with their rights and obligations under the World Trade Organisation (WTO) rules.
In a statement released here, the intergovernmental organisation of developing countries called on WTO Members to respect the legitimacy of the use of TRIPS flexibilities for public health in light of new threats of unilateral trade measures by the United States against India over its intellectual property (IP) laws and regulations. The South Centre statement cautioned that continued pressures by the United States on India and other developing countries "to adopt an IPRs [Intellectual Property Rights] regime that would go beyond the minimum standards in the TRIPS [Trade-Related Aspects of Intellectual Property Rights] Agreement and that does not make use of the flexibilities that are part of TRIPS would have adverse social and developmental effects, including on the public's access to medicines."
The world’s richest nations have admitted that global inequality is appalling. But, the author asks, are they prepared to radically tackle the capitalist system that harbours 'rich tax thieves and appropriators of labour', who increase their wealth with political favours? A system that safeguards the interests of the minority at the expense of the majority poor? The World Economic Forum (January 2014) said that the growing rich-poor income gap is the biggest risk the world is facing for the next decade. The author raises that inequality, the world system’s ‘gift’ to humanity, is not only a process active in poor countries. It is also a regular and integral part of advanced, matured capitalist economies. He cites the message of Pope Francis on the World Day of Peace pointing to the ‘new tyranny’ of ‘unfettered capitalism’ and calling for action ‘beyond a simple welfare mentality’saying: ‘I beg the Lord to grant us more politicians who are genuinely disturbed by the state of society, the people, the lives of the poor'. The author however calls for the pressure for change to come from the people, cautioning that the class interests of elites make a vow to fight inequality a day dream.
This paper by researchers at the International Monetary Fund appears to debunk a tenet of conservative economic ideology — that taxing the rich to give to the poor is bad for the economy. It incorporates recently compiled figures comparing pre- and post-tax data from a large number of countries. The authors say there is convincing evidence that lower net inequality is good economics, boosting growth and leading to longer-lasting periods of expansion. The study concludes that redistributing wealth, largely through taxation, does not significantly impact growth unless the intervention is extreme.
Due to a number of bottlenecks, the generic pharmaceutical manufacturers in the East African Community region produce at a cost disadvantage compared to their large-scale Asian counterparts. This article highlights some of the key areas where civil society has engaged and can still engage with local pharmaceutical industries to address these challenges. While the local manufacturing sector can play an important role in increasing access to and promoting the affordability of medicines in the region, a lot of support is needed for them to not only increase their production capacity but also to make a greater contribution to health care in the EAC region. the author argues that health civil society now needs to get into wider campaigns for the development of regulatory guidelines stating requirements for manufacturers of generic medicines to develop local capacity and undertake increased technology transfer into the region while at the same time lobbying EAC partner states to create subsidies and concessions that can boost the local pharmaceutical manufacturers’ capacity to adequately provide the much needed legitimate, affordable and quality medicines.
This Oxfam report timed for the World Economic Forum (WEF) in Davos raised that unless bold political solutions are instituted to curb the influence of wealth on politics, governments will work for the interests of the rich, while economic and political inequalities continue to rise. In the report Oxfam called for those in the WEF to not dodge taxes in their own countries or in countries where they invest and operate, by using tax havens; not use their economic wealth to seek political favours that undermine the democratic will of their fellow citizens; to make public all the investments in companies and trusts for which they are the ultimate beneficial owners; to support progressive taxation on wealth and income; to challenge governments to use their tax revenue to provide universal healthcare, education and social protection for citizens; and to apply a living wage in all the companies they own or control.
The South African (SA) government has implemented comprehensive tobacco control measures in line with the requirements of the Framework Convention on Tobacco Control. The effect of these measures on smoking prevalence and smoking-related attitudes, particularly among young people, is largely unknown. This paper describes the impact of a comprehensive health promotion approach to tobacco control amongst SA school learners with evidence from four successive cross-sectional Global Youth Tobacco Surveys (GYTSs) in 1999, 2002, 2008 and 2011 among nationally representative samples of SA grades 8 - 10 school learners. Smoking-related attitudes and behaviours showed favourable changes over the survey period. The surveys demonstrated that the comprehensive and inter-sectorial tobacco control health promotion strategies implemented in SA have led to a gradual reduction in cigarette use amongst school learners. Of concern, however, are the smaller reductions in smoking prevalence amongst girls and black learners and an increase in smoking prevalence from 2008 to 2011. Additional efforts, especially for girls, are needed to ensure continued reduction in smoking prevalence amongst SA youth.
Alcohol was the cause of nearly five million deaths globally in 2010, an increase of over one million deaths recorded ten years earlier. It was the leading risk factor for disease in southern sub-Saharan Africa (SSA). Several factors account for the increasing harm associated with alcohol in Africa among which are the availability of a wide variety of alcoholic beverages, rising urban populations, more disposable income to purchase alcohol, and unrestrained marketing and promotion of alcohol. Using a variety of strategies, producers of alcohol target young people and women with aspirational messages and other exhortations in an onslaught of marketing and promotion. The author argues that missing in the discussion on alcohol in most African countries is the understanding that alcohol marketing is not an ordinary economic activity and that the business of alcohol (an addictive substance with high potential for harm) can subvert individual rights and democratic principles. This paper discusses these issues with particular attention to the harms caused by alcohol (to drinkers and non-drinkers alike), the potential for far-reaching harms to individuals and the society at large if the present scenario continues, and how these harms can be averted or minimized with the implementation of evidence-based policies.