This paper states that heavily indebted and poor countries (HIPCs) have started accumulating external debt reaching extreme ratios of debt to GDP and exports. These HIPCs are facing a food crisis and a decline in exports and GDP exposing them to shock and leading them to more debt. The author asserts that HIPCs lack appropriate tools to deal with multiple external shocks and will be affected in the long run by the likely reduction in social spending. This will affect the Millennium Development Goals affecting indices like infant mortality thus lowering the economic growth rates. The paper uses available data to make projections and comparisons and highlight the bleak picture. The paper advises that the donors should provide financing for the most vulnerable countries to preserve their gains and prevent a humanitarian crisis. The rich world and the International Financial Institutions (IFIs) should reshape their policy agenda, focusing much more attention and providing more resources and assistance to low-income countries. The call for a temporary debt moratorium on all official debt of low-income countries by the IFIs is commendable but far from adequate.
Health equity in economic and trade policies
This book explores the history of and current collision between two of the major global phenomena that have characterized the last 30 years: the spread of HIV and AIDS and other diseases of poverty and the ascendancy of neoliberal economic ideas. The book explains not only how International Monetary Fund policies of restrictive spending have exacerbated public health problems in developing countries, in particular the HIV and AIDS crisis, but also how such issues cannot be resolved under these economic policies. It also suggests how mounting global frustration about this inability to adequately address HIV and AIDS will ultimately lead to challenges to the dominant neoliberal ideas, as other more effective economic ideas for increasing public spending are sought. In stark, powerful terms, Rowden offers a unique and in-depth critique of development economics, the political economy dynamics of global foreign aid and health institutions, and how these seemingly abstract factors play out in the real world - from the highest levels of global institutions to African finance and health ministries to rural health outposts in the countryside of developing nations, and back again.
Migration to and from mines contributes to HIV risks and associated tuberculosis (TB) incidence. Health and safety conditions within mines also promote the risk of silicosis (a TB risk factor) and transmission of tuberculosis bacilli in close quarters. In the context of migration, current TB prevention and treatment strategies often fail to provide sufficient continuity of care to ensure appropriate TB detection and treatment. Reports from Lesotho and South Africa suggest that miners pose transmission risks to other household or community members as they travel home undetected or inadequately treated, particularly with drug-resistant forms of TB. Reducing risky exposures on the mines, enhancing the continuity of primary care services, and improving the enforcement of occupational health codes may mitigate the harmful association between mining activities and TB incidence among affected communities. A number of immediately available measures to improve continuity of care for miners, change recruitment and compensation practices, and reduce the primary risk of infection may help reduce South Africa’s TB burden.
Uganda is considering an anti-counterfeit bill which analysts say will impair the country’s ability to import and export cheap but effective generic medicines. Activists fear that the bill, once enacted, will deny Ugandans access to safe, effective, quality and affordable generic medication, which currently forms the bulk of Uganda’s medicine imports. Edgar Tabaro, a Ugandan lawyer specialising in trade-related matters, questions the necessity of the bill, saying that whatever it ostensibly seeks to address is covered by different laws like the Trademarks Act, Copyright Act, the Patents Act and the Trade Secrets Act. Rosette Mutambi, executive director of the Coalition for Health Promotion and Social Development (HEPS-Uganda), regards the bill as a threat to the lives of many Ugandans who largely depend on generic anti-retroviral drugs and other medicine. She said only about 10% of the medicines used in Uganda are locally manufactured. And only about 5 to 7% of the imported medicines are original brands, meaning that about 93% of imported drugs are generics, mostly imported from India.
African and Pacific countries continue to negotiate the challenging Economic Partnership Agreements (EPAs) with the European Union. These new agreements have the potential to help African countries accelerate their economic growth and develop more resilient economies. However, the presence of negotiating deadlocks or a sense of fatigue as well as the lack of real appetite for these agreements among many African, Caribbean, and Pacific (ACP) negotiators, raise legitimate questions regarding their structure and content, as well as their ability to constitute instruments to leverage economic growth.
This report examines the range of contingency measures available in trade agreements and the role that these measures play. These measures allow governments a certain degree of flexibility within their trade commitments and can be used to address circumstances that could not have been foreseen when a trade commitment was made. The tension between credible commitments and flexibility is often close to the surface during trade negotiations. One of the main objectives of this report is to analyse whether the World Trade Organization (WTO) provisions provide a balance between supplying governments with necessary flexibility to face difficult economic situations and adequately defining them in a way that limits their use for protectionist purposes. The report also discusses alternative policy options, including the renegotiation of tariff commitments, the use of export taxes, and increases in tariffs up to their legal maximum ceiling or binding.
Critics of 'me-too' innovation often argue that follow-on drugs offer little incremental clinical value over existing pioneer products, while at the same time increasing health care costs. This study examines whether consumers view follow-on and pioneer drugs as close substitutes or distinct clinical therapies. For five major classes of drugs, it found that large reductions in the price of pioneer molecules after patent expiration – which would typically lead to decreased consumption of strong substitutes – have no effect on the trend in demand for follow-on drugs. The findings are likely unaffected by health insurance, competitive pricing of me-toos, marketing, and switching costs.
Anti-counterfeiting initiatives might have a negative impact on access to medicines while not addressing the problem of fake medicines, particularly in developing countries, says a panel, which met on 25 September at the World Intellectual Property Organization General Assemblies. Confusion between legitimate generic medicines, poor quality medicines and those illegally copying the trademark of a brand-name product could have a devastating impact, and a precise definition and scope of counterfeiting is needed, they said. IP enforcement measures should only be used against drugs with trademark violations. Counterfeit medicines are products that are packaged to intentionally look like a legitimate product but are not. This is a trademark infringement. On the other hand, substandard medicine is a legitimately produced medicine that does not meet the standards set by the relevant drug regulatory authority. This is an issue of quality control. ‘When we speak about anti-counterfeiting initiatives, we are basically referring to the global IP enforcement agenda,’ Sangeeta Shashikant, senior legal advisor at the Third World Network, said at the meeting.
From the 1960s to the present, many African integration groupings have emerged and faded away. Within the various integration groupings, the development of trade has been a major objective pursued through programmes aimed at achieving a free trade area, a customs union and a common market. But outcomes of decades of experimentation with integration in Africa have on balance remained modest. For instance, African trade statistics continue to paint a generally modest picture of trade between regional economic communities (RECs), as well as intra- African trade. The countries generally lack a strong industrial capacity to produce diversified manufactured goods for trade within regional markets. Many of the multiple national currencies in Africa lack convertibility and efforts towards monetary, financial and physical integration have not been very promising. The cost of doing business in the continent is generally high, due in part to infrastructure gaps, duplicative border procedures and cumbersome paper requirements. Paperless trade still remains a distant objective. The free movement of people and the right of establishment have progressed in some RECs, but remain a paper objective in many other African subregions.
At the end of the World Intellectual Property Organization (WIPO) General Assemblies, held from 25–30 September 2009, frustration at the lack of consensus was palpable, especially among developing countries calling for a legally-binding international instrument. ‘We believe our countries are being treated unfairly,’ said a delegate from Burundi during the plenary session, in reference to the fact that there is as yet no international instrument to protect traditional knowledge and genetic resources. ‘The [WIPO] Secretariat is an arbiter and should intervene,’ he added. But others questioned the legally binding instrument as an outcome. Korea suggested in plenary that ‘perhaps we can prevent misappropriation without proprietisation,” and suggested looking at options to protect traditional knowledge and genetic resources within the existing system, and several developed countries said a renewed mandate should not commit to a specific outcome. Botswana and Zimbabwe mentioned efforts through the African Regional Intellectual Property Office (ARIPO) to create a regional instrument, while Ecuador spoke of creating a national biodiversity and traditional knowledge database that would include sui generis protection measures.