Health equity in economic and trade policies

Neo-colonial economies and ecologies, smallholder farmers and multiple shocks: The case of cyclones Idai and Kenneth in Mozambique and Zimbabwe
African Centre for Biodiversity (ACB)L ACB, South Africa, 2020

The African Centre for Biodiversity (ACB) exposes how the two cyclones that battered Mozambique and parts of Malawi and Zimbabwe in March and April 2019 must be understood against the backdrop of the political and economic drivers of ecological degradation. These include development loans and aid, rapacious natural resource extraction and social and cultural displacement. The authors examine the interconnections between climate change, deforestation, agricultural expansion and resource extractivism, as drivers of social and political instability and food insecurity in these countries, while enriching a small political elite. The paper unpacks how the national and international disaster response to the cyclones inadequately addressed the scale of the overlapping crises that the cyclones revealed, calling for approaches that go beyond narrow disaster management to one based on equity and justice in local economies and in relationships with the global economy.

We need to rethink the whole international economic system in terms of rights for poor countries
Piketty T: Le Monde, 2021

By refusing to lift the patents on vaccines against Covid-19, the author argues that western high income countries have shown an inability to take into account the needs of the South. Beyond the right to produce, the commentary proposes that the debate on the reform of international taxation cannot be reduced to a discussion between rich countries aimed at sharing the profits currently located in tax havens. Plans being discussed at the Organisation for Economic Cooperation and Development envisage that multinationals will make a single declaration of their profits at the global level, in itself is an excellent thing. But when it comes to allocating this tax base between countries, the plan is to use a mixture of criteria (wage bills and sales in different territories) which in practice will result in rich countries receiving more than 95% of the reallocated profits, leaving negligible funds for poor countries. The author suggests that low income countries need to be at the table in such discussions.

Global Wage Report 2020-21: Wages and minimum wages in the time of COVID-19
International Labour Organisation, Geneva, ILO, 2020

This ILO report examines the evolution of real wages globally and by region, as well as the relationship between minimum wages and inequality, and the wage impacts of COVID-19 . It identifies the conditions under which minimum wages can reduce inequality and how adequate minimum wages, statutory or negotiated, can play a key role in a human-centred recovery from the pandemic.

WTO COVID-19 TRIPS waiver proposal: Myths, realities and an opportunity for governments to protect access to lifesaving medical tools in a pandemic
Medecins Sans Frontieres: Access Campaign, 2021

One of the challenges faced in the COVID-19 pandemic is the negative impact that intellectual property (IP) barriers have had in the past and are anticipated to have on the scale up of manufacturing and supply of lifesaving COVID-19 medical tools across the world. Because the pandemic is an exceptional global crisis, the World Trade Organization (WTO) can invoke a waiver of certain IP rights on these technologies under WTO rules. Given this, South Africa and India submitted a landmark proposal earlier this year to the WTO requesting that WTO members waive four categories of IP rights – copyright, industrial designs, patents and undisclosed information under the Agreement of Trade-Related Intellectual Property Rights (TRIPS) until the majority of the world population receives effective vaccines and develops immunity to COVID-19. In the course of discussion, opponents of the TRIPS waiver proposal have raised arguments against the waiver. This brief presents the reasons for the waiver, and addresses the counter arguments to the points raised by those opposing it.

Developed countries continue to block TRIPS waiver proposal
TWN: Info Service on WTO and Trade Issues (Nov20/24), November 2020

Following the waiver proposal to suspend various provisions of the WTO’s TRIPS Agreement in combating the COVID-19 pandemic, the United States, the European Union, Japan, and Switzerland among others are reported to have adopted “stonewalling” tactics to block progress towards a General Council decision on this issue. These countries have described the waiver as a departure from the past WTO agreements, lacking specific measures, arguing also that not protecting intellectual property (IP) will reduce investment in medical technology. In response South Africa commented that current “bilateral deals do not demonstrate global collaboration but rather reinforce nationalism, enlarging chasms of inequality.” India said that while “the TRIPS flexibilities do allow limited policy space for public health, they were never designed to address a health crisis of this magnitude (such as the COVID-19 pandemic).” The waiver proposal has come into a global stage where it is increasingly clear that the developing and least-developed countries are unlikely to get easy and affordable access for the new therapeutics and vaccines for COVID-19, calling for human lives to take precedence over the profits of the big pharmaceutical companies.

Feral Atlas: The More-Than-Human Anthropocene
Tsing A; Deger J; Saxena A; Zhou F: Stanford University, doi: 10.21627/2020fa, 2020

Feral Atlas invites you to explore the ecological worlds created when nonhuman entities become tangled up with human infrastructure projects. Seventy-nine field reports from scientists, humanists, and artists show you how to recognize “feral” ecologies, that is, ecologies that have been encouraged by human-built infrastructures, but which have developed and spread beyond human control. These infrastructural effects, Feral Atlas argues, are the Anthropocene. Playful, political, and insistently attuned to more-than-human histories, Feral Atlas does more than catalogue sites of imperial and industrial ruin. Stretching conventional notions of maps and mapping, it draws on the relational potential of the digital to offer new ways of analysing—and apprehending—the Anthropocene; while acknowledging danger, it demonstrates how in situ observation and transdisciplinary collaboration can cultivate vital forms of recognition and response to the urgent environmental challenges of our times.

Letter supporting proposal by India and South Africa on waiver from certain provisions of the TRIPS agreement for the prevention, containment and treatment of COVID-19
Civil society signatories: 2020

This open letter calls on WTO Members to strongly support the adoption of the text proposed by India and South Africa in their proposal for “Waiver from certain provisions of the TRIPS Agreement for the prevention, containment and treatment of COVID19” (Waiver Proposal), recognising the consensus that curbing the spread of COVID-19 demands international collaboration to speed and scale up development, manufacturing, and supply of effective medical technologies, with calls including from several Heads of State for medical products for COVID-19 to be treated as global public goods. Seven months into the pandemic, there is no meaningful global policy solution to ensure access, inequality in access to critical technologies, rejection by the pharmaceutical industry of the COVID-19 Technology Access Pool (C-TAP) launched by WHO to voluntarily share knowledge, IP and data, has been rejected by the pharmaceutical industry and intellectual property infringement disputes. While the TRIPS Agreement contains flexibilities that can promote access, many WTO Members may face challenges in using them promptly and effectively. The signatories argue that unless concrete steps are taken at the global level to address intellectual property and technology barriers, the above mentioned failures and shortcomings will replay as new medicines, vaccines and other medical products are rolled out.

Over 80 per cent of IMF Covid-19 loans will push austerity on poor countries
Oxfam: Oxfam UK, United Kingdom, 2020

Over 80% of the International Monetary Fund’s (IMF) Covid-19 loans recommend that poor countries hit hard by the economic fallout from the COVID-19 pandemic adopt tough new austerity measures in the aftermath of the health crisis. Since the pandemic was declared in March, 76 out of 91 IMF loans – 84% – negotiated with 81 countries push for belt-tightening that could result in deep cuts to public healthcare systems and social protection. Government failure to tackle inequality ―through support for public services, workers’ rights and a fair tax system― left them woefully ill-equipped to tackle the Covid-19 pandemic. The authors argue that the IMF has contributed to these failures by consistently pushing a policy agenda that seeks to balance national budgets through cuts to public services, increases in taxes paid by the poorest, and moves to undermine labour rights and protections. As a result, when Covid-19 hit, only one in three countries, covering less than a third of the global workforce, had safety nets for workers to fall back on if they lost their job or became sick. The analysis also found that just 8 out of 71 World Bank health emergency response projects approved between April and end of June this year aim to eliminate healthcare fees, which are prohibitive in at least 56 of these countries.

Recovering Better from COVID-19 Will Need a Rethink of Multilateralism
Kozul-Wright R: Development (2020) 1-5, doi:, 2020

The world economy is experiencing a deep recession amid a still unchecked pandemic. The author argues that the commitment to recovering better will not materialize if, as happened after the global financial crisis, high income countries resort to a policy mix of austerity, liberalization and quantitative easing. Such an approach will only worsen a whole set of pre-existing conditions and in particular, high inequality, excessive debt (both public and private and weak investment—that will lead to a lost decade, particularly for low income countries. What is proposed to be needed instead is an expansionary plan for global recovery, that can return even the most vulnerable countries to a stronger position than before the crisis. This paper sets out some of the key elements of such a plan and argues that its implementation will require systematic reforms to the multilateral trade and financial system if a more resilient recovery is to turn into a sustainable and inclusive future.

Thandika Mkandawire: A ‘young’ African economist’s appreciation
Chelwa G: Journal of African Studies, doi: 10.1080/00020184.2020.1836913, 2020

At the invitation of African Studies, Grieve Chelwa reflects on Thandika Mkwandawire’s life and work and impact on the social and economic sciences in Africa. Mkwandawire’s career spanned over four decades with a long and diverse list of publications. Chelwa refers to five specific publications that have helped to make sense of Africa’s place and the place of African economists in the seemingly never-ending debates about the continent’s prospects for economic development. Chelwa calls these his favourite things, ‘because Thandika was African development scholarship’s saxophonist.’