Health equity in economic and trade policies

Intellectual Property and Access to Science
South Centre: Research Paper 69, 2016

The boundaries between scientific and technological knowledge are nebulous in some technical fields, such as the biological sciences and their applications. This has led to the appropriation under patents of knowledge (such as on specific genes) of scientific nature, which may not only have negative effects for the further development of science and new technological contributions, but also encroach on the fundamental right of access to science. The South Centre argues in this paper that the patenting policies adopted by some universities and other research institutions may aggravate this problem. Court decisions in the USA and Australia and some national laws (e.g. Brazil) have limited the possibility of that appropriation, but this is still feasible in many jurisdictions. The authors argues that other measures – such as a well formulated research exception, the limitation of the patent claims’ scope, and legislation mandating open access to research results achieved with public funding – may mitigate the effects of the exclusivity granted by patent rights, but more fundamental policy changes may be necessary in order to preserve scientific outcomes in the public domain for free use and follow-on research.

China loans Africa much less than you think (and four other lessons from a new database)
Benabdallah L; Robertson W; Wang Y: African Arguments, June 2016

A detailed new database provides information on Chinese loans to African governments and state-owned enterprises (SOEs). Started in 2007 the database details a total of $86.9 billion of Chinese loans from 2000 to 2014, with the loans verified on the ground or with relevant stakeholders and cross-checked the data in multiple languages. This paper reports five initial lessons that emerge from the endeavour. Media perceptions of Africa-China relations tend to emphasise high sums of money going from China to Africa – such as reports that $1 trillion in Chinese financing destined for Africa by 2025 – but the reality appears far more modest. According to the database, China loaned $86.9 billion to African governments and SOEs from 2000 to 2014. Although the average value of Chinese loans to Africa from 2000-14 may be just $6.2 billion/year, this number has been growing in recent years. While China is sometimes portrayed as only being interested in Africa’s natural riches, the data paints a more complex picture. 28% of Chinese financing goes to transport; 20% to energy; and 8% communication. When China’s engagement in Africa is talked about in the international media, “aid”, “loans”, “investment”, and “development finance” are often mixed up or used interchangeably. That means that whenever China offers any money to an African country, it is typically interpreted as a combination of aid and development assistance. The database avoids these conceptual confusions by focusing on loans without trying to define these as either aid or not. It tracks both concessional and commercial lines of credit extended by government, policy, and commercial banks and their corresponding suppliers/contractors. The project shows that using clearly defined categories such as loans can be a much more meaningful and unambiguous approach to understanding the impacts of Chinese money in African countries than many previous methods.

Progress achieved in restricting the marketing of high-fat, sugary and salty food and beverage products to children
Kraak V; Vandevijvere S; Sacks G;Brinsden H; Hawkes C; Barquera S; Lobsteind T; Swinburn B: Bulletin of the World Health Organization 94(7), 540-548, 2016

In May 2010, 192 Member States endorsed Resolution WHA63.14 to restrict the marketing of food and non-alcoholic beverage products high in saturated fats, trans fatty acids, free sugars and/or salt to children and adolescents globally. The authors examined the actions taken between 2010 and early 2016 – by civil society groups, the World Health Organization (WHO) and its regional offices, other United Nations (UN) organisations, philanthropic institutions and transnational industries – to help decrease the prevalence of obesity and diet-related non-communicable diseases among young people. By providing relevant technical and policy guidance and tools to Member States, WHO and other UN organisations have helped protect young people from the marketing of branded food and beverage products that are high in fat, sugar and/or salt. The progress achieved by the other actors the authors investigated appears variable and generally less robust. The authors suggest that the progress being made towards the full implementation of Resolution WHA63.14 would be accelerated by further restrictions on the marketing of unhealthy food and beverage products and by investing in the promotion of nutrient-dense products. This should help young people meet government-recommended dietary targets. Any effective strategies and actions should align with the goal of WHO to reduce premature mortality from non-communicable diseases by 25% by 2025 and the aim of the UN to ensure healthy lives for all by 2030.

The retreat of neoliberalism
Gumede W: Pambazuka News, 21 July 2016

An internal IMF report admitting the destructive nature of neoliberalism may have come too late for many African countries. The neoliberal structural adjustment programs have led to economic hardships, political instability and conflicts in most African countries where they have been implemented. The report makes three devastating conclusions: One, that the neoliberal reform program has not delivered increased economic growth. Secondly, neoliberal reforms have increased inequality. And thirdly, the increased inequality caused by neoliberal reforms has in turn undermined the level and sustainability of economic growth. The report states that the removal of barriers to capital flows, or financial openness, has often resulted in short-term speculative, so-called “hot” inflows, in developing countries. However, such speculative capital inflows to African countries are often quickly withdrawn by industrial country investors as they seek better returns elsewhere, destabilising African economies which were initial recipients of such “hot” inflows. Such speculative inflows neither boost growth nor allow the African country to share the costs of such destabilisation with the industrial countries from which speculators originate. The authors conclude that there was an increased “acceptance of controls to limit short-term debt flows that are viewed as likely to lead to – or compound – a financial crisis”. They argue that while exchange rates and financial policies could help to alleviate risks of increased financial instability, “capital controls are a viable, and sometimes the only, option when the source of an unsustainable credit boom is direct borrowing from abroad”. The report says that although high public debt is detrimental to growth and welfare, it would be better for African and developing countries to pay off their public debt over a longer time, rather than cut current productive spending needs. To lower public debt, proponents of neoliberal reforms have proposed that taxes should be raised or public spending cut, or both. If African countries do not come up with quality policies, or if they have them, but the policies are captured by corrupt elements, or half-heartedly implemented, or not implemented at all, they won’t be able to take advantage of the seeming retreat of the four-decade long globally dominant “neoliberalism”.

‘Neoliberal Epidemics’ in Global Context
Schrecker T; Bambra C: Policies for Equitable Access to Health, 2016

Conditionalities attached to loans from the World Bank and IMF were among the key negative influences on health and its social determinants between 1980 and 2000 in many of the more than 75 low- and middle-income countries in which they were applied. Best available evidence suggests that this 'neoliberal epidemics' era is not over. In the future, neoliberalism is likely to reflect the erosion of territorial divisions between core and periphery, or the global North and the global South, in the world economy. The authors write that the success of efforts to fight neoliberal epidemics and reduce health inequalities will depend on blurring boundaries: between the global and local frames of reference, and between public health practice and the politics of health. This last blurring means a return to the wisdom of Rudolf Virchow, to the effect that ‘medicine is a social science, and politics is nothing else but medicine on a large scale’. As Martin McKee and colleagues wrote in a 2012 commentary on the failure of austerity policies, ‘Virchow’s words are as relevant today as they ever were’. Understanding how to translate that insight into political action will require the development of a comparative political science of health inequalities – a critically important project that remains in its infancy.

African Economic Outlook 2016
African Development Bank (AfDB); Organisation for Economic Co-operation and Development; UN Development Programme (UNDP): 2016

How Africa urbanises will be critical to the continent’s future growth and development, according to the African Economic Outlook 2016. Africa’s economic performance held firm in 2015 amid global headwinds and regional shocks. The continent remained the second fastest growing economic region after East Asia. In 2015, net financial flows to Africa were estimated at USD 208 billion, 1.8% lower than in 2014 due to a contraction in investment, while official development assistance increased by 4%; and remittances remain the most stable and important single source of external finance at USD 64 billion in 2015. According to the authors, if harnessed by adequate policies, urbanisation can help advance economic development through higher agricultural productivity, industrialisation, services stimulated by the growth of the middle class, and foreign direct investment in urban corridors. It also can promote social development through safer and inclusive urban housing and robust social safety nets. Finally, it can further sound environmental management by addressing the effects of climate change as well as the scarcity of water and other natural resources, controlling air pollution, developing clean cost-efficient public transportation systems, improving waste collection, and increasing access to energy. Seizing this urbanisation dividend requires bold policy reforms and planning efforts, however, such as by strengthening local governance, tailoring national urban strategies to specific contexts and diverse urban realities and harnessing innovative financing instruments.

Poverty amidst plenty: How Africans are robbed of benefits of mineral wealth
Obeng K: Pambuzuka News, June 2016

The author argues that Africa has not benefited substantially from its mineral wealth and that it is essential for resource-rich African countries to tailor their economic policies to harness and utilise mineral revenues to improve the productivity of non-mineral sectors to break out of the extractive enclave. The article observes that the remarkable extractives-driven economic growth of the last decade across Africa failed to trickle down. It was jobless, benefited foreign corporates and the local elite, and it widened the gap between the rich and the poor. If Africa is to avoid the failures of the previous decades and successfully transition from its present state to that foreseen by Agenda 2030 then the author proposes that it must better harness the potential benefits of its vast mineral wealth. African countries must institute fiscal reforms that will ensure that they are better positioned to derive maximum benefit from the next commodity price super cycle; they must plug loopholes that continue to facilitate the bleeding of much needed development revenues via illicit flows; countries must align all relevant local frameworks to the African Mining Vision, thereby putting the needs of citizens at the centre of their natural resource management agenda; and Africa must unite in a broad and strong push for long overdue global tax reforms.

THE CAADP Results Framework (2015 - 2025)
African Union: New Partnership for Africa's Development, Adis Ababa, 2016

The Comprehensive Africa Agricultural Development Programme (CAADP) Results Framework is an essential component in facilitating CAADP implementation. The AU Malabo Declaration in June 2014 sent the goals for African countries, including a 10% public spending target for agriculture, a commitment to zero hunger by 2025, reducing stunting to 10%, halving poverty, by 2025, and providing preferential and participation for women and youth in gainful and attractive agribusiness This document presents the critical actions required to achieve agricultural development agenda targets. The indicators are accompanied by baseline data and targets that can be achieved within the next 10 years. The framework provides standardised tools which can be used by CAADP stakeholders at country, REC (Regional Economic Community) and continental level to measure agricultural performance and progress. It intends to be used in improving planning processes and strengthening existing monitoring and evaluation systems to achieve CAADP targets within the next 10 years.

Africa's Blue Economy: A policy handbook
United Nations Economic Commission for Africa, March 2016

Africa’s 'Blue world' is made of vast lakes and rivers and an extensive ocean resource base. The Blue Economy can play a major role in Africa’s structural transformation, sustainable economic progress, and social development. The largest sectors of the current African aquatic and ocean based economy are fisheries, aquaculture, tourism, transport, ports, coastal mining, and energy. This Policy Handbook, offers a step by step guide to help African member States to better mainstream the Blue Economy into their national development plans, strategies, policies and laws. The Blue Economy approach is premised in the sustainable use, management and conservation of aquatic and marine ecosystems and associated resources.

Gender Equality and Equity in Health Will Anchor Drive Towards a Sustainable National Development
Chatterjee S; Kariuki S: Inter Press Service, April 2016

The Government of Kenya (GoK) in partnership with United Nations Population Fund (UNFPA) at the sidelines of the 60th Session of the UN Commission of Women in New York launched the report on the ‘Assessment of the UNFPA Campaign to End Preventable Maternal and New-born Mortality in support of the Campaign for Accelerated Reduction of Maternal Mortality in Africa’ The report captures the important strides the country has made to significantly address disparities in advancing maternal and new-born health at all levels, as part GoK's commitment to address inequalities, as a key principle of Agenda 2030, to ensure that no one is left behind. This video records the event.

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