The emergence of an increasingly global economy suggests that the ability of individual countries to shape their own destinies is becoming more difficult. International trends and pressures now influence national, and even local, health care policy making. Researchers from the University of the Witwatersrand, South Africa, together with Oxford University, looked at the effect of globalisation on health issues in South Africa and assessed its influence compared to national and local forces. Political and economic developments in the international arena will inevitably influence health issues in South Africa. Institutions such as the WHO and the World Bank, together with international events such as the spread of AIDS, affect health care in the country. However local forces also play a large part in shaping the future of the South African health service.
Health equity in economic and trade policies
"February 26, 2005 has been named a day of international protest against the actions of the Government of India. People around the world are calling to question the humaneness of a patent modification that permits the private sector to profit from public health. The Indian Patent Ordinance prescribes “TRIPS-PLUS” standards, which takes the country beyond the commitments agreed to under the TRIPS agreement. The Patent act has fostered the pharmaceutical industry in India, provided affordable medication to millions within India and the rest of the developing world. As of December 26, 2005, by Presidential Ordinance, the patent Act has been modified; we now face Product Patent protection for pharmaceuticals and agrochemicals in India."
The emergence of an increasingly global economy suggests that the ability of individual countries to shape their own destinies is becoming more difficult. International trends and pressures now influence national, and even local, health care policy making. Researchers from the University of the Witwatersrand, South Africa, together with Oxford University, looked at the effect of globalisation on health issues in South Africa and assessed its influence compared to national and local forces. Political and economic developments in the international arena will inevitably influence health issues in South Africa. Institutions such as the WHO and the World Bank, together with international events such as the spread of AIDS, affect health care in the country. However local forces also play a large part in shaping the future of the South African health service.
Since the 1980s, neoliberal policies have prescribed reducing the role of governments, relying on market forces to organize and provide health care and other vital human services. In this context, international trade agreements increasingly serve as mechanisms to enforce the privatization, deregulation, and decentralization of health care and other services, with important implications for democracy as well as for health. Critics contend that social austerity and "free" trade agreements contribute to the rise in global poverty and economic inequality and instability, and therefore to increased preventable illness and death.
International AIDS activists working for access to affordable AIDS treatment called on the Indian Government to repeal the law that introduced product patent protection on medicines through an Ordinance, promulgated December 26, 2004. "India should be proud to be producing and exporting cheap, generic AIDS drugs for people in need. The changes to the patent law will increase the price of new drugs, as well as some AIDS medicines that are already produced and exported in generic form," said Rolake Nwagwu of Positive Action for Treatment (PATA), Nigeria. "Rising treatment costs will spell disaster for people with HIV in India and around the world." 8,500 people with HIV die daily worldwide due to lack of access to treatment.
Has health benefited from the Poverty Reduction Strategy Paper (PRSP) process launched in 1999 by the international community? The first part of the paper examines the macro-economic constraints on health care financing and considers whether enhanced debt reduction, flexibility on fiscal deficits and the potential for increased aid would alleviate these constraints. The authors conclude that the PRSP process has not lived up to the expectations it has generated.
Efforts to bring antiretroviral treatment to AIDS patients in developing countries are threatened by the looming implementation of new World Trade Organisation patent rules, the charity Médecins Sans Frontières warned in December. The organisation’s TRIPS (trade related aspects of intellectual property rights) agreement comes into force for most signatories on 1 January 2005. It requires the organisation’s members to grant 20-year patents to new pharmaceutical products. Only the least developed countries can postpone implementation until 2016.
WHO estimates that currently one third of the world's population lacks access to essential drugs. Over fifty percent of people in the developing world especially in Africa and Asia do not have access to even the most basic essential drugs. There are many factors which influence and maintain the higher and unaffordable prices of drugs, however, lack of price control measures and the pricing policies of multinational pharmaceutical companies are considered the most important contributing factors. This paper presents an overview on Globalization, Intellectual Property Rights (IPRs) and Patents, which have taken a new turn with the introduction of the Agreement on Trade-Related aspects of Intellectual Property Rights (TRIPs Agreement).
Health reforms based on market principles have been introduced widely in both developed and developing countries over the past 20 years. In developing countries, international donors have insisted on health reform as a precondition of providing external aid. The reform packages that have been introduced have been strikingly similar across countries as wide apart as Uganda, Bolivia, and Russia. Uganda embarked on market based health reforms in 1994. These reforms have not only failed to improve health services and the health of the population but have arguably been the key factor behind their deterioration. What can we learn from Uganda's experience?
This Working Paper was written by Tenu Avafia, a tralac researcher, and examines the potential impact of the proposed Free Trade Agreement (FTA) between SACU and the United States from the perspective of public health. Avafia examines the ongoing negotiations and expresses concerns about the possible impact of the FTA on public health in the SACU region, particularly, the impact that the proposed FTA is likely to have on the ability of SACU countries to source the most affordable essential medicines required to address urgent public health concerns. Avafia goes on to say that it would be imprudent to enter into a bilateral agreement that contains less favourable provisions on essential medicines than those found in the multilateral arena such as the Doha Declaration on TRIPs and Public Health and the WTO General Council Decision of 30 August 2003.