There were sobering messages on global economic prospects emerging from the meeting of the World Bank and International Monetary Fund in Tokyo in early October 2012. Developing countries’ Finance Ministers and Central Bank officials voiced their concerns on the failure of developed countries to deal with their economic situation and on the policy and political paralysis preventing solutions. They argued that developing nations were also suffering from the spillover effects of policies adopted by some developed countries, particularly their provision of huge volumes of credit credit, the continuing European debt crisis, and the looming threat of the United States’ “fiscal cliff”. A major setback was the missing of the deadline to resolve the issue of altering the quotas of the International Monetary Fund with the aim of providing developing countries with a higher overall share, to improve their say over the policies of the institution. The Tokyo meeting was supposed to settle the question but was unable to come to a decision. The G24 group of developing countries argued that failure to meet the deadline undermined the IMF’s credibility.
Health equity in economic and trade policies
In response to the early online release of a French study in September 2012, which suggested that genetically modified (GM) maize may promote cancer and early death in rats, a number of environmental and development organisations working in South Africa have written this open letter to government demanding an immediate ban on human consumption of GM maize. In contrast to the 90-day studies conducted by Monsanto, which developed the particular variety of maize in question, th French study ran for two years and revealed long-term health hazards. Monsanto has repeatedly asserted Roundup Ready maize is safe. Over 70% of maize consumed in South African is GM, according to this letter, and over 40% of the national crop is of the Roundup Ready variety. The letter notes that in many high income countries Roundup Ready maize is considered fit for consumption by livestock only.
The main aim of this assessment was to identify the existing occupational safety and health, working conditions, and environmental challenges in the weaving sector in Addis Ababa and their impact on productivity, quality and access to external markets. Researchers targeted women weavers in the three categories namely the micro-level weavers who weave in their homes, weavers in cooperatives and those weaving in small-scale enterprises. Respondents from all three categories reported poor working conditions and environment, and had low productivity and product quality. Weavers and owners of the small-scale enterprises were not aware of the benefits of improving working conditions, occupational safety and occupational health. Comfort in terms of the design of their workstations and ease-of-use of machinery was often not even considered by respondents to be of any importance. Most work rooms had poor light and little ventilation and were often overcrowded, as micro-level weavers shared their work space with children and other family members, all of whom are exposed to occupational hazards as well. Participants called for continuous support and especially the development of policy tools and bilingual guides for continuous improvement that would not only support their survival, but also their growth and ability to compete on local and export markets.
In developing countries, jobs are a cornerstone of development, with a pay off far beyond income alone. They are critical for reducing poverty, making cities work, and providing youth with alternatives to violence, according to the World Development Report 2013. The report focuses on employment, stressing the role of strong private sector-led growth in creating jobs, and outlines how jobs that do the most for development can spur a virtuous cycle. These jobs include those that raise incomes, make cities function better, connect the economy to global markets, protect the environment, and give people a stake in their societies. The report finds that poverty falls as people work their way out of hardship and as jobs empower women to invest more in their children. Efficiency increases as workers get better at what they do, as more productive jobs appear, and as less productive ones disappear. And ultimately, the report concludes, societies flourish as jobs foster diversity and provide alternatives to conflict.
The lack of a global legal framework to guide national action and international cooperation to reduce risk factors related to alcohol abuse and unhealthy diet significantly hinders the capacity of nations worldwide to unilaterally and collectively curb the expanding epidemics of non-communicable diseases (NCDs), according to this paper. A number of commentators have suggested the adoption of comprehensive treaties or framework conventions on obesity, or alcohol or both. Given the legal, political, budgetary, and time-related limitations to the development and adoption of all-encompassing treaty regimes to address obesity and alcohol abuse, the authors recommend an alternative legal strategy to counter these rising NCD epidemics. In particular, they call for the prompt adoption of a WHO/UNICEF global code of practice on the marketing of unhealthy foods and beverages to children. Such a non-binding international legal instrument has significant advantages over a treaty approach at the present time. It would provide a much-needed step towards advancing meaningful engagement with and holding to account all relevant actors, including national governments, private industry, and UN agencies, in protecting children everywhere from harm. The WHO Framework Convention on Tobacco Control (“FCTC”) addresses one of the major risk factors contributing to NCDs by establishing a global legal framework to counter the tobacco pandemic: in response, the authors call on the global community to act collectively to establish a legal architecture to regulate a central component of these two other major risk factors.
On 6 September 2012, Japan’s ruling party, the House of Representatives, ratified the controversial Anti-Counterfeiting Trade Agreement (ACTA) in the absence of opposition parties, counting only the votes of the ruling party. Critics have denounced the move as undemocratic, also claiming that the Japanese mass media has marginalised the issue in the arena of public debate. Meanwhile, processes in several ACTA signatory states seem to be stalled. The author of this article notes that it is unlikely that ACTA will become an international treaty, with an apparent stalemate between the United States administration and legislators about ratification procedures, and the European Union’s recent vote against ratifying the agreement. Besides Japan, seven governments are reported to have signed ACTA, namely Australia, Canada, Morocco, New Zealand, Singapore, South Korea and the United States. Switzerland has not signed nor ratified. ACTA will have significant repercussions for public health, as the treaty aims to strengthen patent protection for pharmaceutical companies, wuth negative consequences for the production of affordable generic medicines in the developing world.
African, Caribbean and Pacific countries have two more years to negotiate economic partnership agreements (EPAs) with the European Union (EU), before the decision is taken to withdraw their free access to the EU market, according to amendments to the market access regulation adopted on 13 September 2012. Members of the European Parliament (MEPs) voted to extend the 2014 deadline proposed by the Commission and give ACP countries until 2016 to ratify their EPAs before losing the right to duty-and-quota-free access to the EU that they have been enjoying since 2007. The content of the EPAs have been contested in some countries in Africa. MEPs consider that unlimited and unconditional preferences are not a sustainable option but also agree that the EU should allow them a ‘realistic timeframe’ to work towards ‘fair and development-focused’ EPAs with African, Caribbean and Pacific (ACP) partners. Eight countries have not ratified EPAs: Botswana, Namibia, Cameroon, Fiji, Ghana, Ivory Coast, Kenya and Swaziland.
Swiss pharmaceutical company Novartis has begun its court case to appeal in the Indian Supreme Court in a final bid to overturn a ruling earlier this year to prevent the company from renewing its patents on life-saving drugs. If Novartis wins the appeal, it will undermine a key public health safeguard in Indian patent law specifically designed to prevent drug companies from abusive patenting practices that keep medicine prices high, says international humanitarian medical organisation Médecins Sans Frontières (MSF), which relies on affordable generic drugs produced in India to carry out its work in 68 countries. MSF alleges that, for the past six years, Novartis has been trying to browbeat India into changing Section 3d of India’s patent law, which says that a new form of a known medicine can only be patented if it shows significantly improved therapeutic efficacy over existing compounds. This is a provision to stop the common industry practice of extending, or ‘evergreening,’ their patent monopolies for routine modifications of known compounds. Section 3d, which is in line with international trade rules, formed the basis for Novartis not being granted a patent for its cancer drug imatinib mesylate (marketed as Gleevec) in 2006, as Novartis’ patent application was on a new form of the imatinib molecule already described several years previously in patents in the United States and other developed countries.
Countries have reached universal health coverage by different paths and with varying health systems. Nonetheless, the trajectory toward universal health coverage regularly has three common features, identified in this paper. The first is a political process driven by a variety of social forces to create public programmes or regulations that expand access to care, improve equity, and pool financial risks. The second is a growth in incomes and a concomitant rise in health spending, which buys more health services for more people. The third is an increase in the share of health spending that is pooled rather than paid out-of-pocket by households. This pooled share is sometimes mobilised as taxes and channelled through governments that provide or subsidise care – in other cases it is mobilised in the form of contributions to mandatory insurance schemes. The predominance of pooled spending is a necessary condition (but not sufficient) for achieving universal health coverage. The authors describe common patterns in countries that have successfully provided universal access to health care and consider how economic growth, demographics, technology, politics, and health spending have intersected to bring about this major development in public health.
Much has changed in the world since economic partnership agreements (EPAs) negotiations between the European Union (EU) and African, Caribbean and Pacific (ACP) countries started 10 years ago. Emerging developing countries have increased their share of the world market and China has become one of the largest trading nations, while ACP countries have diversified trading partners and external funders. Today both the EU and the ACP countries struggle with the mess that the extended and deadlocked EPA negotiations have created. The interim EPAs have complicated the negotiations even further, causing rifts in the regions, and the refusal of the EU to swiftly amend them left the negotiations stuck with protracted discussions on contentious issues. The author of this article calls on the EU not to force ACP countries to accept agreements simply to avoid losing trade preferences. And he argues further that it is a problem when trade negotiations are held behind closed doors and policies are based on secret (unless leaked) mandates, with hardly any parliamentary involvement. Economic reform is too important to all layers of society to be left to behind closed door negotiations.