Health equity in economic and trade policies

“Big Food,” the Consumer Food Environment, Health, and the Policy Response in South Africa
Igumbor EU, Sanders D, Puoane TR, Tsolekile L, Schwarz C, Purdy C, Swart R, Durão S and Hawkes C: Plos Med (9) 7: July 2012

The report asserts that in South Africa, as in other jurisdictions, “Big Food” (large commercial entities that dominate the food and beverage environment) is becoming more widespread and is implicated in unhealthy eating. “Small food” remains significant in the food environment in South Africa, and it is both linked with, and threatened by, Big Food. Big Food in South Africa involves South African companies, some of which have invested in other (mainly, but not only, African) nations, as well as companies headquartered in North America and Europe. These companies have developed strategies to increase the availability, affordability, and acceptability of their foods in South Africa; they have also developed a range of “health and wellness” initiatives. Whether these initiatives have had a net positive or net negative impact is not clear. The authors argue that the South African government should act urgently to mitigate the adverse health effects in the food environment in South Africa through education about the health risks of unhealthy diets, regulation of Big Food, and support for healthy foods.

Civil society groups reject foreign investment in African farming
Network of Farmers and Agricultural Producers Organizations (ROPPA), West African Platform of Civil society organisations on the Cotonou Agreement (POSCAO-AC), Coalition of African Organisations on Food Security and Sustainable Development (COASAD) et al:

In this open letter from 13 African civil society organisations, they argue that sub-Saharan Africa is caught between the desire to regain control of its own development and excessive reliance on external sources of funding. In the past decade, African states have committed to dedicate more public resources to agriculture and to promote regional agricultural policy and trade through regional trade blocs like ECOWAS and NEPAD. These commitments testified to a real commitment to agriculture on the part of the African authorities, as well as to a new desire to assume control of African development in dialogue with local populations, and they were a sign to social movements and networks of peasants and producers that agriculture had regained its position at the heart of the political agenda. Unfortunately the methodology adopted for the formulation of the Comprehensive Africa Agriculture Development Programme, NEPAD’s initiative to boost agricultural productivity in Africa, rapidly degenerated, and the National Agricultural Development Programmes, promoted from above with insufficient dialogue with the concerned actors, appeared to be merely occasions for negotiating new aid. The letter argues that success in agricultural policies in Europe, the United States and in emerging countries like Brazil and India, have always been the product of sovereign will and of a partnership between the states and the economic actors, that is the producers, the processors, the traders. Therefore external funders and foreign investors are not the appropriate role players to drive agricultural policy in Africa.

Development cooperation and emerging powers: New partners or old patterns?
Sidiropoulos E: Zed Books, May 2012

This new book explores the development policies of Brazil, China, India, Mexico and South Africa. Using a case study approach, the author charts the evolution of South-South cooperation and elaborates on the lessons learnt from traditional forms of external funding. Against the background of the changes in the international system of development cooperation, she also discusses the possibility for convergence or conflict in this transitional phase of the architecture of development cooperation. The emergence of new development partners should be seen as the starting point for the gradual emergence of more comprehensive and balanced international development cooperation, bringing greater gains to aid-dependent economies, including key international development issues such as international tax cooperation, sovereign debt workouts and international economic governance. Emerging economies want to be rule makers, not just rule takers, and increasingly are making their voices heard in international forums. In so doing they are eroding the West's 'monopoly' on developmental issues.

Drug safety needs global cooperation of drug regulators, officials say
Saez C: Intellectual Property Watch, 19 May 2012

On 18 May 2012, a few days before the 2012 World Health Assembly, the permanent mission of Brazil organised an informal meeting on sanitary regulation and how to improve global cooperation among drug regulatory agencies. Margaret Chan, Secretary-General of the World Health Organisation (WHO), discussed the WHO drug prequalification programme, which she said was intended to give the opportunity for manufacturers from low- and middle-income countries to enter the market with straight quality and safety standards, and to enter into fair competition with other manufacturers. Many countries lacked capacity to pre-qualify their medical products, such as vaccines, as they did not have a functional national drug regulatory authority. These authorities often lacked resources and support from government and other stakeholders. Medicins sans Frontiers voiced its support for regional cooperation between regulatory agencies, adding that WHO should continue the development of norms and standards for phamacovigilence and support their implementation at country level. The Indian delegation identified lack of harmonisation of regulatory systems as a challenge and argued for the exchange and sharing of information among drug regulatory agencies.

Economic Development in Africa Report 2012: Structural transformation and sustainable development in Africa
United Nations Conference on Trade and Development (UNCTAD): April 2012

This report contends that Africa should not follow the same ‘grow now, clean up later’ approach that was adopted by currently industrialised countries. The continent should instead pursue a different path that reconciles economic growth with environmental sustainability. The report urges African governments to shift from traditional to modern, less-polluting energy sources, wherever these energy sources are economically and environmentally viable, and to promote a shift to organic agriculture to ensure environmentally sustainable increases in harvests, to bring higher prices to farmers and to keep rural populations engaged in farming rather than migrating to the cities. The report calls for developed countries to increase financial assistance to Africa, but emphasises that equally important will be greater technology transfer from developed and emerging countries to Africa, increased South-South cooperation in green technology use and adaptation, and more flexibilities in the design of the global intellectual property rights regime. More "policy space" will be needed for African governments so that they have the ability to use incoming funds and technology in the most efficient way for their specific circumstances. Each African country will have to design strategies and policies based on its own sectoral and resource priorities, environmental challenges, initial conditions and domestic capabilities. Countries that are already embarked on that path in Africa include Kenya, Mauritius and South Africa.

Emergence of biopharmaceutical innovators in China, India, Brazil, and South Africa as global competitors and collaborators
Rezaie R, McGahan AM, Frew SE, Daar AS and Singer PA: Health Research Policy and Systems 10(18), 6 June 2012

Developed countries have traditionally been the source of most biopharmaceutical innovations as well as the destination for the resulting economic and health benefits. As a result, most prior research on this sector has focused on developed countries. This paper seeks to fill the gap in research on emerging markets by analysing factors that influence innovative activity in the indigenous biopharmaceutical sectors of China, India, Brazil and South Africa. Using qualitative research methodologies, the authors show how biopharmaceutical innovation is taking place within the entrepreneurial sectors of these emerging markets, identify common challenges that indigenous entrepreneurs face and highlight the key role played by the state. Their findings reveal that the transition to innovation by companies in the emerging markets is characterised by increased global integration. Further findings suggest that biopharmaceutical innovators in emerging markets are capitalising on opportunities to participate in the drug development value chain. In this way, they are developing capabilities and relationships for competing globally both with and against established companies headquartered in developed countries.

Going public to improve investment in African agriculture
Smaller C: International Institute for Sustainable Development, October 2011

The culture of secrecy that surrounds agricultural land deals raises concerns about government misconduct in relation to issues of public interest, according to this article. There is a growing global consensus in favour of contract transparency and a few governments have started publishing contracts or improving legislation on transparency, with Liberia leading the way. After a review and renegotiation of all extractive industry concessions and contracts, President Sirleaf introduced the Liberia Extractive Industry Transparency Initiative Act (the LEITI Act), which requires all payments by individual companies and operating contracts and licenses to be published and reviewed on the LEITI website. This bold step has not deterred investors, as initially feared. Other countries are following suit. Ghana has also started publishing contracts in the oil sector, and Ethiopia has started making certain contracts public, the article notes. Some countries, including Sierra Leone, Ghana and Liberia, require large investment projects to be ratified in parliament, ensuring a layer of public scrutiny.

Regional economic outlook: Sub-Saharan Africa: Sustaining growth amid global uncertainty
International Monetary Fund: April 2012

Sub-Saharan Africa continues to record strong economic growth, despite the weaker global economic environment. Regional output rose by 5% in 2011, with growth set to increase slightly in 2012, helped by still-strong commodity prices, new resource exploitation, and the improved domestic conditions that have underpinned several years of solid trend growth in the region’s low-income countries. But there is variation in performance across the region, with output in middle-income countries tracking more closely the global slowdown and with some sub-regions adversely affected, at least temporarily, by drought. Threats to the outlook include the risk of intensified financial stresses in the euro area spilling over into a further slowing of the global economy and the possibility of an oil price surge triggered by rising geopolitical tensions.

The state of debt: Putting an end to 30 years of crisis
Jubilee Debt Campaign: May 2012

This report investigates the external debts of both governments and the private sector in the global South. Analysing recently compiled data from international financial institutions, it finds that private sector debt payments out of impoverished countries are now double those of the public sector, a complete turnaround since the year 2000. What is of concern is the fact that similar high levels of private sector debt have been the main cause of the financial crisis in Europe. Across the 32 low- and lower middle-income countries where data is available, private sector external debt payments were found to have increased from 4% of export earnings in 2000 to 10% in 2010. In contrast, government external debt payments for these countries have fallen from 20% of export revenues in 1998 to 5% in 2010. The negative impacts of the financial crisis – including falling trade revenues, loss of money sent home from migrants and multinational companies sending more money back to the rich world – have seen lending to the 35 most impoverished country governments almost double from $5 billion in 2007 to $9 billion in 2009. As a result, government debt payments by impoverished countries are predicted to rise by a third by 2014. Although debt cancellation has released some countries from one debt trap, the Jubilee Debt Campaign argues that the developed country debt crisis has led to an increase in unregulated and opaque private lending, which could increase social inequality and the risk of further economic crisis. A new system for monitoring and regulating the way money moves across the world is needed, so that finance works for the benefit of everyone.

Africa Progress Report 2012
Africa Progress Panel: 17 May 2012

According to this report, Africa’s economic outlook is positive in some respects, as the continent is home to seven of the world’s fastest-growing economies, with 70% of Africa’s population living in countries that have averaged economic growth rates in excess of 4% over the past decade. However, the report also records that most countries are not on track to achieve the Millennium Development Goals by 2015, flagging slow progress in areas such as child nutrition, child survival, maternal health, and education. The need for equitable growth is all the more critical, the report states, because of Africa’s profound demographic shift towards youth, as well as high levels of population growth. It calls for a greater focus by policymakers on jobs, justice and equity to ensure sustainable, shared growth that benefits all Africans. Failure to generate equitable growth could result in rising levels of youth unemployment, social dislocation and hunger. Africa’s governments and development partners must urgently draw up plans for a big push towards the 2015 Millennium Development Goals, the report says.

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