According to this study, the rate of increase in consumption of ‘unhealthy commodities’ - namely soft drinks, processed foods, tobacco and alcohol - is fastest in low- and middle-income countries (LMICs), with little or no further growth expected in high-income countries (HICs). The pace at which consumption is rising in LMICs is even faster than has occurred historically in HICs thanks to multinational companies, which have now achieved a level of penetration of food markets in middle-income countries similar to what they have achieved in HICs. Higher intake of unhealthy foods correlates strongly with higher tobacco and alcohol sales, suggesting a set of common tactics by industries producing unhealthy commodities, the authors argue. Contrary to findings from studies undertaken several decades ago, urbanisation no longer seems to be a strong risk factor for greater consumption of risky commodities at the population level, with the exception of soft drinks. Rising income has been strongly associated with higher consumption of unhealthy commodities within countries and over time, but mainly when there are high foreign direct investment and free-trade agreements. Economic growth does not inevitably lead to higher unhealthy-commodity consumption.
Health equity in economic and trade policies
As the nineteenth International AIDS Conference took place in Washington DC, thousands of protesters marched on the White House with a set of demands to end the epidemic. The march consisted of a coalition of AIDS advocacy and activist groups organised under the mantra ‘We Can End AIDS’. At the forefront were calls for an end to free trade deals that protesters argue make vital AIDS medicines unaffordable. They pointed out that free trade deals with the Barack Obama administration contain excessively stringent protections for pharmaceutical patents on AIDS drugs. A spokesperson for the demonstration urged governments to accept recommendations related to intellectual property rights in a July 2012 report issued by the Global Commission on HIV and The Law (included in last month's newsletter), an independent high-level legal commission made up of former heads of state and leading legal, human rights and HIV experts. The Commission recommended a moratorium on TRIPS patent enforcement on pharmaceutical products, which they argue will allow developing countries to manufacture low-cost generic medicines urgently needed for their populations.
Local users are now the main source of electronic waste in Africa, but illegal imports of old computers, televisions, and other electronics devices from Europe, Asia, and North America still make their way there. That’s the finding of Where Are WEEE in Africa?, a new United Nations Environment Programme (UNEP) report about waste electronic and electrical equipment—also known as WEEE, or e-waste—in Benin, Côte d’Ivoire, Ghana, Liberia, and Nigeria.1 A large portion of these imports are of good quality, have a decent life expectancy, and bring many socioeconomic benefits, according to the report, but the rest is hazardous junk that is often resold and recycled under unsafe conditions. This article discusses the findings from the Where Are WEEE in Africa? report and the problems of its safe recycling and disposal.
Traditional long-established food systems and dietary patterns are being displaced in Brazil and in other countries in the South (Africa, Asia, and Latin America) by ultra-processed products made by transnational food corporations (‘Big Food’). This displacement, the authors of this paper argue, is increasing the incidence of obesity and of major chronic diseases and affects public health and public goods by undermining culture, meals, the family, community life, local economies, and national identity. In Brazil, the penetration of transnational companies has been rapid, but the tradition of shared and family meals remains strong and is likely to provide protection to national and regional food systems. The Brazilian government, under pressure from civil society organisations, has introduced legislation to protect and improve its traditional food system - by contrast, the governments of many industrialised countries have partly ceded their prime duty to protect public health to transnational companies. The authors recommend that the experiences of countries like Brazil in the South that still retain traditional food systems should be used as a basis for policies that protect public health.
Information Communication Technology (ICT) has revolutionized modern living, international business, global governance, communication, entertainment, transport, education, and health care. This has been driven by unprecedented high volumes of production and usage of consumer electronic products, in particular, personal computers, mobile phones, and television sets. Access to ICT has been identified as an indicator of a country’s economic and social development. The difference in access to ICT between developed and developing countries is commonly referred to as the “digital divide”. Africa has been undergoing rapid ICT transformation in recent years, attempting to bridge this divide by importing second-hand or used computers, mobile phones, and TV sets from developed countries. The countries of the region, however, lack the infrastructure and resources for the environmentally sound management (ESM) of electrical and electronic waste (e-waste) arising when such imports reach their end-of-life. The report analyses the flows of electrical and electronic equipment and e-waste and makes recommendations for African countries to prevent the import of e-waste and near-end-of-life equipment without hampering the socio-economically valuable trade of EEE of good quality.
In South Africa, as elsewhere in the world, large commercial entities that dominate the food and beverage environment (‘Big Food’) are becoming more widespread and are implicated in unhealthy eating. Interestingly, the authors of this study found that small independent producers (‘Small Food’) remain significant in the food environment in South Africa, and are 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, as well as having 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 recommend that the South African government act urgently to mitigate the adverse health effects in the food environment in South Africa through education about the health risks of unhealthy diets and regulation of Big Food, including support for healthy foods.
From the United Nations Conference on Sustainable Development (Rio+20) "The Future We Want", the conference outcome document, agreed upon by member states attending the 20-22 June conference, highlights the fact that better health is a “precondition for, an outcome of, and an indicator of all three dimensions of sustainable development”. The outcome document emphasizes the importance of universal health coverage to enhancing health, social cohesion and sustainable human and economic development. It acknowledges that the global burden and threat of non-communicable diseases (NCDs) constitutes one of the major sustainable development challenges of the 21st century. The document states: “We are convinced that action on the social and environmental determinants of health, both for the poor and the vulnerable and the entire population, is important to create inclusive, equitable, economically productive and healthy societies. We call for the full realization of the right to the enjoyment of the highest attainable standard of physical and mental health”.
In order to ensure their population's regular access to essential medicines, many countries are faced with the policy question of whether to import or manufacture drugs locally. For domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines. This paper considers the 'make-or-buy' dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania's imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. The study finds that Tanzania is limited by weak political support for the use of Trade-Related Aspects of Intellectual Property Rights (TRIPS) flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to externally -financed tenders make it difficult to obtain economies of scale and provide competitive prices. Within the "make-or-buy" context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty governments face to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on TRIPS. The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives.
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.
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.