Health equity in economic and trade policies

Fourth BRICS Summit: Delhi Declaration
Brazil, Russia, India, China and South Africa (BRICS): 29 March 2012

In this declaration from the fourth annual BRICS summit, held in March 2012, participants call for a more representative international financial architecture, with an increase in the voice and representation of developing countries and the establishment and improvement of a just international monetary system that can serve the interests of all countries and support the development of emerging economies. The declaration expresses BRICS’s concern at the slow pace of quota and governance reforms in the International Monetary Fund (IMF), calling for greater representation of developing countries by January 2013. The declaration reiterates BRICS’ position that that the heads of the IMF and the World Bank be selected through an open and merit-based process, and that Bank leadership must commit to transform the Bank into a multilateral institution that truly reflects the vision of all its members. The declaration also announces BRICS’s intention to set up a new Development Bank for mobilising resources for infrastructure and sustainable development projects in BRICS and other developing countries.

India grants first compulsory licence for patented drug
Estavillo M: Intellectual Property Watch, 12 March 2012

In a move welcomed by many in the international community, India has granted its first compulsory licence to a local generic drug maker to manufacture and sell a cancer drug, Sorafenib tosylate, which is patented by German pharmaceutical giant, Bayer, under the brand name Nexavar. Compulsory licensing is one of the flexibilities on patent protection under the World Trade Organisation’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, and it allows developing countries to manufacture affordable generic versions of patented medicines needed for public health in developing countries. Natco, the Indian generic producer, has already developed a process to manufacture the drug, expected to be ready for marketing in April 2011. It is anticipated that Bayer will make an appeal against the decision, which requires Natco to pay a quarterly royalty at 6% of the net sales of the drug, far below Bayer’s asking royalty of 15%. Médecins Sans Frontières said the ruling has ended Bayer’s monopoly in India on the drug and could set a precedent for making more expensive patented drugs available for compulsory licensing.

A blank cheque for abuse: the Anti-Counterfeiting Trade Agreement (ACTA) and its impact on access to medicines
Medicins Sans Frontieres: Access Campaign, February 2012

In this update to Medicins Sans Frontieres’ (MSF) November 2010 report on the Anti-Counterfeiting Trade Agreement (ACTA) - which has so far been signed by most developed nations - the impact of ACTA on access to medicines is investigated. Although a number of provisions that were harmful to access to medicines in developing countries were removed during the negotiations, the final text remains problematic, according to MSF. The agreement, for example, will undermine the ability of developing country governments to apply the Doha Declaration to protect public health. It puts medical distributors, non-governmental organisations and public health authorities at risk of severe penalties, while allowing for continued border detention of in-transit medicines destined for developing countries. ACTA undermines the role of the judiciary in protecting the right to health and balance private intellectual property rights with the larger public interest, and acts as a deterrent to the production and trade in generic medicines, as it provides for excessive punishment, shifts the risks entirely on to the generic manufacturer, and grants few protections against abuse. MSF states that it does not recognise the legitimacy of ACTA because it has been negotiated in secret with little room for public engagement. The authors conclud that ACTA is a cynical exploitation of concerns around unsafe medicines and is not a legitimate response to the problem of counterfeiting.

An ecological approach to non-communicable disease prevention in the workplace
De Villiers A, Senekal M and Fourie J: Occupational Health Southern Africa 17(4) July-August 2011

Non-communicable diseases (NCDs) are the leading cause of death globally, killing more people each year than all other causes combined. Furthermore, behavioural risk factors for NCDs fall increasingly on poorer people within all countries, mirroring the underlying socio-economic determinants. The need for prevention efforts through well-planned, cost-effective and feasible interventions across all levels of society is therefore obvious, the authors of this paper argue. The workplace is argued to provide an important setting for ecological models that ensure the both the policies and the environments that enable health.

China's relationship with Africa: West has no right to criticise
Glennie J: The Guardian, 8 February 2012

China has asserted that its aid to Africa has no strings attached. The author of this article argues that in contrast China's activities in Africa, like those of other major external funders have conditionalities attached. There is an oft-repeated Western view that China's only interest in Africa is to extract its natural resources. However in Mozambique China's investments are more targetted at the industrial sector, and there are numerous infrastructure and development projects across the continent attesting to the effectiveness of Chinese investment. The author notes that African governments would be foolish to believe that their relationship with China will avoid all the political wrangling inherent in aid and trade relationships. He warns that rather than casting aspersions on China's role in Africa. Western governments should acknowledge their own mixed record in African relations, and build a more balanced analysis of the costs and benefits of China's growing engagement in international development.

China’s growing role in Africa: Myths and facts
Ali S and Jafrani N: International Economic Bulletin, Carnegie Endowment for International Peace, 9 February 2012

According to this article, Africa has much to gain from China’s growing presence on the continent, though it is not without some negative impacts. Increased trade and investment links are particularly promising, as they have the potential to support poverty alleviation and sustain recent economic gains. However, African countries must exercise their bargaining power more effectively to ensure that they benefit from the growing relationship, including in areas such as modern technology transfer. It is also the continent’s responsibility to make sure that, as it takes advantage of Chinese investments, competition is preserved and encouraged and regulatory frameworks are improved, including mining codes, by increasing transparency and accountability of contracts. In addition, large flows of Chinese investment and aid should not be allowed to delay much-needed domestic reforms, such as strengthening economic management and improving the business environment. These are needed to attract foreign direct investment from Western countries, which in turn would help to counterbalance potential overdependence on China’s investment. Africa does not have to choose between the West and China – it can have both.

Draining development? Controlling flows of illicit funds from developing countries
World Bank: February 2012

A growing concern among those interested in economic development is the realisation that hundreds of billions of dollars are illicitly flowing out of developing countries to tax havens and other financial centres in the developed world. This new book by the World Bank assesses the dynamics of these flows, much of which is from corruption and tax evasion. What causes them, what are their consequences and how might they be controlled? The chapters by authors from a variety of backgrounds, including criminologists and practicing lawyers as well as economists, examine many dimensions of the phenomenon. Some chapters examine major illegal markets (drug trafficking and human smuggling) to assess how they contribute to these flows, while others are concerned with the corporate role in the phenomenon, particularly the possibility that transfer pricing (in which firms set prices for international trade among wholly owned affiliates) might play a major role in moving money illicitly.

Neoliberal development macroeconomics: A consideration of its gendered employment effects
Braunstein E: United Nations Research Institute for Development, Paper 14, 23 February 2012

In this UNRISD paper, the author reviews research on the employment impacts of neoliberalism, specifically on women’s employment. She considers a number of aspects that are central to employment issues: the slowdown in economic growth and the decline in the responsiveness of employment to growth; the impact of trade and investment liberalisation, informalisation and inflation targeting on employment; the consequences of increasingly frequent economic crises; and the public sector. The author contends that the Washington consensus’ macroeconomic policy conventions – liberalisation, privatisation and macro stability – have become so globally entrenched that they are rarely questioned by the academic and policy establishment. To this effect, she points to numerous, wide gaps in research into the employment impacts of neoliberal macroeconomic development policy.

Occupational allergy and asthma in the seafood industry: Emerging issues
Jeebhay MF: Occupational Health Southern Africa 17(6), November-December 2011

Increased demand for seafood and its functional by-products has been associated with a concomitant rise in fishing and aquaculture activities. This increased consumption and processing of seafood is associated with more frequent allergic health problems among seafood processors, according to this overview of occupational allergies and asthma in seafood-exposed workers. It illustrates the changing nature of the fishing and seafood processing industry in the midst of ecological degradation and globalisation. It provides detailed insights into the major and minor allergens that have been identified and other pathophysiological mechanisms that have been ¬implicated in airway inflammation. More refined exposure assessment studies in recent times have enabled detailed characterisation of allergen exposure response relationships, which confirm the increased risk associated with elevated allergen exposures. Directions for future research and preventive strategies are outlined.

Regional economic performance in 2011 and medium-term prospects
Southern Africa Development Community: February 2012

According to the Southern Africa Development Community’s (SADC) latest financial report, the region recorded an average real GDP growth of 4.7% in 2011, which is 0.8% below the 2010 growth rate of 5.5%. Inflation pressures gathered in most SADC Member States; however, regional inflation averaged 8.3%, almost the same level as in 2010. The average fiscal deficit deteriorated to 4.8% of GDP in 2011 compared to 3.2% of GDP in 2010. However, general government debt remained at 2010 level of 39% of GDP. The current account deficit of the balance of payments improved marginally from 8.8% of GDP in 2010 to 8.3% of GDP in 2011. Medium-term prospects are good but downward risks are high partly as a result of the sovereign debt crisis in the European Union.

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