Health equity in economic and trade policies

What Does the Seventy-third World Health Assembly Mean For Socio-economic Survival of Countries, Food Security, and International Cooperation in the COVID-19 Pandemic
Ssemakula M: People’s Health Movement (PHM) and Human Rights Research Documentation Centre (HURIC) –UGANDA, 2020

COVID-19 has underpinned unprecedented economic instability and global food supply disruptions in Africa. This has put global cooperation (aid, partnerships and concession finance) on test after the economic downturn in the world economy performance. This article provides a discourse on damaging interruptions caused by the pandemic on socio- economic survival of countries and food security, and how that relates to the gaps in interventions in IHR core principles reported by WHO member states and UN agencies at seventy-third World Health Assembly, which PHM closely followed through its WHO Watch programme.

Conclusions and outcomes from SATUCC seminars during the 16th Southern African Civil Society Forum
SATUCC: Botswana, August 2020

The 16th Southern African Civil Society Forum (CSF) was held remotely in late August due to the challenges posed by COVID-19. In seminars at the forum hosted by SATUCC, and with evidence presented from studies implemented for SATUCC, it was noted that the pandemic has amplified a number of challenges that workers were already facing before COVID-19, such as increase of insecure and informal work, lack of social protection and rising unemployment, exacerbating poverty and inequalities. Youth were found to be more vulnerable due to high youth working poverty rates and because the youth are over-represented in vulnerable and informal employment. Young women are facing an increasing double burden to manage both paid work and unpaid care and household work due to widespread school closures. The sessions identified that trade unions should be actively involved in the formulation and implementation of responses to COVID-19 at both national and regional level and that the issues facing workers should be addressed in social dialogue and in the collective bargaining agreements. Trade unions should be pro-active in bringing alternative proposals for building sustainable economies after the pandemic.

COVID-19: South Africa, India call for enabling technology transfer in TRIPS
Third World Network: TWN Info Service on Health Issues, August 2020

At the WTO’s TRIPS Council meeting on 30 July, members discussed South Africa’s proposal (IP/C/W/665) for members to come up with proposals, share information and national experiences, pointing out how the 2030 SDGs may be achieved through an effective framework for technology transfer. India reminded the TRIPS Council that any discussion on “E-Commerce will lack meaning if the gaping digital divide, partly arising out of lack of access to technologies and furthered by the pandemic, continues to exist.” In conclusion, India said that “it is of utmost importance for developing countries to adopt e-commerce and IP policies that are mutually supportive and in line with their developmental goals and policy specificities.”

Fostering local production of essential medicines in Nigeria
Fatokun O: Bulletin of the World Health Organisation 98, doi:, 2020

Consistent availability and access to medicines in low- and middle-income countries is a challenge. As a result, the governments in these countries have shown increasing interest in local pharmaceutical production as a means of promoting technology transfer, building capacity and improving access to essential medicines. In Nigeria, the Five Plus Five-Year Validity (Migration to Local Production) policy aims to reduce the number of pharmaceutical products imported into Nigeria and encourage local production of essential medicines. The Five Plus policy follows a fiscal policy measure implemented since 2016 which reduced the import adjustment tax under the Economic Community of West African States Common External Tariff on pharmaceutical raw materials from 5–20% to 0% and imposed a 20% import adjustment tax on four groups of imported drugs that can be produced by local manufacturers, including antimalarials, antibiotics, alkaloid derivatives and vitamins. While local pharmaceutical production in some low-income countries is not viable because of limited local technical expertise or low economies of scale, this issue may not be the case in Nigeria, given its large population, huge potential market and local expertise and experience for the manufacture of essential medicines.

Lessons from COVID-19: Pharmaceutical Production as a Strategic Goal
Correa C: South Centre, South Views 202, 2020

The economic and financial crisis generated by COVID-19 has deepened initiatives - which are not entirely new - to sustain local production of pharmaceuticals through a variety of mechanisms aimed at recovering 'strategic autonomy'. The pharmaceutical industry (including biotechnological products) can be one of the axes in new policy frameworks oriented to local production. A UNCTAD study concluded that in many developing countries companies have achieved the economies of scale required to produce medicines competitively and will expand over the next decade. Taking advantage of these opportunities to strengthen a pharmaceutical/ biotechnology industry may require the reformulation of industrial policies, to promote the sector as a generator of value added, employment and foreign exchange, as well as an instrument for achieving health autonomy to address public health needs. The author argues that this requires the deployment of well-articulated instruments, in line with the concept of 'mission-oriented industrial strategy'.

An assessment of workers’ rights in the mining sector during the COVID-19 Lockdown
Mlevu S: Centre for Natural Resource Governance, Zimbabwe, May 2020

This situation update from the Centre for Natural Resource Governance Zimbabwe looks at how the mining companies have been handling labour concerns as they have been operating during the lockdown. The authors report from various mines that companies have been making piecemeal commitments to health and safety of the employees, with some ignoring stipulated health measures. It also identifies only one company in Mutoko that invested time and money towards the health and safety of their employees during the lockdown. During the lockdown, the authors report that some workers have failed to get their salaries, while some workers have gone for 3 months without pay. The authors recommend that government convene a Tripartite Negotiating Forum to discuss the conduct of employers and their employees during the lockdown, that the Labour Act be revised to provide for the conduct of employers and employees during emergencies; that companies provide decent accommodation to their employees to minimise staff movements and contact with community members and protective equipment for all workers despite rank or grade who are working during the pandemic.

The Impact of COVID-19 on SADC Economy
SADC Macroeconomic Subcommittee, SADC Secretariat: SADC, Gaborone, May, 2020

This report presents the impact of the COVID-19 Pandemic and implications for SADC Region as monitored by the SADC Macroeconomic Subcommittee, supported by the SADC Secretariat. It provides policy recommendations to Member States. The report recommends policy interventions in the face of the significant global economic downturn from COVID-19, including adding to the focus on health and humanitarian responses, strengthening early warning systems, response and mitigation of pandemics and disasters that have proved to be major threats to education, tourism, informal sector and other sectors; and developing Roadmaps and Action Plans that prioritize investments and channel scarce resources to identified economic sectors to resuscitate their economies, strengthen resilience and improve competitiveness, based on the SADC macroeconomic convergence programme.

'Alternative Mining Indaba': you should not only take oil and diamonds
Evans J: News 24, February 2020

A group of about 70 people from the Alternative Mining Indaba marched to the Mining Indaba 2020 held at Cape Town International Conference Centre to highlight their concerns over the problems extractive mining is causing for communities who live near mines. Rev. Martha Mutswakatira, from the Reformed Church in Zimbabwe, who had walked down Adderley Street with the civil society activists in her white collar on Wednesday, said communities are carrying the cost of damages caused by extractive mining. One man from Angola among the Alternative Mining Indaba picket said: "When you come to Africa you need to invest in people: You should not only take oil and diamonds, and leave people with their hands empty." They demanded legal reforms, responsible supply chains, and that mines that pollute be prosecuted. They also called for the legalisation of artisanal mining, with licences being granted to these miners, and that miners and mineworkers be entitled to health and social care. They recommend carbon taxing of mining companies, not allowing social initiatives by mines to be tax deductible, and a move away from fossil fuels. The group also called for the mining industry to provide compensation for former miners' whose health has been adversely affected. Their memorandum was accepted by a delegation which included the International Council on Mining and Minerals; the Department of Minerals and Energy and the Minerals Council South Africa.

Tackling injustices of occupational lung disease acquired in South African mines: recent developments and ongoing challenges
Kistnasamy B; Yassi A; Yu J; et al: Globalization and Health 14(60), doi: 10.1186/s12992-018-0376-3, 2018

This study aimed to assess developments over the last 5 years in providing compensation, quantify shortfalls and explore underlying challenges for ex mineworkers and their families. Using the database with compensable disease claims from over 200,000 miners, the medical assessment database of 400,000 health records and the employment database with 1.6 million miners, rates of claims, unpaid claims and shortfall in claim filing were calculated for each of the southern African countries with at least 25,000 miners who worked in South African mines, by disease type and gender. Interviews were also conducted in Johannesburg, Eastern Cape, Lesotho and a local service unit near a mine site, supplemented by document review and auto-reflection, adopting the lens of a critical rights-based approach. A myriad of diverse systemic barriers persist, especially for workers and their families outside South Africa. Calculating predicted burden of occupational lung disease compared to compensable claims paid suggests a major shortfall in filing claims in addition to the large burden of still unpaid claims. Despite progress made, our analysis reveals ongoing complex barriers and illustrates that the considerable underfunding of the systems required for sustained prevention and social protection (including compensation) needs urgent attention. With class action suits in the process of settlement, the globalized mining sector is now beginning to be held accountable.

WHO response to WTO member state challenges on tobacco, food and beverage policies
Barlow P; Labonte Rl McKee M; Stuckler D: Bulletin of the World Health Organisation 97(1) 846-848, 2019

In 2013, the World Health Assembly endorsed the World Health Organization’s (WHO) Global action plan for the prevention and control of noncommunicable diseases (NCDs) 2013–2020 to achieve a 25% reduction in mortality from NCDs by 2025. WHO’s Global Action Plan is ambitious. In the late 1990s, WHO used its treaty- making powers to address the issue of tobacco use, leading to the Frame-work Convention on Tobacco Control (FCTC). It enabled WHO to have a greater presence at World Trade Organization (WTO) meetings, supporting countries in their efforts to protect their populations against the harms from tobacco. While WHO was present when tobacco trade may conflict with public health concerns, this was not the case in WTO discussions concerning nutrition policy. Even though the Global action plan for the prevention and control of NCDs 2013–2020, fully recognizes the need for action on trade in certain foods and beverages, it was not possible to find any evidence of WHO participation in nutrition-related trade challenges, such as those related to unhealthy food high in salt, fat and sugar, alcohol, soft-drinks and infant milk formulae. The authors suggest that WHO can learn from its past successes in championing tobacco control at the WTO. The lack of a treaty similar to the FCTC for nutrition-related diseases may discourage WHO participation because such absence limits the perceived legitimacy of WHO input. Further investigations are necessary to understand why WHO has yet to comment on food and beverage regulations at WTO’s committee.