Health equity in economic and trade policies

Recommendations of the Third EU-Africa Business Forum
European Commission Development I-center, 28 September 2009

The Third EU-Africa Business Forum concluded its discussions in Nairobi, Kenya, (28-29 September 2009) with a consensus on the need for Africa to shift its policy objective from poverty reduction to the more dynamic goal of wealth creation. There was also broad agreement on the need for greater regional integration, increased investment and improved infrastructure. The EU has pledged some €5 billion in funding, 1.5 billion of which has been earmarked for the specific goal of promoting regional integration. Commenting on the Forum, Stefano Manservisi, the European Commission’s Director-General for Development noted that now, more than ever, good policy must be in place along with a sound enabling framework allowing the private sector access to credit, knowledge and skills. […] European Union companies were encouraged to increase investment in Africa to take advantage of the huge opportunities that currently exist on the continent. Other delegates noted that the continent offers impressive returns on investment and immense potential, particularly in areas such as agro-pressing, industrial production, construction and the service sector. They also pointed to the paramount importance of infrastructure and energy which feature prominently on Africa's development agenda and where opportunities were noted to exist for joint ventures.

Reconsidering regional integration in sub-Saharan Africa
McCarthy C: Tralac and Danida, 2010

This paper explores regional integration in Africa. The author observes that fragmentation of countries has led to the absence of scale in the production of goods and services. Industrialisation and regional integration policies were proposed to overcome this. For some communities, such as the Southern African Development Communities, there were also political objectives. None of the regional integration arrangements are yet fully fledged customs unions. The author notes the limits to intraregional trade by virtue of the low industrial capacity of the countries in the region. However regional integration provides in theory the economies of scale that attract investment and protects producers within a common market. He argues that these benefits of regional integration have not been achieved. As regional integration is argued to be important, the author argues that it needs to be more strongly based on national strategies for enhancing production capacities.

Recovering Better from COVID-19 Will Need a Rethink of Multilateralism
Kozul-Wright R: Development (2020) 1-5, doi: https://doi.org/10.1057/s41301-020-00264-y, 2020

The world economy is experiencing a deep recession amid a still unchecked pandemic. The author argues that the commitment to recovering better will not materialize if, as happened after the global financial crisis, high income countries resort to a policy mix of austerity, liberalization and quantitative easing. Such an approach will only worsen a whole set of pre-existing conditions and in particular, high inequality, excessive debt (both public and private and weak investment—that will lead to a lost decade, particularly for low income countries. What is proposed to be needed instead is an expansionary plan for global recovery, that can return even the most vulnerable countries to a stronger position than before the crisis. This paper sets out some of the key elements of such a plan and argues that its implementation will require systematic reforms to the multilateral trade and financial system if a more resilient recovery is to turn into a sustainable and inclusive future.

Redistribution, Inequality, and Growth
Ostry JD, Berg A, Tsangarides CG: International Monetary Fund, Research Department, February 2014

This paper by researchers at the International Monetary Fund appears to debunk a tenet of conservative economic ideology — that taxing the rich to give to the poor is bad for the economy. It incorporates recently compiled figures comparing pre- and post-tax data from a large number of countries. The authors say there is convincing evidence that lower net inequality is good economics, boosting growth and leading to longer-lasting periods of expansion. The study concludes that redistributing wealth, largely through taxation, does not significantly impact growth unless the intervention is extreme.

Regional economic outlook: Sub-Saharan Africa: Back to high growth?
International Monetary Fund: April 2010

According to this report, the current economic slowdown in sub-Saharan Africa may soon be over. Output is projected to expand by 4¾% in 2010, compared to 2% in 2009. Most countries in the region are now bouncing back from the growth slowdown or contraction in output experienced during the global recession. The brevity of the slowdown owes much to the relative strength of the region’s economies heading into 2008–2009, the expansionary macro-economic stance then adopted by most countries, and the relatively quick recovery in global economic activity. The report predicts that prospects for 2011 and beyond look good. Output growth is projected to accelerate to 5¾% in 2011, playing off the expected continued improvement in global economic conditions. Over the medium term, growth rates in most sub-Saharan African countries are expected to be only marginally below those enjoyed in the mid-2000s. In the meantime, most countries have been able to shield pro-poor and pro-growth public spending. According to preliminary budget out-turn numbers, health and education spending increased in real terms in 20 of the 29 low-income countries in the region in 2009. In a similar vein, government capital spending also looks to have held up in 2009, increasing in real terms in more than half of the countries in the region.

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.

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.

Regional integration, fragility and institution building: An analytical framework applied to the African context
Verdier T: European University Institute Working Paper, June 2010

This paper discusses how regional integration processes may contribute to state building and reduce economic and social insecurity. After presenting a simple conceptual framework to discuss the effects of external and regional integration in weak states, it analyses the policy trade-offs that may arise in such contexts. The paper then reviews the specific regional experiences of sub-Saharan countries. Finally, it discusses policy implications for the European Union (EU) in the context of its regional trade and development policies with African countries. The author concludes that a two-tier approach to regional integration, which combines both top-down and bottom-up processes, is necessary; the EU approach to regional integration in Africa should promote ‘building blocks’ and not ‘stumbling blocks’; and specific considerations should be given to make the strategy for trade integration responsive to the needs of fragile states.

Registering new drugs for low-income countries: The African challenge
Moran M, Strub-Wourgaft N, Guzman J, Boulet P, Wu L et al: PLoS Medicine 8(2), 1 February 2011

In this study, the authors argue that an optimal drug registration approach for Africa should reliably evaluate safety, efficacy, and quality of drugs for African use. It should include African expertise, contribute to building African regulatory capacity, and, ultimately, expedite African access by reducing duplicative and sequential reviews by different regulators. However they present an overview of the current situation that shows the present system of drug approval to be far from achieving these goals, with inefficiencies in the use of regulatory resources and in the uptake of capacity-building opportunities for African regulators. As a result regulatory processes and decisions may not meet current needs. The authors recommend that countries institute formal twinned regulatory reviews, fund Centres of Regulatory Excellence in each of Africa’s main regions and conduct a strategic review of WHO drug pre-qualification disease and product priorities.

Registering new drugs for low-income countries: The African challenge
Moran M, Strub-Wourgaft N, Guzman J, Boulet P, Wu L et al: PLoS Medicine 8(2), 1 February 2011

In this study, the authors argue that an optimal drug registration approach for Africa should reliably evaluate safety, efficacy, and quality of drugs for African use. It should include African expertise, contribute to building African regulatory capacity, and, ultimately, expedite African access by reducing duplicative and sequential reviews by different regulators. However they present an overview of the current situation that shows the present system of drug approval to be far from achieving these goals, with inefficiencies in the use of regulatory resources and in the uptake of capacity-building opportunities for African regulators. As a result regulatory processes and decisions may not meet current needs. The authors recommend that countries institute formal twinned regulatory reviews, fund Centres of Regulatory Excellence in each of Africa’s main regions and conduct a strategic review of WHO drug pre-qualification disease and product priorities.

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