Health equity in economic and trade policies

Trade talks between the European Union and southern African countries have opened up serious differences between Europe and South Africa, and between South Africa and her neighbours. At the heart of the difficulties are the Economic Partnership Agreements (EPAs) which countries of the African, Caribbean and Pacific (ACP) grouping are negotiating to get preferential access to European markets. A number of southern African countries have just signed an Interim EPA (IEPA) with Europe but South Africa has baulked at signing, threatening the future of the Southern African Customs Union – the world's oldest.Resolving the difficulties will require a lot of political will and sensitivity from both South Africa and the EU, writes AllAfrica guest columnist Nkululeko Khumalo of the South African Institute of International Affairs.

In recent years there have been enormous changes in our technology, our economy, and our society. But has there been progress? asks economist Joseph Stiglitz. In the countries that have been less successful, globalization is often viewed with suspicion. "As I have argued elsewhere, there is a great deal of validity to the complaints of those who are discontent. In much of the world, there has been in recent years a slowing of growth, an increase in poverty, a degradation of the environment, and a deterioration of national cultures and of a sense of cultural identity."

The authors have done a comparative study of revenue allocation in mineral-rich contexts, looking at existing criteria and reform modalities adopted to allocate and use EI revenues and examining the political bargains that enabled such distribution. The authors contend that two factors are crucially important - and explanatory of - devolution of revenues to subnational jurisdictions: the bargaining power of subnational actors as well as their connectedness to the central politics.

According to this report by Oxfam, poor-quality, or ‘substandard’, medicines threaten patients and public health in developing countries. Prioritisation of medicines regulation by developing-country governments, with the technical and financial support of rich countries, is badly needed. However, under the guise of helping to address dangerous and ineffective medicines, rich countries are pushing for new intellectual-property rules and reliance on police – rather than health regulatory – action. This approach will not ensure that medicines consistently meet quality standards. Worse, new intellectual property rules can undermine access to affordable generic medicines and damage public health. Oxfam argues. Developing countries must improve medicines regulation – not expand intellectual-property enforcement – in order to ensure medicine quality. Oxfam recommends that developed-country governments should expand funding and support for national and regional initiatives that increase the ability of drug-regulatory authorities in developing countries to protect their populations from harmful products, and stop pursuing TRIPS-plus enforcement measures (intellectual property rules that exceed minimum obligations under global trade rules) through internal regulations, multilateral trade initiatives, bilateral trade agreements, or through technical assistance. Developing-country governments should prioritise the expansion of public health-care infrastructure and invest in drug-regulatory authorities' capacity together with the provision of free essential medicines, as well as promote generic competition in national medicines policies, including implementation of TRIPS flexibilities in national laws, and reject initiatives modeled on ACTA, and any other TRIPS-plus enforcement initiatives. Oxfam calls on the World Health Organisation (WHO) to prioritise its comprehensive programme of work, which underpins access to affordable, quality medicines for its Member States, and disband IMPACT, the controversial task force that inappropriately uses an intellectual property framework to evaluate the public-health problem of unsafe medicines. Oxfam also calls on pharmaceutical companies to adhere consistently to WHO quality standards and to recognise the damage inflicted on public health as a result of the confusion of quality with intellectual-property issues in initiatives such as IMPACT, and correct this fundamental error in their public statements and documents.