This report by the United Nations assesses global progress towards meeting Millennium Development Goal (MDG) 8: Develop a global partnership for development. According to the report, only five member countries of the Development Assistance Committee have met their pledge, made in 2005, to pay 0.7% of their gross national as official development assistance, representing a major shortfall in funding. Market access (trade) has not improved, for developing countries, with no reductions in tariffs and no agreements having yet been reached at the Doha negotiations. The debt situation of many developing and transition economy countries deteriorated during the financial and economic crisis owing to the slowing down of the global economy and the fall in trade, remittances and commodity prices. In terms of access to affordable essential medicines, the report urges countries without significant pharmaceutical manufacturing capacity to take advantage of flexibilities in the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to import affordably priced essential medicines or, if they have the capacity, to produce generic pharmaceuticals and promote foreign investment to acquire new technologies for producing the medicines. With regard to new technologies, disparities between developed and developing countries remain. Large regional disparities in the use and uptake of information and communication services also persist. For instance, access to the Internet at broadband speeds remains very low in developing countries and is practically negligible in less-developed countries.
Health equity in economic and trade policies
This report was prompted by tailings dams disasters and rising global concerns about the safety, management and impacts of storing and managing large volumes of mine tailings. The report laments that although the number of dam failures has declined over many years, the number of serious failures has increased, despite advances in the engineering knowledge that can prevent them. The report makes two recommendations that can help the industry to eliminate tailing dam failures. Firstly, it calls for a “safety-first” approach to tailings storage that should be reflected in both management actions and on-the-ground operations. The report also recommends establishing a UN Environment stakeholder forum to facilitate international strengthening of tailings dam regulation. These approaches could include establishing a database of mine sites, identifying best practice and developing technical solutions to the main causes of failure. The assessment also discusses how mining firms can adopt cleaner processes, new technologies and re-use materials in order to reduce waste.
In this policy brief, the authors argue that mineral wealth can be harnessed for equitable and sustainable development if countries: design and implement comprehensive, inclusive and rights-based social policies; build strong democratic institutions; and develop the policy space to foster productive diversification while safeguarding macroeconomic stability. Public revenues generated through mineral production can provide a starting point for building state capacity that delivers on economic and social development objectives. States should enhance their capacity to strategically mobilise and allocate resources, the authors argue, as well as enforce standards and regulations, and establish social pacts through funding, delivering and regulating social services and social programmes. For countries that are dependent on mineral revenues, social policy is a crucial instrument to harness the development potential of mineral wealth while helping to avoid the pitfalls associated with the resource curse.
This paper aimed to investigate the relationship between mining and tuberculosis (TB) in sub-Saharan Africa. The authors used multivariate regression to estimate the contribution of mining activity to TB incidence, prevalence, and mortality, as well as rates of TB among people living with HIV, with control for economic, health system, and population confounders. Mining production was associated with higher population TB incidence rates, with an increase of mining production of 1 SD corresponding to about 33% higher TB incidence or 760 000 more incident cases, after adjustment for economic and population controls. Similar results were observed for TB prevalence and mortality, as well as with alternative measures of mining activity. Independent of HIV, there were significant associations between mining production and TB incidence in countries with high HIV prevalence and between log gold mining production and TB incidence in all studied countries. The authors conclude that mining is a significant determinant of countrywide variation in TB among sub-Saharan African nations. Comprehensive TB control strategies should explicitly address the role of mining activity and environments in the epidemic.
This paper examined sulphur dioxide (SO2) emission trends, emission regulations and residents’ perceived health risks from exposures to such emissions at Selous Metallurgical Complex platinum group metal smelting facility in Zimbabwe. SO2 data from roof monitoring sites at the smelter furnace were aggregated into annual, quarterly and monthly emission trends from 2008 to 2015. The regulatory regime’s ability to protect human health from SO2 pollution in communities located around the smelter was examined. Questionnaire responses to perceived health risks from SO2 exposure from 40 purposively sampled residents were assessed. Between 2008 and 2015, annual SO2emissions increased from 7951 to 2500 tonnes. Emissions exceeded the recommended standard limit of 50 mg/Nm3, presenting considerable adverse health risks to local residents. Concerns relating to inefficient environmental impact assessment licensing system, poor monitoring and auditing by the environmental management agency, as well as non-deterring SO2emission exceedance penalties were identified as major drivers of emission increase. Thirty-two of the forty respondents perceived exposure to SO2 emissions as adverse and the cause of their illnesses, with coughing, nasal congestion and shortness of breath the most frequently self-reported symptoms. A set of legally-binding SO2 emission standards supported by stringent environmental impact assessment licensing arrangements for smelting industries are suggested for development and enforcement to reduce the SO2 emission problem. Community participation in SO2 emissions monitoring was also proposed as a core part of sustainable environmental management in communities located around smelters.
In a statement People's Health Movement (PHM) and Medicus Mundi International (MMI) pointed out the weaknesses of the draft roadmap established by the WHO for an enhanced global response to the adverse health effects of air pollution. In it, they argue that this draft misses an analysis of the current economic and trade-related rules that would prevent the establishment of a robust plan of action. PHM and MMI see serious barriers for the transfer to clean technologies due to the continuing pressure for higher levels of intellectual property protection and investor state dispute settlements in trade agreements. PHM and MMI urge member states to insist on a more strategic and focused approach to the social and economic determinants of air pollution and to address these fundamental issues.
Parliamentarians are pressurising Uganda to revoke the interim trade agreement signed between the European Union and the East African Community. The Ugandan MPs claim the partial Economic Partnership Agreement (EPA) signed at the close of last year entrenches 'unfair treatment' of the five-member bloc. The Parliamentary Committee on Trade, Industry and Tourism is presently evaluating the significance of the trade relationship with EU, following a petition from over a dozen civil society groups.
The international medical NGO, Medecins Sans Frontieres (MSF), is urging G8 nations and the UN to push for speedy delivery of the cheapest and latest anti-AIDS drugs to developing countries. MSF stressed that this was vital to head off a looming supply and cost crisis, because "access to newer drugs is increasingly critical, as the growing number of people with HIV/AIDS currently on treatment will inevitably develop resistance to first-line treatments".
The Indian government's efforts to bring in affordable patented medicines for chronic and lifestyle ailments, may hit a roadblock with multinational companies trying to stall the move. The mechanism would have increased affordability of drugs like Tarceva, Herceptin, Pegasys and Januvia used for treatment of chronic ailments, which at present are exorbitantly priced. Government put forth a model to multinational pharmaceutical companies, which has not met with much enthusiasm from the industry. It asked them to ensure that patented drugs introduced in the country are priced cheapest here than anywhere in the world. Significantly, the recommendations say that patented block-buster drugs that have no substitute in the market and offer substantial therapeutic benefit should be offered at prices 40% to 70% cheaper than the maximum retail price through the public health system.
The Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising, adopted on 29 October 2010 and the Convention of Biological Diversity (CBD), both have implications for the WHO intergovernmental dialogue on influenza preparedness and virus sharing. Article 8 requires countries to ‘pay due regard’ to ‘cases of present or imminent emergencies that threaten or damage human, animal or plan health’. Article 4 calls for ‘due regard’ to be paid to ongoing work or practices, provided such work or practices are supportive of and do not run counter to the objectives of the Convention of Biological Diversity (CBD) and the Protocol. The CBD and protocol are important as they have a legally binding status as they are treaties. Notably the United States is not party to the CBD.