Malaria Fight, a Must for EU’s FTT Earmarking

 

Pending or already made cuts in foreign aid expenditure are threatening the gains achieved in malaria control and prevention. Revenues from a Financial Transaction Tax (FTT) would be a suitable resource for the European Union (EU) to partly allocate to Global Fund needs for malaria fight.  As such, by including malaria in FTT revenues earmarking the EU would take on unprecedented solidarity and better the coherence of its policies, strategies and practices.

 

Malaria Fight, a Must for EU’€™s FTT Earmarking

by DanielDionisio*

 

WHO figures highlight that since the United Nations laid down its Millennium Development Goals in 2000, the mortality rate from malaria has dropped 25% worldwide and 33% in Africa, where 90% of malaria-related deaths occur. And 50 countries around the world are  on track to reduce their malaria case incidence rates by 75% by 2015 –€“ in line with World Health Assembly and Roll Back Malaria targets. 

Meanwhile, the Global Fund has been delivering nearly half of the whole financing for malaria prevention and control.

However, currently pending or already made cuts in foreign aid expenditure , bound up with the global economic slump, are threatening progress.

These prospects would heavily impact on the fact that malaria still kills about 655,000 people every year and sickens millions more, at a time when the scourge is worsening in some of sub-Saharan Africa’€™s countries, such as the Democratic Republic of Congo and Nigeria, where the assessment of malaria situation is hard because of insufficient monitoring.

Admittedly, the downfall of international aid sounds like a mockery now that the cost of malaria fighting is definitely within grasp. Indeed, drying up stagnant pools of water where mosquitoes breed and securing insecticide-treated bed nets, which are the cornerstone of malaria wane, are no doubt cheap and affordable procedures.

But, based on the need of uninterrupted medicine supplies, which adds to requirements of  public awareness maintenance and bed nets recurring replacement for prevention, even small funding cuts could undermine headway.

As such, it is really bad news that a just passed EU slimmer budget could cost, EU parliament approval pending, more than €10 billion aid cutback for 2014 to 2020 period. Astonishingly, this runs against EU’€™s engagement as the world’€™s largest aid donor until now.

And this occurs at a time when budget constraints in traditional donor countries worldwide  are already putting foreign aid effectiveness at risk.

 As a result, health organisations are foreseeing heavy cuts in aid financing including to malaria prevention and control.

As reported, Global Fund estimates foreshadow that disbursement from main supporters  -€“ which encompass the European Commission (EC), EU member states, the United States and Japan -€“  will turn down from US$ 3.5 billion in 2012 to US$ 3.3 billion in 2013. Estimates also  warn that funding from private donors is turning down as well, from US$ 181.6 million to US$ 164 million, meaning 6% decline.

Margaret Chan, director-general of the WHO, recently called for more engagement from backers in the battle against malaria. In the latest World Malaria Report, she wrote “…the available funding still falls short of the resources required to reach the health-related Millennium Development Goals and other internationally-agreed global malaria targets. An estimated US$ 5.1 billion is needed every year between 2011 and 2020 to achieve universal access to malaria interventions. At present, only US$ 2.3 billion is available, less than half of what would be needed. There is an urgent need to identify new funding sources in order to further scale up and sustain malaria control efforts, and to protect the investments made in the last decade. We also need to examine new ways to make existing funds stretch further by increasing the value for money of malaria commodities and the efficiency of service delivery…”€.

On the same wavelength, the African Leaders Malaria Alliance (ALMA) warned at its 28 January 2013  gathering in Addis Ababa that malaria could break out again in many countries should the funding gaps go unfilled. That could actually wipe out already achieved gains.

Inherently, the ALMA meeting stressed that “€œchildren with no immunity who have been protected over the past three years are beginning to get exposed, and the number of malaria cases among young children is expected to increase significantly this year if replacement nets do not come”€.

And since the Global Fund has been the leading actor in malaria control worldwide, ALMA asked on world leaders to back the Global Fund’€™s efforts  to collect monies for 2014 to 2016 period, as a key move in preserving the benefits already attained.

So, it comes as no surprise that in the aftermath of a January 2013 approval by 11 EU countries of an agreement to set up a financial transactions tax (FTT), development cooperation organizations called on the EC to align with France by devoting 10% of the revenues “€œto the benefit of the poorest in the world”.

Relevantly, while the EC has now to submit a proposal on how to earmark FTT revenues, Algirdas Semeta, the EU Commissioner for taxation, recently said that “the considerable new revenues” the tax will generate ” (estimated at €37 billion per year) could be used for growth-friendly investment”, and to back broader commitments such as aid to poor countries.

To the point, FTT revenues would be a suitable resource for the EU to partly allocate to Global Fund needs for malaria fight.

In this regard, although the Global Fund was among the top recipients of EU contributions in 2011, the EU should scale up its support now that the Fund still suffers from cash  shortage.

As such, by including malaria in FTT revenues earmarking the EU would take on unprecedented solidarity and better the coherence of its policies, strategies and practices.

As a fitting step, this move would offset feeling that the EU global plan for health, development cooperation seemingly falls short of adequate coherence, innovative financing and collaboration with interested parties, while commitment in R&D for poverty-related neglected diseases is not spread evenly between member states and only totals 0.0024% of EU’€™s combined GDP.

Actually, adding to a December 2012 call by the Executive Director of Roll Back Malaria Partnership for “…new financing mechanisms..”€ including “.€œ.. financial transactions taxes…”€, ALMA leaders convened at the Addis Ababa meeting  jointly asked for “…innovative financing mechanisms, including introducing levies on financial transactions…”€ to further scale up and sustain malaria control efforts.

But, is the EU leadership ready to put these requests into effect while seriously  taking development groups’€™ question into account “€œWhy are EU leaders saying they support aid commitments, then not defending them in EU budget talks?”€

 

*Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is advisor for “Medicines for the Developing Countries”€ for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). 

 

 

 

 

 

 

 

FARMACI ESSENZIALI E MALATTIE TRASCURATE; UN’ESPERIENZA DIDATTICA SULLA SALUTE GLOBALE

Lo scorso 8 febbraio si è conclusa, presso l’€™Università  di Ferrara, la 9a edizione del corso “€œFarmaci essenziali e malattie trascurate”€. Il corso, dedicato agli studenti di Farmacia ma aperto a chiunque abbia interesse per gli argomenti trattati, consiste in un ciclo di seminari sul tema dell’accesso alle cure da parte delle popolazioni svantaggiate

 FARMACI ESSENZIALI E MALATTIE TRASCURATE

UN’€™ESPERIENZA DIDATTICA SULLA SALUTE GLOBALE

a cura di Anna Siniscalchi*, farmacologa dell’€™Università  di Ferrara

 

Lo scorso 8 febbraio si è conclusa, presso l’€™Università di Ferrara, la 9a edizione del corso “€œFarmaci essenziali e malattie trascurate”€. Il corso, dedicato agli studenti di Farmacia ma aperto a chiunque abbia interesse per gli argomenti trattati, consiste in un ciclo di seminari sul tema dell’€™accesso alle cure da parte delle popolazioni svantaggiate.

Gli obiettivi e la struttura

L’€™idea del corso è nata dalla constatazione dell’€™esigenza dei docenti/ricercatori e degli studenti universitari di non concentrarsi solo sul raggiungimento dei propri obiettivi immediati – il superamento degli esami o le proprie ricerche – ma di aprirsi ad altre esperienze e interessi culturali. Il tema della salute richiede competenze versatili e informazioni trasversali: ai futuri farmacisti, che studiano i farmaci in tutti i loro aspetti, dalla struttura chimica agli effetti biologici, alla formulazione e alle norme che ne regolano la dispensazione, interessano anche gli aspetti sociali, politici ed economici che vi ruotano intorno. In modo simile i futuri medici e operatori sanitari, studiando le diverse patologie e le terapie opportune, sentono la necessità  di occuparsi anche della questione del diritto alla salute.

Il primo obiettivo del corso è di attirare l’attenzione degli studenti sulla questione della non disponibilità  dei farmaci per le popolazioni più povere, far riflettere che non tutti coloro che hanno mal di denti, o un’€™infezione, o l’€™AIDS, possono entrare in una farmacia o in un ambulatorio e uscire con l’€™antidolorifico o l’€™antibiotico o l’€™anti-retrovirale.

Il secondo obiettivo è interrogarsi sull’€™origine di questa diseguaglianza e fornire informazioni documentate, provenienti da diversi approcci culturali, sugli strumenti e i livelli di intervento necessari per azzerarla con grande urgenza.

Oltre a docenti dell’€™Università  di Ferrara e di altre Università , sono stati coinvolti nella realizzazione del corso relatori provenienti da diverse istituzioni e organizzazioni: Istituto superiore di sanità , Croce rossa italiana, Osservatorio italiano sulla salute globale, senza dimenticare l’€™industria farmaceutica. La collaborazione con Medici senza frontiere, impegnati nella loro Campagna per l’€™accesso ai farmaci, è stata preziosa fin dalla prima edizione.

Gli studenti hanno risposto con grande interesse e partecipazione, seguendo il corso in gran numero (oltre 1800 iscritti a partire dall’€™anno accademico 2004-05) e intervenendo spesso alla discussione dei temi trattati.

Per non disperdere il patrimonio di contributi raccolti, è stato pubblicato il volume “€œL’€™accesso ai farmaci nei paesi in via di sviluppo. Approfondimenti interdisciplinari su un’€™emergenza sanitaria”€ (A. Siniscalchi & P. Bergamini Eds., UnifePress, 2010), che si pensa ora di aggiornare e riproporre in una nuova edizione.

L’€™edizione 2013

La prima giornata è stata dedicata agli aspetti giuridico-economici. Serena Forlati, del Dipartimento di Giurisprudenza dell’Università  di Ferrara, ha trattato il tema “€œLa salute come diritto umano”€, tracciando la storia dei diritti umani e del riconoscimento del diritto alla salute, a partire dalla Dichiarazione universale dei diritti umani e dalla Costituzione dell’€™Organizzazione mondiale della sanità (OMS), alla Dichiarazione di Alma Ata, al Patto delle Nazioni unite per i diritti economici, sociali e culturali, sottolineando tuttavia che i meccanismi di controllo a livello internazionale non sono molto efficaci.

Marika Macchi, del Dipartimento di Scienze dell’€™Economia e dell’€™Impresa dell’€™Università  di Firenze, ha parlato di proprietà  intellettuale, di brevetti e delle recenti opportunità  offerte dai sistemi open source, che potrebbero essere applicati anche ai prodotti farmaceutici.

La seconda giornata è stata dedicata ai temi che danno il titolo al corso: Anna Siniscalchi ha illustrato la lista dei farmaci essenziali dell’€™OMS e le malattie neglette. Si è parlato poi del percorso di ricerca e sviluppo (R&S) del farmaco: dall’€™individuazione del target, alla sua validazione, alla sperimentazione preclinica e clinica, sottolineando gli aspetti etici, nonchè i tempi e i costi legati all’€™intero processo. In particolare, è stata illustrata la ricerca di base volta allo sviluppo di nuovi farmaci per le tripanosomiasi e la leishmaniosi, che Maria Paola Costi svolge al Dipartimento di Scienze della vita dell’€™Università  di Modena e Reggio Emilia.

La terza giornata ha visto l’€™intervento di Medici senza frontiere: Stella Egidi ha illustrato le campagne su cui si concentra attualmente l’€™associazione, dai conflitti alla malnutrizione, dalla lotta all’€™AIDS, malaria e tubercolosi, ai problemi delle formulazioni pediatriche e dell’€™incremento delle malattie croniche. Sara Gaspani ha approfondito il tema delle contraffazioni e dei farmaci substandard, ha trattato di quality assurance e del programma di prequalificazione OMS, sottolineando la necessità  di rafforzare i controlli e le agenzie regolatorie. Donata Rodi, dell’€™Università  di Ferrara, ha posto l’€™accento sul problema delle malattie non trasmissibili, riportando dati epidemiologici sull’€™epilessia, che in molti Paesi non è opportunamente curata, ed è causa di esclusione e stigma.

La quarta giornata è stata dedicata ai vaccini, con l’€™intervento di Laura Pacifici (Croce rossa), che ha esposto le ragioni dell’€™insuccesso della campagna di vaccinazione antipolio in Pakistan e delle violenze che si sono verificate. Flavia Riccardo, dell’€™Istituto superiore di sanità , ha invece discusso del problema dell’€™accesso alle cure e ai servizi sanitari, e in particolare alle vaccinazioni, da parte delle popolazioni migranti in Italia, distinguendo fra popolazione migrante residente, richiedenti asilo, migranti irregolari.  Francesco Nicoli, dottorando in International Health presso la LMU di Monaco di Baviera, ha illustrato la propria esperienza di ricerca clinica svolta in Tanzania, su 96 pazienti HIV+, con lo scopo di correlare il loro status immunologico con i livelli di anticorpi contro Tat.

L’€™ultima giornata ha visto la partecipazione di Nicoletta Dentico (Osservatorio italiano sulla salute globale) e di Mario Ottiglio (International Federation of Pharmaceutical Manufacturers & Associations) che hanno dibattuto su possibili soluzioni atte a rendere accessibili le cure, con un particolare accento sui partenariati pubblico-privati per lo sviluppo di nuovi prodotti farmaceutici (PDP).

Nicoletta Dentico ha compiuto un breve excursus storico sulle politiche sanitarie, con il passaggio progressivo da un approccio fondato sulle politiche pubbliche ed i piani nazionali degli anni ‘€™60 e ‘€™70, ai processi di privatizzazione degli anni ‘€™80 e ‘€™90, fino all’€™insorgere del “€œfilantro-capitalismo”€ in risposta al fallimento del mercato e delle politiche pubbliche. Si è poi soffermata sulle PDP, sottolineandone il ruolo determinante in termini di  leadership scientifica e di identificazione delle linee di R&D da seguire, senza dimenticare tuttavia la necessità  di coinvolgere direttamente i Paesi endemici e l’€™OMS.

L’€™impegno dell’€™industria farmaceutica sul fronte delle malattie neglette è stato esposto da Mario Ottiglio che, dopo aver ribadito i costi elevati di R&S di nuovi farmaci, ha riportato dati aggiornati sull’€™incremento sia di investimenti in R&S, sia di donazioni da parte dell’€™industria, e sul suo coinvolgimento in numerosi progetti anche di PDP.

La giornata si è conclusa con il contributo diretto degli studenti, che hanno partecipato alla discussione generale sui temi trattati, animata da Umberto Pizzolato, di Medici senza frontiere.

————————————————————–

Anna Siniscalchi, professoressa di Farmacologia all’€™Università  di Ferrara, ha svolto attività  di ricerca nell’€™ambito delle Neuroscienze, documentata da numerose pubblicazioni su riviste internazionali. I suoi studi riguardano  i meccanismi di neurotrasmissione in condizioni fisio-patologiche  e le variazioni indotte da farmaci neuroattivi. Oltre agli insegnamenti di Farmacologia e di Tossicologia, impartiti nella Facoltà  di Farmacia, ha coordinato il Corso “€œFarmaci essenziali e malattie trascurate”€, nel quale sono trattati i temi del diritto alla salute e dell’€™accesso alle cure, con particolare riferimento alle popolazioni economicamente svantaggiate. E’€™ membro dell’€™Osservatorio Italiano sulla salute globale.

News Link n. 37

 

 

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 37 

Elections in Italy: Where do parties stand on foreign aid? 

What will universal health coverage actually cover? 

Who Should Pay for Global Health, and How Much?

WHO/World Bank convene ministerial meeting to discuss best practices for moving forward on universal health coverage

Global Fund News Flash: Issue 14 

Food Sovereignty: Think Globally, Eat Locally

John Kerry to USAID: ‘Deeply, deeply committed’

What We’re Looking For in the IOM Report on PEPFAR 

Meeting the President’s Challenge to End Extreme Poverty

David Cameron considers diverting foreign aid   

Key Eurozone banks step back from food speculation 

IMF fails to find consensus on quota formula reform 

Girls & women: New education project to transform lives 

Working Toward Polio Eradication In 2018  

Cell phones can speed up malaria treatment in remote areas 

Report On First Round Of Projects Of Seed Treaty Benefit-Sharing Fund

WIPO Side Event Addresses Recent Developments Related To The Nagoya Protocol  

Event Explains Partnerships In Natural Products Research Through Thai Experience With Novartis 

Fast New Test Could Find Leprosy Before Damage Is Lasting 

DNDi Latin America receives 2013 Carlos Slim Award for Innovations in Neglected Disease Drug Development  

Medicines Patent Pool Recognised in WHO, WIPO, WTO Study on Health and Access to Medicines

UN Takes On Organised Crime And Fraudulent Medicines 

Lack of access to technology ‘hampers detection of substandard drugs’

Strengthening global action against poor quality drugs 

Healthcare still disrupted in the Central African Republic 

Trade Commissioner: EU To Seek GIs In US FTA, But No New ACTA

 

 

News Link n. 36

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 36

Salute e sanità a Cuba (parte I) 

Salute e sanità a Cuba (parte II) 

Drugmakers eye Africa’s middle classes as next growth market 

Letter Shows US Pressure On Global Fund For Compulsory Licensing, Generics 

President Obama Delivers SOTU Address, Mentioning Trade Agreements, AIDS-Free Generation  

Obama Takes Swipe At Patent Trolls In Call For Further Reform

Indian generics in need of policy tonic

La rappresentanza decentrata della Cooperazione italiana nei Paesi in via di sviluppo  

Medici italiani in Africa

New findings offer systemic solutions to address non-communicable diseases (NCDs) in low- and middle-income countries

UNDP chief calls for ‘permanent’ focus on NCDs 

Texts Show Details Of EU Parliament Transparency Directive Vote   

Piebalgs urges EU countries to fill the gap on development aid 

What Does the Future Hold for EU Aid? 

Q&A: FGM Is About Culture, Not Religion 

International Day of Zero Tolerance to FGM: Working Together To End a Devastating Practice

Women’s lives put at risk in India by private healthcare providers 

India’s Leadership Furthers Global Child Survival Movement   

Financing Global Health: the Story is Stagnation

Justine Greening: Development in transition

UK Appoints IP Attaché To ASEAN Countries 

A step closer to realising the potential of agroforestry

An online debate about the UN General Assembly vote in favour of Universal Health Coverage   

Lamy: Coherence between health, intellectual property and trade key to access to medicines  

 

 

 

 

 

 

 

 

 

News Link n. 35

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 35

Catherine Feeney: Business unusual at WFP  

EU budget deal freezes foreign aid spending   

Promoting Access to Medical Technologies and Innovation

WHO   expert   says   too   many   women   dying   from   preventable   deaths 

My Hope for 2030: Building a Vision for Women and Girls 

Gender equality ‘central’ to all other development, say women’s groups 

How fake drugs cause the spread of untreatable TB in developing countries  

Feeding a Disease With Fake Drugs  

TB vaccine trial disappoints 

Tánaiste: What Europe Needs Now Is Certainty   

Polio Talks At WHO Board: Between Progress Made, The Final Push And The Role Of Partnership  

When India Works  

GAVI funds vaccines to protect girls against cervical cancer 

UE: una buona salute per tutti  

FAO: New GMOs Rising In Developing Countries; Public Sector Key

Expiring GMO Patents Raise Regulatory Issues; Private Sector Takes Measures 

IMF moves on voting reform, division lin 

How Much Health Foregone? 

Tackling Non-Communicable Diseases In Low- and Middle-Income Countries: Is the Evidence from High-Income Countries All We Need?

 

 

News Link n. 34

 

The news links are part of the research project GESPAM (Geopolitica, Salute Pubblica e Accesso alle Medicine/Geopolitics, Public Health and Access to Medicines), which aims to focus on the best options for the use of trade and government rules related to public health by resource-limited countries.

 

News Link 34

What happened in Davos https://www.devex.com/en/news/80207/print

Threatened aid cuts seen as big blow to malaria fight   http://www.euractiv.com/development-policy/health-experts-fear-aid-cuts-har-news-516905

FTT deal ignites debate on how to allocate funds http://www.euractiv.com/development-policy/meps-advocacy-groups-hail-ftt-ne-news-517262

Much talk, few results? African Union summit ends   https://www.devex.com/en/news/80214/print

Presidential Inbox: Integrating Global Health Into the Pivot Strategy   http://blogs.shu.edu/ghg/2013/01/28/presidential-inbox-integrating-global-health-into-the-pivot-strategy/ 

Could China and Its Fellow BRICS Nations Lead the Way on Climate Change?  http://blogs.cgdev.org/globaldevelopment/2013/01/could-china-and-its-fellow-brics-nations-lead-the-way-on-climate-change.php

Human resource development and capacity-building during China’s rapid scale-up of methadone maintenance treatment services  http://www.who.int/bulletin/volumes/91/2/12-108951.pdf 

Africa: Supporting Women in Agriculture for a ‘Prosperous’ Africa  http://allafrica.com/stories/201301291552.html?mkt_tok=3RkMMJWWfF9wsRouvKzOZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YYDTMB0dvycMRAVFZl5nQhdDOWN

Genetic Resources And Traditional Knowledge : Getting The Rules Right For Agriculture: A Key Challenge For WIPO’s IGC  http://www.ip-watch.org/?p=26071&utm_source=post&utm_medium=email&utm_campaign=alerts

FAO and TABLE FOR TWO to fight hunger and poverty  http://www.fao.org/asiapacific/rap/home/news/detail/en/?news_uid=169043&mkt_tok=3RkMMJWWfF9wsRouvKXIZKXonjHpfsX87%2B0uX6%2Bg38431UFwdcjKPmjr1YYDTsN0dvycMRAVFZl5nQhdDOWN

David Owen’s NHS bill offers a final chance to save our health service   http://www.newstatesman.com/politics/2013/01/david-owens-nhs-bill-offers-final-chance-save-our-health-service 

Potential Elements Of The WHO Global R&D Treaty: Tailoring Solutions For Disparate Contexts http://www.ip-watch.org/?p=25957&utm_source=post&utm_medium=email&utm_campaign=alerts 

WHO Executive Board Concludes After ‘Unpredecented’ Workload  http://www.ip-watch.org/2013/01/30/who-executive-board-concludes-after-unpredecented-workload/print/

WHO Board Approves Resolution On Neglected Diseases; Sets Next Meeting On Substandard Medicines http://www.ip-watch.org/?p=25932&utm_source=post&utm_medium=email&utm_campaign=alerts

Debate Erupts At WHO Over “Consensus” On Financing R&D For The Poor  http://www.ip-watch.org/?p=25910&utm_source=post&utm_medium=email&utm_campaign=alerts

Governments Put WHO’s Independence At Heart Of Reform Debate  http://www.ip-watch.org/?p=25892&utm_source=post&utm_medium=email&utm_campaign=alerts

World Bank Group President Jim Yong Kim Speech on Anti-Corruption at the Center for Strategic and International Studies  http://www.worldbank.org/en/news/speech/2013/01/30/world-bank-group-president-jim-yong-kim-speech-anti-corruption-center-for-strategic-and-international-studies 

The private sector: A critical but misused partner   https://www.devex.com/en/news/80187/print

 

 

 

 

 

Pending Cutback In EU Spending For Development Cooperation

The European Commission's claims of support for development cooperation contrast with budget cuts for aid, raising doubts about the EU'€™s real will and ability to address today'€™s overall challenges and push for inclusive and sustainable development
 Pending Cutback In EU Spending For Development Cooperation

By Daniele Dionisio [1]

The European Commission (EC) released on 29 June 2011 a budget proposal for 2014-2020, where €70 billion is allocated to the heading “€œGlobal Europe,”€ which covers the European Union (EU)’€™s operating plan in the world, including development and humanitarian aid [2]. However, the latest draft proposal laid down by Council President Herman Van Rompuy sharply cuts back [3] development aid and humanitarian assistance by almost €10 billion, to €60.6 billion.

And word is spreading that foreign aid cuts could include a €3.3 billion cut [4] to the European Development Fund (EDF), the largest part of the EU aid budget aimed at African countries.

Moreover, although the EU just adopted a friendly 2013 budget for development cooperation [5], compared with 2012 spending levels, shortfalls are reportedly expected [6] since the budget would fall short as to EC estimates for 2013.

As such, the negotiations for the broader 2014-2020 EU budget continue to be mired in uncertainty [7] by ongoing gridlocks and frictions within governments and institutions. Overall, while affluent EU countries push to either freeze spending or slash budget off the Commission’€™s proposal, other countries, in unison with the Commission and European Parliament, want to increase spending [8].

Meanwhile, development groups claim that proposed cuts to the Global Europe heading are “€œfurther disproportionate [9]”€. They are asking “€œWhy are EU leaders saying they support aid commitments, then not defending them in EU budget talks?”€

These circumstances add room for mistrust about coherence and reliability the EU seemingly laid down in a Joint Africa-EU Strategy [10] as a long-term partnership between EU and the African Union (AU) Commission to finance a series of development goals, including the AU-administered Research Grant Programme [11] to build science and technology development in Africa. Yet, despite EC commitment, a 2014-2020 renewal of funding for this programme is at risk owing to competing EU priorities.

This landscape does not bode well as regards EU steadiness in collaborating with the newly launched AU’€™s Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa [12], which aims at reducing the dependency of African countries on international financing for health, medicines and R&D, and promoted African-owned solutions.

These concerns add to criticism that the EU is becoming more protectionist [13] in agriculture, trade and aid areas, where a number of EU member states seemingly use foreign aid as a “€œbargaining chip”€ for or against priorities such as the Common Agricultural Policy (CAP). [4]

Relevantly, the cutback proposed by Van Rompuy has drawn criticism of disproportionally cracking down on issues including EDF, than for spending on CAP. And substantial reform of EU’€™s agricultural subsidies [13] is being called for.

Criticism is significant now that nongovernmental organizations in EU and ACP (Africa, the Caribbean and the Pacific) countries recently alerted to the risk [14] that the EU development agenda could divert aid funds away from the poorest people and negatively affect the foundation of the Cotonou Agreement [15], the guiding framework of EU-ACP cooperation.

This couples with fear that terms threatening access to medicines by the worst-off people could be approved in forthcoming negotiations for an EU-Thai agreement [16], and in an EU-India trade deal [17] now on track to conclusion [18].

This includes displeasure bound up with the controversial EU involvement in the Anti-Counterfeiting Trade Agreement [19] (or ACTA).

And it comes as no surprise that all of this occurs at a time when the EU global plan for health, development cooperation seemingly falls short of [20] adequate coherence, innovative financing and collaboration with interested parties, while commitment in R&D for poverty-related neglected diseases (NDs) is not spread evenly between member states and only totals 0.0024% of EU’€™s combined GDP [21].

Relevantly, the EU just succeeded in opposing [22] any mention of the Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) report and recommendations [23] (including a medical R&D treaty, innovative financing sources and the de-linkage of R&D cost from the price of health products) in the lame resolution EB132/R7[24] [pdf] on NDs passed at WHO Executive Board meeting which took place 21-29 January 2013.

The conflicting issues above raise doubts about EU’€™s real will and ability to address today’€™s overall challenges and push for inclusive and sustainable development. Bridging these gaps would be a matter of priority and a way for the EU to gain indisputable leadership. To this aim, the EU should better the coherence of its policies, strategies and practices.

 

Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is reference advisor for “€œMedicines for the Developing Countries”€ for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). 

URLs in this post:

[1] Article previously published on Intellectual Property Watch: http://www.ip-watch.org/2013/01/31/pending-cutback-in-eu-spending-for-development-cooperation/  

[2] aid: http://www.euractiv.com/development-policy/georgieva-pledges-fight-prese…

[3] cuts back: http://static.euractiv.com/sites/all/euractiv/files/MFF%20Van%20Rompuy%2…

[4] €3.3 billion cut: https://www.devex.com/en/news/79771/print

[5] 2013 budget for development cooperation: http://www.europarl.europa.eu/resources/library/media/20121210RES04509/2…

[6] shortfalls are reportedly expected: http://europa.eu/rapid/press-release_MEMO-12-975_en.htm

[7] uncertainty: http://www.publicserviceeurope.com/article/2774/eu-leaders-fail-to-do-bu…

[8] spending: https://www.devex.com/en/news/79814/print

[9] further disproportionate: http://www.concordeurope.org/180-eu-budget-talks-forgetting-development-…

[10] Joint Africa-EU Strategy: http://www.consilium.europa.eu/uedocs/cms_data/docs/pressdata/en/er/9749…

[11] Research Grant Programme: http://hrst.au.int/en/rgp?q=rgp

[12] AU’€™s Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa: http://www.au.int/en/sites/default/files/Shared_Res_Roadmap_Rev_F%5b1%5d.pdf

[13] more protectionist: http://www.odi.org.uk/opinion/6953-european-union-eu-budget-common-agric…

[14] alerted to the risk: http://www.devex.com/en/news/78315/print

[15] Cotonou Agreement: http://ec.europa.eu/europeaid/where/acp/overview/cotonou-agreement/index…

[16] EU-Thai agreement: http://www.ipsnews.net/2012/12/thai-eu-fta-raises-alarm-for-people-with-…

[17] EU-India trade deal: http://www.ip-watch.org/2012/02/10/eu-india-summit-kicks-off-amidst-warn…

[18] conclusion: http://donttradeourlivesaway.wordpress.com/2013/01/14/india-receives-pos…

[19] Anti-Counterfeiting Trade Agreement: http://www.msfaccess.org/content/acta-and-its-impact-access-medicines

[20] falls short of: http://www.ip-watch.org/?p=24380&utm_source=post&utm_medium=email&utm_ca…

[21] is not spread evenly between member states and only totals 0.0024% of EU’€™s combined GDP: http://www.dsw-online.org/fileadmin/user_upload_en/PDF/GH_R_D_EU/Saving_…

[22] opposing: http://www.ip-watch.org/2013/01/28/who-board-approves-resolution-on-negl…

[23] report and recommendations: http://www.who.int/phi/cewg_report/en/index.html

[24] EB132/R7: http://apps.who.int/gb/ebwha/pdf_files/EB132/B132_R7-en.pdf

 

26 Years On: A Need for a Moral Revolution in Maternal Health Care

“True compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring.” 

 

26 Years On: A Need for a Moral Revolution in Maternal Health Care*

by AKU KWAMIE on JANUARY 22, 2013 Â· 

Research Fellow, Ghana Health Service/University of Ghana; Emerging Voice 2012

We gathered at the foot of Mount Meru for three days: 800 researchers, practitioners, advocates, policy-makers and donors, to discuss the state of quality maternal health care. The fact that we were congregated in one of the oldest inhabited regions on Earth, where women and girls had been dying in childbirth – for millennia – was not lost on the delegates.

The conference itself was a typical affair: well organised, with a steady stream of findings. Yet, the question of implementation – how do we actually do it – played on so many lips. There was palpable dissatisfaction that after CEDAW, Nairobi, Cairo, Beijing, we were still here. The maternal health community has been at this for a long time, even longer than the 26 years since the launch of the Safe Motherhood Initiative. When I canvassed my fellow delegates about their optimism – can we make it? – the collective response was overwhelmingly ‘yes’. Why? Because we have more technology, more attention, and more money than ever (attention and money are always nice). Of course progress has been made, yet we still have unanswered questions on an unfinished agenda.

To the clichéd, but true avowal that pregnancy is not a disease, our approaches remain depressingly biomedical. The belief that technology, signed declarations, or more money is the answer, is false. Listening to various presentations, I was reminded of his book The Honour Code, where philosopher Kwame Anthony Appiah discusses the role of honour in moving ‘moral revolutions’ forward. Appiah theorises that transforming societies happens when the integrity of that society’s honour is breached. He shows how this happens, citing examples like foot-binding, duelling, and even the trans-Atlantic slave trade. We change our practices when they come into conflict with honour. When our practices are no longer honourable, we can dismantle them quickly. Radically, this implies that all of our evidence, resources, and political will may well be drops in the ocean, but not the deluge that we require to halt needless maternal deaths once and for all. What we need to improve the quality of maternal care is a moral revolution.

While no one at the conference would disagree that the challenges we face are rooted in power structures, one could not help but notice a few things about the conference itself: that only one-third of the conference steering committee represented countries with the greatest maternal death burden; and less than half of the presentations were from ministries or universities in the ‘south’. With the exception of large delegations from the host country Tanzania, and notably Bangladesh, the low presence of some of the heavy-burden countries was observed. This is not to take away from those present. But it does illustrate that within our own communities, we still have work to do to amplify the voices that need to be heard, and do so without being tokenistic. We cannot lead the charge for moral revolution in the broader world when we maintain the same old structures among ourselves.

The other thing I kept mulling over was the topic of continuity of care that is equitable, accessible, and respectful – was this any different from having strong health systems able to deliver services when and where they are needed? If we centralise the quality of women’s lives, then our health systems should serve them well at all points during those lives. This also includes those women who provide the bulk of services and are ill-served by the systems in which they work. As we wrote last year (and is outlined in a proposed manifesto for maternal health), the brutality of maternal death is that it occurs where the social, economic, and political disempowerment of women intersect, during a vulnerable period in their lives. In such complex systems, the future is not knowable. But this also means the future is not a given, and change, from an unexpected place is possible.

On the conference’s opening day, the excellent Dr Agnes Binagwaho, whose energising comments have been highlighted elsewhere, noted the coincidence of the Reverend Dr Martin Luther King Jr.’s birthday, by quoting: â€œTrue compassion is more than flinging a coin to a beggar; it comes to see that an edifice which produces beggars needs restructuring.” Our edifices are our disciplines, our systems and our funding streams. We need to find new ways of building our communities so that we can change our broader societies. This is particularly true on the eve of a new, post-MDG agenda, the topic of which was raised during the conference only by those with an international view, while those managing the daily crises in communities and facilities remained focused on just that.

We need a moral revolution in maternal health care. If ‘Arusha’ becomes another name on the list as we wait for another 26 years, would there be any honour in that?

 

*This post was crossposted from International Health Policies website