News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 361

 

WHO: Survey on pathogen sharing and access and benefit sharing arrangements 

12 December: Universal Health Coverage (UHC) Day 

Watch the GAP! A critical civil society perspective on the “Global Action Plan for Healthy Lives and Well-Being for All” 

Have Countries Forgotten about the Sustainable Development Goals? The Case of the Americas by Francisco Becerra-Posada 

Developing Countries Urged to Take Charge of Their Digital Future by Juliet Nabyonga-Orem 

With ‘digital transformation,’ UNDP seeks to stay relevant and add value 

The right to health: supporting marginalised people living and working in urban informal spaces

EU Commission: Social protection expenditure and its financing in Europe: A study of national policies 

Neoliberal Health Restructuring, Neoconservatism and the Limits of Law: Erosion of Reproductive Rights in Turkey 

AIM proposal for fair and transparent prices for pharmaceuticals 

Drug Makers Cry Wolf Yet Again 

Do large pharma companies provide drug development innovation? Our analysis says no 

Sanofi, Maker of World’s Top-Selling Insulin, to Exit Diabetes Research 

Сommunities make an invaluable contribution to the AIDS response 

Congo Authorities Say Ebola Survivor Falls Ill Second Time 

Ebola Surges After Attacks On Healthcare Workers 

DRC Ebola update 

WHO Recommends Worldwide Adoption Of All Oral-Regimen For MDR/RR-TB 

OneHealth Initiative: Rabies Webinar – 14th of January 2020 

AUDIO: If We Are to Achieve Zero-leprosy by 2030, This Is the Best Time and Opportunity 

Leveraging Urban Leaders To Battle NCDs – Healthy Cities Partnership Expands To 70 

Are INGOs ready to give up power? 

UNDP: Human Development Report 2019 

Human Rights Reader 507 

“I Could Double That.” A Tech Philanthropist Takes on India’s Daunting Challenges 

Turkey: ICJ and IBAHRI call for release of Osman Kavala following European Court of Human Rights decision 

Indigenous groups call for voice at COP25 climate talks 

EU leaves Poland out of 2050 climate deal after standoff 

European Green Deal will change economy to solve climate crisis, says EU 

IFRC makes climate action its top priority 

Will Funding Marine Planning Help Save Our Troubled Seas? 

9th December 2019: Open letter on the Energy Charter Treaty (ECT)

 

Digital advances would ideally offer opportunities for improved and efficient service delivery, population participation in decision making and accountability, but pose a risk of exclusion of the poor and marginalized. These are population segments who will be left behind in consultations, service delivery and economic opportunities through use of digital innovations. Such gaps are recipe for abuse and exploitation of the poor by the powerful.

Relevantly, a conducive environment for successful deployment and use of technology is important. This involves appreciation of the scope of technology revolution as a transition involving optimizing social, political and economic conditions for inclusive growth in the digital age as opposed to isolated digital policies

By Juliet Nabyonga-Orem

World Health Organization, Inter-Country Support Team for Eastern & Southern Africa; Health systems and services cluster; P.O Box CY 348; Causeway, Harare, Zimbabwe

Developing Countries Urged to Take Charge of Their Digital Future

 

We are in an era of digital technology which is advancing at a very fast pace in developing countries. In as much as this creates opportunities for growth and better service delivery, challenges and risks are real. It is against this backdrop that the Pathways for prosperity Commission (here in referred to as the Commission) set out to investigate how developing countries can embrace advances in technology effectively. Through a research and consultative process that started as far back as January 2018, the Commission proposes rational solutions developing countries can implement in embracing digital solutions for the benefit of everyone.

Embracing opportunities accorded by advances in technology whilst guarding against risks lies the interface for wide spread adoption.  Indeed, opportunities do exist in developing countries that can be leveraged. For example, 43 countries in sub Saharan Africa are implementing a Health Information System Strategy based largely on the use of ICT (Information and Communications Technology). Eight percent of people in developing countries live under a cellular internet signal although only 30% have ever used the internet. The Commission further cautions that “do not connect people to the internet just for the sake of it, people must be able to make use of it to improve livelihoods”.

There are concerns to be addressed. The use of digital solutions in developing countries today is described as suboptimal at best or chaotic at the worst. Several countries in Sub Saharan Africa have witnessed an epidemic of pilots of digital solutions to improve service delivery and monitoring that are never scaled up, and in influx of APPs with varied relevance to developing countries’ health systems. In majority of African countries, capacity for health technology assessment to guide decision making is at infancy. The Pathways for prosperity Commission further highlights the low human capital, lack of digital readiness, ineffective institutions and a difficult business environment as major challenges.

Digital advances would ideally offer opportunities for improved and efficient service delivery, population participation in decision making and accountability, but pose a risk of exclusion of the poor and marginalized. Whether developing countries can ensure reach of digital solutions to the poor and vulnerable cannot be ascertained and the Commission likens “trickle-down digitalization” to failed attempts of “trickle-down growth” to deliver inclusive development. How can developing countries purposively plan for inclusiveness?  A significant proportion of the population live below the poverty line as high as 28% in Colombia; 65% in Burundi. These are populations who will be left behind in consultations, service delivery and economic opportunities through use of digital innovations. Such gaps are recipe for abuse and exploitation of the poor by the powerful.

Loss of jobs due to advances in technology is a real fear that must be handled carefully to mobilize popular support for technology development. Taking an example of Africa, mobile money banking by mobile telephone providers impacted on use of banking services which concern was real to commercial banks. In some countries this happened in a regulatory vacuum and subsequent efforts to introduce a tax on such transactions resulted in tensions between the government and the population. On a positive note however, linkages with mobile money banking and commercial banks have been forged paving a way for a fruitful coexistence.

The Commission draws our attention to the importance of a conducive environment for successful deployment and use of technology and refers to this as “getting the analogues matters right in a digital age”.  This involves appreciation of the scope of technology revolution as a transition involving optimizing social, political and economic conditions for inclusive growth in the digital age as opposed to isolated digital policies. In this regard, availability of essential physical infrastructure, foundational digital systems and investment capital are among the prerequisites for wide spread adoption.

Challenges notwithstanding, the Commission asserts that developing countries should not resign to being passive observers but should take charge of their digital future. In rising to the challenge, the following are proposals to embrace:

• Creation of a digital compact involving all stakeholders to guide coordination, deployment and use of technology and improve inclusiveness and adoption of consensual options. The effective use of such a compact will be premised on strong institutions and regulatory frameworks that are enforced. An important component of such effective partnership efforts that has not received much recognition in the past is institutionalization of mechanisms to manage conflict of interest. This is crucial given the important role of the private sector in technology development who have been labeled as “for profit”.
• Technology advances must put people at the center, be it to spur economic growth, improve service delivery, participatory processes the focus must be the people as major beneficiaries. In ensuring this, training in digital use should be mainstreamed in training curriculum for all learners. Relatedly, Governments must make information relating to their programs, including budgets, publicly available.
• The private sector and government must put in place foundational digital systems which are interoperable.
• Public and private actors must make deliberate efforts to leave no one behind through embracing business models that enable the poorest to access and use digital solutions; provide incentives or regulation to encourage pro-poor innovation. Private sector needs to work towards a balance between profitability, affordability and user experience.
• The role of governments in ensuring meaningful contribution of digital solution to economic development and efficient service delivery is paramount. Particularly is addressing technical disruptions and advancing digital transformation which the commission contends that should not be left technical agencies with a narrow mandate.
• Governments need to actively purpose to embrace digital solutions. While the private sector and donors need to explore regulatory solutions designed to meet the unique needs of developing countries, governments need to explore ways to ensure effective regulation.

 

 

Of the reviews presented or committed to be presented by countries of the Region of the Americas towards achieving the Sustainable Development Goals, there are some that have presented once, others twice or with a commitment to present a second time, while many that have not done so

By Francisco Becerra-Posada MD, MPH, DrPH

Public Health Policy

Have Countries Forgotten about the Sustainable Development Goals?

The Case of the Americas

 

The world is seeing a series of political changes, such as the ones in Mexico, Argentina, countries in Europe; unrest due to economic or policy changes as has happened in Hong Kong, France, Bolivia, Ecuador, Peru to mention a few. Economic trade war between the USA and China, and a constant threat to world peace by unilateral actions from a few countries. Also, we have seen and continue seeing the longstanding discussions and push back from establishment around climate change and its implications towards humanity as a whole.

These chaotic times we are facing make one wonder what has happened to the work countries were supposed to be doing towards achieving the Sustainable Development Goals (SDGs). There is evidence that countries have reported advances of the proposed objectives they signed up for and the reviews they have or will be presenting are stored by the UN in the Voluntary National Reviews Database.

Of the reviews presented or committed to be presented by countries of the Region of the Americas, there are some that have presented once, others twice or with a commitment to present a second time, while many that have not done so.

Of the 35 countries in the Region (not counting territories), Table 1 presents those countries that have reported or will report on the advances on the SDGs.

Table 1. Countries of the Region of the Americas that have presented or committed reviews on advances on the SDGs

  Source: Voluntary National Reviews Database,  https://sustainabledevelopment.un.org/vnrs/

Of the 35 countries in the region, 11 countries have or will present one review only by 2020. Of these seven are from the Caribbean and four of the continental region [*]: Bolivia, Canada, El Salvador and Paraguay. Of those presenting or committed to present twice, 13 countries have done so, amongst them, five countries of Central America. Only Nicaragua has not signed up for the review of their advances. Some countries of the continental Americas have yet to present or commit to: Guyana, Nicaragua, Suriname, United States and Venezuela.

The Caribbean has still to move forward and start committing to present their reviews. Of the 13 countries (including Cuba, Dominican Republic and Haiti), only six have done or committed to present the reviews.

Hopefully all SDGs are being covered and fully reviewed. Advancing towards the implementation of the planned interventions in each country is key as to diminish social determinants that hinder the advancement of a better life of millions of people that live in poverty and see their needs not fulfilled.

Hopefully the reviews speak of real advances and policy -social and economic- changes towards bringing these populations in need forward and their governments don’t leave them behind.

———————————

[*] Countries are being considered geographically, not by geo-political organizations.

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 360

 

The economy of well-being: between European objectives and national realities 

The Bretton Woods Institutions, 75 years on: reform or risk irrelevance 

25 November 2019, WHO reform EB 146/33: Involvement of non-State actors in WHO’s governing bodies. Report by the Director-General

Web consultation with non-State actors on their participation in WHO governance 

Information session to non-State actors: WHO Headquarters, Geneva Salle D on Monday 16 December 10:00-12:00 Geneva time. If you wish to participate, please register for the session 

WHO response to WTO member state challenges on tobacco, food and beverage policies 

Labelling changes in response to a tax on sugar-sweetened beverages, United Kingdom of Great Britain and Northern Ireland 

WHO: public health round-up 

$262 million subsidy should not go to pharma giants Pfizer and GSK for pneumococcal vaccine 

Opinion: Step up the fight against HIV 

HIV treatment access isn’t rising fast enough to reach 2020 targets, UNAIDS report shows 

HIV treatment for children to be produced for under one dollar a day 

Samoa shuts down government as measles death toll rises to 53 

DRC Ebola update 

Swine fever raises fears of bird flu pandemic 

ONE HEALTH: Awareness to Action – Antimicrobial and Anthelmintic Resistance Conference, Dublin, 27 November 2019 – Proceedings 

Health workers’ education and training to prevent antimicrobial resistance 

Time for $5: GeneXpert diagnostic tests 

More pregnant women and children protected from malaria, but accelerated efforts and funding needed to reinvigorate global response, WHO report shows 

Meeting the needs of people with physical disabilities in crisis settings 

Human Rights Reader 506 

Thirty years of children’s rights – what has Europe achieved? 

Why No Talk of an Inequality Emergency? By Ted Schrecker 

Biofortified Food, a Business Boost for Smallholder Farmers 

Care for Economic Development, Then Care for Food Nutrition, Food Researcher Tells Africa’s Politicians 

Fixing the Business of Food 

Africa’s Civil Society Calls for Action as COP25 Kicks off in Madrid 

Why COP25 matters to the emergency aid sector 

Countries are ‘exposed and vulnerable’ to health impacts of climate change 

Agricultural emissions: Not enough cash for solutions 

Failure to understand and declare an inequality emergency reflects the success of neoliberalism or ‘market fundamentalism’ as a global class project of restoring inequality and the privileges of the rich to the levels that prevailed before what has been called the ‘great compression’ that reduced inequality after World War II in much of the high-income world, and inspired egalitarian visions far outside it

By Ted Schrecker 

Professor of Global Health Policy, Newcastle University

Why No Talk of an Inequality Emergency?

 

We hear much talk now of a climate emergency.  As I was revising a talk I give frequently on ‘global health in an unequal world’, I realised that there is no talk of an inequality emergency, either globally or close to home, although the same macroeconomic trends and political choices driving increased inequality within national borders and on a variety of smaller scales are often involved wherever on the map one happens to look.  (On these inequalities at metropolitan scale, I cannot recommend too highly photographer Johnny Miller’s compelling aerial images.)

Why is there no talk of such an emergency?  Many manifestations of climate change occur on a scale that makes them fodder for our spectacle-hungry visual media: think Californian and Australian wildfires; collapsing glaciers; and catastrophic damage from hurricanes and floods.  The casualties of inequality tend to be smaller in scale and less visible: the lives ended sooner and more painfully than they should have been because of the accumulated damage done by relying on food banks and fearing the ‘brown envelope’ that initiates the vicious privatised process of fitness-for-work assessments here in the UK, or the estimated 300,000 women per year who die in pregnancy or childbirth from causes that are routinely avoided in the high-income world.   Academically, it may be effective to compare the annual toll from death in pregnancy and childbirth to the crash of two or three airliners every day of the year, as a colleague and I have done, but such comparisons have little salience in the broader, media-corrupted world of political priorities.

Relatively vast resources have been devoted to climate science – the Intergovernmental Panel on Climate Change is the world’s largest-ever scientific collaboration – and climate researchers  long ago realised that just generating more evidence was never going to be enough to generate the change needed.   So many became advocates, for example tracing 63 percent of cumulative worldwide emissions of carbon dioxide and methane between 1751 and 2010 to just 90 massive state- and investor-owned corporations (and their customers, of course).  More recently, another group of authors (supported by more than 11,000 signatories) argued that ‘Scientists have a moral obligation to clearly warn humanity of any catastrophic threat’.  Researchers on health inequalities, in particular, have generally been more circumspect.  In the UK, advocacy that looks far enough ‘upstream’ at the economic and political substrates of health inequalities – more on that point later – is unlikely to be acceptable to agencies of the capitalist state and the trustees of billionaires’ fortunes whose funding priorities shape the direction of academic research and the career paths of academics.  And the health inequalities of greatest concern, by definition, do not affect ‘all of us’.  Whether the consequences of climate change will genuinely do so is too complex a question to be investigated here, but the question is well worth asking.  Certainly, its effects will be felt first and worst by those least implicated in its origins.

Another issue is the decades-long rhetorical and ideological Thatcherite drumbeat that ‘there is no alternative’ to rising inequality and the policies that drive it.  This problem is particularly acute with regard to the austerity that has been thoroughly discredited in terms of the macroeconomic objectives of sustaining growth that it was supposed to achieve, whether in the era of World Bank and IMF-mandated structural adjustment or, more recently, in post-2010 responses to the financial crisis.  As Nobel prize-winning economist Paul Krugman commented in the run-up to the 2015 UK election: ‘All of the economic research that allegedly supported the austerity push has been discredited. On the other side of the ledger, the benefits of improved confidence failed to make their promised appearance. Since the global turn to austerity in 2010, every country that introduced significant austerity has seen its economy suffer, with the depth of the suffering closely related to the harshness of the austerity’.  Post-2015, of course, austerity in the UK became harsher still, demonstrably redistributing income and resources upward within British society, through both tax and benefit ‘reforms’ and savagely destructive cuts to local authority budgets.

Now, austerity has become normalised; it is part of the quotidian policy landscape to the extent that we are almost no longer capable of rage when the strutting, glossy Home Secretary straightfacedly claims that poverty is not the government’s problem, when the evidence is overwhelming that post-2010 public policy has systematically and premeditatedly made the problem worse.  Despite the best efforts of the fossil fuel industry, we can imagine a decarbonised economy, even though we may not be able to specify its details.  Too many of us now have difficulty imagining economic systems that do not operate as what Serge Halimi, the editor of Le Monde Diplomatique, has called an ‘inequality machine’.  A powerful antidote to this well-funded intellectual cauterisation is the United Nations Conference on Trade and Development’s 2017 blueprint for a global new deal.  How many global health researchers have read it, I wonder?  How many medical or MPH students have been asked to do so?

Back to the view looking upstream.  Failure to understand and declare an inequality emergency reflects the success of neoliberalism or ‘market fundamentalism’ as a global class project of restoring inequality and the privileges of the rich to the levels that prevailed before what has been called the ‘great compression’ that reduced inequality after World War II in much of the high-income world, and inspired egalitarian visions far outside it.  The evidence on this point can’t even be summarised here – I am glad to provide key sources – but in the context of the work that academics do, two decades of marketisation in British universities must be understood as part of the project.  Centrally funded institutions that served a public educational and scholarly purpose were dismantled, replaced by corporate-style enterprises organised around generating income from deep-pocketed funders and indebted students, with careers often ended by failure to put out salable products.

Isn’t this a form of conspiracy theory, you ask?  Empirically, the best rejoinders come from the work of journalists like Jane Mayer and historians like Stefan Collini and Nancy MacLean.  Conceptually, an especially apposite riposte comes from the brilliant legal historian Douglas Hay, who established himself in the field with the research that underpinned the following conclusion: ‘The private manipulation of the law by the wealthy and powerful’ in eighteenth-century England ‘was in truth a ruling-class conspiracy, in the most exact meaning of the word. …. The legal definition of conspiracy does not require explicit agreement; those party to it need not even all know one another, provided they are working together for the same ends.  In this case, the common assumptions of the conspirators lay so deep that they were never questioned, and rarely made explicit’ (1).  Enough said.

(1)  Hay, D.  Property, Authority, and the Criminal Law. In D. Hay et al., Albion’s Fatal Tree: Crime and Society in Eighteenth-Century England (pp. 17-64). New York: Pantheon, 1975

This posting also appears on Prof. Schrecker’s blog
 ‘Health as if Everybody Counted’

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 359

 

WHO defers South Africa’s proposal on expanding access to cancer treatments including cell and gene therapies until 2021 

25 November 2019, WHO reform EB 146/33: Involvement of non-State actors in WHO’s governing bodies. Report by the Director-General 

International NGOs call on EU Member States to end deadlock on corporate tax transparency 

Italy’s health performance, 1990–2017: findings from the Global Burden of Disease Study 2017 

Life expectancy and disease burden in the Nordic countries: results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 

Patents in Pharmaceuticals: The Emerging Sharp Sword to the Fragile Health Systems in the 21st Century by Michael Ssemakula 

French Parliament To Require Disclosure Of Public Funds Used In R&D For New Drugs Entering Market 

ABUSE OF ORPHAN DESIGNATION LEADS TO EXORBITANT DRUG PRICE 

Public-private partnership launched to develop new drugs for roundworm infections 

Mosquito breeding trial raises hopes of defeating dengue 

Efficacy of a Tetravalent Dengue Vaccine in Healthy Children and Adolescents 

Gavi, The Vaccine Alliance: Doubling Down on Coverage, Partnerships, and Transition Incentives for the Next Phase 

Eastern Equine Encephalitis Virus — Another Emergent Arbovirus in the United States 

Four Ways to Prevent Deaths from Lassa Fever 

DRC Ebola update 

Dead and injured following attacks on Ebola responders in the Democratic Republic of the Congo 

November 18-19, 2019: First scientific workshop EECA INTERACT 2019 on HIV, tuberculosis, and hepatitis in Eastern Europe and Central Asia (EECA), Almaty, Kazakhstan 

The impact of Egypt’s mass hepatitis C screening on health care workers 

Innovative WHO HIV testing recommendations aim to expand treatment coverage 

THE STOP TB PARTNERSHIP INTERACTIVE TB MAPPING TOOL 

Antimicrobial resistance; an emerging crisis 

Opinion: Global solidarity key to tackling superbugs 

World Antibiotic Awareness Week: Lack of access 

Plague in Zimbabwe from 1974 to 2018: A review article 

Dementia in Elderly People: an European Priority Non Ruled by a Communitarian Strategy by Pietro Dionisio 

UK development bank accused of failure to safeguard Congolese workers 

Addressing the context and consequences of substance use, misuse, and dependence: A global imperative 

The catastrophic and impoverishing effects of out-of-pocket healthcare payments in Kenya, 2018 

Human Rights Reader 505 

Ten harmful beliefs that perpetuate violence against women and girls 

Q&A: Countries need to prioritise which SDGs to pursue 

Greenhouse Gases At Record Highs – Humanity’s ‘Future Welfare’ At Stake Warns UN Meteorological Agency 

How air quality rules stack up across Europe 

Regional institutions mandated with the overall trusteeship of granting patents like African Region Intellectual Property Organization (ARIPO) responsible for the filing, administering, examining and granting of patents for 18 Contracting States of the Harare Protocol (ARIPO’s legal instrument on patents), and Organization Africaine de la Propriété Intellectuelle (OAPI) responsible for examining and granting of patents in the 16 Member States in West and Central Africa signatory to the Bangui Agreement, continue to apply insensitive practice of granting these patents which is parallel to WTO TRIPS flexibilities and pharmaceutical exemptions given to the Least Developed Countries (LDC) during this pharmaceutical transition period. Patents remain an emerging sharp sword to fragile and ever hemorrhaging health systems. This is looped in the weak implementation of TRIPS flexibilities in member state national patent laws, infamous practice of processing and granting pharmaceutical patents in LDCs by region institutions like ARIPO which has a direct implication on the member states’ access to affordable medicines, and development of a vigorous generic industry that can check the monopolies in the pharmaceutical sector to enhance availability of cheaper drugs

By Michael Ssemakula

People’s Health Movement

Patents in Pharmaceuticals: The Emerging Sharp Sword to the Fragile Health Systems in the 21^st Century

 The Work of Contemporary Struggles in Countering this Growing Global Threat to Access to Affordable Medicines

 

Quarter of the global populace faces access deficiencies to the most basic essential medicines. For the destitute and impoverished sick in the south constituency, the cost of drugs can determine whether they will be treated [1] or suffer with their ailment in excruciating pain. Numerous individuals who cannot afford the required treatment quite often resort to self-medication using traditional herbs and alternative medicines or a resignation to the natural hypothetical amazing ability of the human body to heal itself. In many instances this has left patients with severe and chronic complications as a result of a failure to treat the medical conditions early. Patents drive medicines’ and health technologies’ prices up, through subsequent monopoly statuses which permit the pharmaceutical companies to charge whatever price the demand side will shoulder. The World Trade Organization Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement, which provides twenty years’ patent protection for pharmaceuticals [2], also comprises safeguards such as compulsory licensing, to ensure that countries can prevail over the patents whenever they are a barrier to access to medicines and in the event that there is violation of patents by the patent holders.

There is an intense lobbying and pushing from the transnational pharmaceutical industry and some Western governments to protect their pharma products and technologies through patents. Patents are often taken as a conduit to provide guaranteed heavy revenue and commercial exclusivity to private companies to enhance the ‘purported’ innovation, investment in research and continuance of scientific progress [3]. But what about the innovations that are publically funded in this contemporary intellectual property regime but their outcomes are exorbitantly priced to the citizenry across the continental divides?

In the overwhelming globalization of capitalism in diverse sectors, pharmaceutical industry inclusive, the use of safeguards in TRIPS remain worryingly unfulfilled. Experience from middle income countries like, Thailand, South Africa, Guatemala and Kenya shows the heavy burdens countries face in implementing the TRIPS Agreement [4] in a manner that protects public health, and emphasizes the vital role played by civil society in defending the right to access to effective and quality affordable medicines. Regional institutions mandated with the overall trusteeship of granting patents like African Region Intellectual Property Organization (ARIPO) responsible for the filing, administering, examining and granting of patents for 18 Contracting States of the Harare Protocol (ARIPO’s legal instrument on patents), and Organization Africaine de la Propriété Intellectuelle (OAPI) responsible for examining and granting of patents in the 16 Member States in West and Central Africa signatory to the Bangui Agreement [5], continue to apply insensitive practice of granting these patents which is parallel to WTO TRIPS flexibilities and pharmaceutical exemptions given to the Least Developed Countries (LDC) during this pharmaceutical transition period. Patents remain an emerging sharp sword to fragile and ever hemorrhaging health systems. This is looped in the weak implementation of TRIPS flexibilities in member state national patent laws, infamous practice of processing and granting pharmaceutical patents in LDCs by region institutions like ARIPO which has a direct implication on the member states’ access to affordable medicines, and development of a vigorous generic industry that can check the monopolies in the pharmaceutical sector to enhance availability of cheaper drugs.

Multiple challenges disproportionately burden the shoulders of the health systems in the global south especially in the sub-Saharan Africa which suffers from numerous communicable and non-communicable (NCD) disease burdens, health epidemics such as AIDS, anthrax, Bovine Spongiform Encephalopathy, drug-resistant tuberculosis and malaria, severe acute respiratory syndrome, avian and swine flus, Ebola, Zika virus, intensified by several other economic challenges through exposure to unfair and unhealthy multilateral trading system. Newer medicines have become more available, however not available to those who need them most due to their tall price tags such as bedaquiline and delamanid which are excessively priced but effective to cure the multidrug-resistant tuberculosis (MDR-TB).

The question remain, what can we do to address the inadequacies in the drug availability and accessibility globally expressly in the high priority countries? How can we build a strong solidarity beyond just lip singing of the “word” itself “solidarity?” Multiple global struggles and movements have come up with strategies to challenge the global apartheid in health accessibility and the hegemony of capitalism as a mechanism to counter the 21^st century neoliberalism syndrome of globalization that has become a malignant neoplasm to the weak health systems.

Profitization in health through taking advantage of inelastic demand for medicines and other medical products is unequivocally a bridge giving the big Pharma super jump-pace to hold global health at ransom! Without doubt, profiting from health is perceived as an “eloquent thought” by big pharma, and also a common anti-humane practice of the corporations in the north pushing for aggressive mechanisms such as TRIPS-Plus to expand their investment multipliers through commercial exclusivity granted by patents to extremely exploit their benefits to the maximum.

More than ever, as anchors of health for all global health strategy, People’s Health Movement together with Third World Network have been so instrumental in safeguarding the full brim attention of global community to health through mobilization, strengthened health struggles, and solidarity against discriminatory health provision modalities. Their programs has encircled countering of ideological shifts and unfriendly profit driven postmodernism threats posed by the pharmaceutical corporations through a series annual trainings organized under their International People’s Health University (IPHU) program- which aims to contribute to ‘health for all’ by strengthening people’s health movements around the globe, providing space for learning, sharing and planning opportunities for people’s health activists, particularly from Third World countries. [6] The recent IPHU training in Cape Town- South Africa [7], was a global slumber breaking alarm to many global public health activists from over 12 countries across six continents about the shocking and deplorable inside of the pharmaceutical world and things big pharma don’t want us to know:- such as research and development costs, developing medicines  and other health products is not as expensive as pharmaceutical industry say! The big Pharma overstates the R&D costs of new drugs to validate their exorbitant pricing [8], and quite often classify ‘opportunity costs’ and non-research based activities [9], For eras-of-time, the global big pharma has spread a deceiving tale justifying the ever-escalating prices of medicines, vaccines, diagnostics, other health products and technologies as something essential and unavoidable. We are paying double for our medicines, some corporations’ research is taxpayer-funded especially at government and university research laboratories, from which most new version of drugs and medicine technologies originate. They get tax havens and other related financial incentives to their research investments [10] and the end result is to shamelessly privatize and patent the final outcomes of the research. The IPHU did not only end on the prices of medicines set but also how patents are granted which some violate the provisions in TRIPS flexibilies through over and over extension of time for patents after making simple compound innovations which prolong monopolies. This is a notorious pharma ploy known as patent evergreening, which lengthen their monopoly and in longrun block entry of affordable generic medicines. There is an emerging evidence that shows the granting of patents over minor modifications of existing medicine products both in the North and South [11]. This tendency has also been noted with great concern by the development, humanitarian and health stakeholders who are worried about the patent abuses where negligible incremental modifications made by big pharma result in unjustified monopolies. Countries with feeble regulations are exploited to the last penny of their health expenditure, big Pharma bullies LDCs through exploiting the gaps and inadequacies in their legal and policy frameworks, and leverage on the influence they have to change global trade rules to benefit themselves.

With participants from diverse culture, profession and career backgrounds in health, policy, academic, humanitarian, and law, the training further disclosed the philosophy of political economy of health, structure of the pharmaceutical industry, medicines related policy and regulation, a profundity learning of the relationship between intellectual property and access to medicines, the requirements of the TRIPS Agreement; public health sensitive TRIPS flexibilities, patentability criteria, opposition systems, exemptions for least developed countries (LDC); TRIPS-plus provisions and implications for access to medicines; and current and new approaches to pharmaceutical research. [12]

 

References

[1] Patents, Access to Medicines and the Role of Non-Governmental Organizations, January 1, 2004 by Nathan Ford

[2] WTO AND THE TRIPS AGREEMENT, https://www.who.int/medicines/areas/policy/wto_trips/en/

[3] WHY PATENTS ARE NECESSARY FOR THE PHARMACEUTICAL INDUSTRY, https://servier.com/en/why-patents-are-necessary-for-the-pharmaceutical-industry/

[4] Patents, Access to Medicines and the Role of Non-Governmental Organizations, January 1, 2004 by Nathan Ford

[5] UNDP WHO Workshop on the Examination of Pharmaceutical Patents: Developing a Public Health Perspective, Cape Town, 30 – 31 October 2008

[6] International People’s Health University, https://phmovement.org/iphu/

[7] https://phmovement.org/course-announcement-the-struggle-for-health-and-access-to-affordable-medicines-cape-town-november-2019/

[8] 6 things big pharma doesn’t want you to know, Access Campaign: 20 Years, https://www.msfaccess.org/6-things-big-pharma-doesnt-want-you-know

[9] 6 things big pharma doesn’t want you to know, Access Campaign: 20 Years, https://www.msfaccess.org/6-things-big-pharma-doesnt-want-you-know

[10] 6 things big pharma doesn’t want you to know, Access Campaign: 20 Years, https://www.msfaccess.org/6-things-big-pharma-doesnt-want-you-know

[11] UNDP WHO Workshop on the Examination of Pharmaceutical Patents: Developing a Public Health Perspective, Cape Town, 30 – 31 October 2008

[12] https://phmovement.org/course-announcement-the-struggle-for-health-and-access-to-affordable-medicines-cape-town-november-2019/

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

News Flash 358

 

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Why Some Global Health Experts Didn’t Sign the Call on the United Nations for Human Rights Guidelines on Healthy Diets and Sustainable Food Systems by David Patterson 

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Week #47 Global Alcohol Policy Round-Up 

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Human Rights Reader 504 

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U.N. Group Launched to put Afghan Women at Centre of Peace Initiatives 

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We have strong technical guidance on healthy diets from WHO in one hand, and an international legal framework which obliges evidence-based State action on health in the other. Together they can reduce diet-related NCDs and promote global health. What are we waiting for?

By David Patterson

Health, Law and Development Consultants

 dpatterson@healthlawdc.com

Disclosure: From 2009 – 2018 David Patterson was senior legal expert, health, for the International Development Law Organization (IDLO). He is now a consultant with IDLO and other health, law and development organizations

Why Some Global Health Experts Didn’t Sign the Call on the United Nations for Human Rights Guidelines on Healthy Diets and Sustainable Food Systems

 

In October 2019 I and three colleagues (Dr Kent Buse, Prof Roger Magnussen and Prof Brigit Toebes) wrote a short article in the British Medical Journal.

We called on the Director-General of the World Health Organization, Dr Tedros, and the United Nations High Commissioner for Human Rights, Dr Bachelet, to lead the development of guidelines for States on human rights, healthy diets, and sustainable food systems. We also provided possible areas of focus, a proposed process, and draft principles to guide the development of the guidelines.

We shared the draft call with a wide range of experts in global health, nutrition, governance, law and human rights for comment and endorsement. There was strong interest, and within a couple of months 180 experts had signed on.

However, some people also told us that they did not agree with our approach and hence could not sign the call. Below are some of the reasons they gave.

First of all, we need to acknowledge that part of the global health community remains sceptical about the United Nations human rights framework. They question how international human rights law can be effective when there is no ‘international police force.’ In the same breath they mention the WTO and international trade law as an example of an international system ‘with teeth.’

Human rights lawyers and advocates know that the answers lie in the multiple ways in which international human rights law influences the behaviour of States and non-state actors.

Most important is the normative role, and here the detailed guidance from the human rights treaty committees is crucial. Pressure to comply then comes from multiple mechanisms, including the periodic reviews of State action under each treaty, and the State-led Universal Periodic Review process. In serious cases, State actions are scrutinized by UN Special Rapporteurs, the UN Human Rights Council, the UN Security Council and the UN General Assembly. Political processes can lead to sanctions and other international pressure. A good example is the October 2019 joint statement by 23 countries in the Human Rights Council on China’s mistreatment of Muslims in Xinjiang province. Without the norms established by human rights treaties, such criticism and action would likely be far weaker.

Human rights norms also inform positive political processes. For example, the UN General Assembly’s 2016 resolution on child, early and forced marriage is firmly grounded in international human rights law.

The international human rights legal framework also influences national judicial decisions and serves as a basis and model for national laws. In some countries international human rights obligations are incorporated directly into national law.

In July 2019, Brigit, Kent, Roger and I suggested in an article in Obesity Reviews that the value of the human rights-based approach to health had been demonstrated over several decades by its application to HIV and AIDS. This included the drafting by a diverse group of experts in 1996 of the United Nations ‘International Guidelines on HIV/AIDS and Human Rights.’

The HIV Guidelines review the application of the UN human rights treaties to the global HIV epidemic. They proved powerful in mobilizing State and non-state actors to strengthen action on HIV, notably on access to treatment and in addressing discrimination and counter-productive criminal sanctions against people living with HIV and other marginalized and vulnerable groups.

Some health experts maintain that the human rights-based approach to HIV was successful because the HIV epidemic affects mostly younger, socially and politically active populations. They question whether applying the same approach to noncommunicable diseases would be as successful. However, they miss the point that a wide range of stakeholders – civil society organizations, including faith communities and labour organizations, women’s and children’s rights organizations, public health advocates, UN system agencies and the UN General Assembly – have all embraced the human rights-based approach to HIV.

The human rights-based approach can mobilize broad community action on NCDs and other global health challenges. For example, in South Africa, the AIDS Law Project evolved into Section 27, a broad health rights organization. Section 27 and the Rural Doctors Association of Southern Africa now partner to support the Rural Health Advocacy Project.

Some global health experts questioned whether the draft call was sufficiently rigorous in its references to the private sector. However, the human rights-based approach requires States to hold the private sector accountable, and in turn makes States accountable for doing so. We referenced the UN Guiding Principles on Business and Human Rights which make this clear. We had to keep the call short – it was not intended to cover all areas of possible action. These will be explored through the development of the guidelines themselves.

There is one further, perhaps uncomfortable, reason why some global health folks don’t want to admit that international human rights law has a central role in global health. It is about hegemony and control of the global health discourse, and the global health dollar. Yet global health challenges will never be solved with bio-medical approaches alone. Conversely, the human rights-based approach is essentially democratic. It demands that affected communities are part of the solution to global health problems, not just the occasional lucky beneficiaries of laboratory-driven largesse.

Recall the 2014 case of the journalist in Sierra Leone imprisoned for questioning his government’s handling of the Ebola response, as reported by the Committee to Protect Journalists. It is a reminder that even the best technical solutions, such as a vaccine against Ebola, will never reach all those in need without strong human rights protections.

We have strong technical guidance on healthy diets from WHO in one hand, and an international legal framework which obliges evidence-based State action on health in the other. Together they can reduce diet-related NCDs and promote global health. What are we waiting for?