SAPs and Africa

1
SAPs and Africa

• In Africa, SAPs have resulted in significant
  macro-economic policy changes and public sector
  restructuring and reduced social provisioning,
  with negative effects on education, health and
  social services for the poor. A recent review of
  available studies on structural adjustment and
  health for a WHO commission states 'The majority
  of studies in Africa, whether theoretical or
  empirical, are negative towards structural
  adjustment and its effects on health outcomes
• Sanders, D. in Globalisation, health and health
  services in
• Sub-Saharan Africa available from
  http//www.choike.org/

2
SAPs and Health
the median per capita health budget for
sub-Saharan Africa is US6 and that the mean for
the lowest income African countries is US3.
According to the WHO, US60 is required per
person per annum to deliver a basic level of
health care. (Bond and Dor 2003)
3
What are the values?

• The UDHR (Universal Declaration of Human Rights)
  (Article 25) cites the right to " a standard of
  living adequate for the health and wellbeing of
  himself and of his family, including food,
  clothing, housing and medical care and necessary
  social services" and the International
  Covenant on Economic, Social and Cultural Rights
  (ICESCR) (UNICESCR, 1966) in Article 12 the
  right of everyone to the enjoyment of the highest
  attainable standard of physical and mental
  health. (London 2004)

4
The challenges

• the challenges posed by neoliberal
  globalisation to our values of equity and social
  justice, to government ability and flexibility to
  implement the public policies that we choose and
  to the public sector health and essential
  services and that are critical for our health
  (EQUINET 2004)

5
Health and the WTO

• WTO agreements limit sovereignty of state
• WB/IM F conditionalities also limit sovereign
  rights of state
• NEED EXPLICIT RECOGNITION THAT INTERNATIONAL
  AGREEMENTS SHALL NOT LIMIT RIGHTS OF STATES TO
  PROMOTE AND PROTECT HEALTH

6
International Trade Justice?

• For discussion
• If a country wins at the DSB, it can retaliate
  by imposing sanctions on the offending country.
• If a big or developed country imposes sanctions
  on a small or developing country, this would have
  significant impact if their trade constituted a
  substantial share of total trade of that country.
  
• Scenario One
• What would happen if a small or developing
  country won and imposed sanctions on a large or
  developed country?
• Could it hurt the big country?
• Scenario Two
• What would happen if there was a dispute between
  two large or developed countries?

7
Nutrition

• Nutrition is the key determinant of health status
• Up to two-thirds of all Africans in this region
  live in rural areas, trying to make a living from
  often marginal land with little opportunity to
  earn wages. Three-quarters of those living in
  rural areas also live below the poverty line.
  Agriculture contributes 35 to the southern
  African regional GDP and 13 of total export
  earnings (SADC, 2004). In addition, about 70 of
  the population of the region depends on
  agriculture for food, income and employment. The
  impact of immediate factors such as drought,
  flooding and unseasonal weather have combined
  with underlying factors such as continual
  poverty, effects of structural adjustment
  programmes and HIV and AIDS to undermine food
  security and the states capacity to respond to
  household food insecurity. In 2003 this resulted
  in more than 16 million people in southern Africa
  suffering from food shortages. More than half the
  Zimbabwean population, over a third of the
  populations of Malawi and Lesotho, a quarter of
  all Zambians and one in 20 Mozambicans needed
  emergency assistance up until the harvests in
  2003. (Chopra)

8
Nutrition and Trade

• UK prime minister Tony Blairs Commission for
  Africa notes
• We live in a world where rich nations spend as
  much as the entire income of all the people in
  Africa subsidising the unnecessary production of
  unwanted food to the tune of almost US1
  billion a day, while in Africa hunger is a key
  factor in more deaths than all the continents
  infectious diseases put together. We live in a
  world where every cow in Europe has received
  almost US2 a day in subsidies double,
  grotesquely, the average income in Africa.

9
Trade Related Intellectual Property
Rights(TRIPs)Riaz Tayob obo Rangarirai
MachemedzeSEATINI ZimbabweEJN Conference29
November 2005South Africa
10
Key Messages TRIPs

• Intellectual Property Rights protection has
  become a more recently a compulsory policy
  through WTO.
• Protection of Intellectual Property Rights is
  argued to enhance investment in innovation. It
  can however create scarcity of technologies,
• TRIPS is an agreement now under the WTO and
  provides for a 20 year intellectual property
  protection on patents
• TRIPs provides flexibilities that countries can
  use to reverse the scarcity of technology rich
  goods like patented pharmaceutical drugs.

11
IPRs

• What is an intellectual property right?
• An intellectual property is a creation of the
  mind
• inventions that are
• New
• Involve an inventive step that is non obvious
• are capable of industrial application - useful
• TRIPs agreement has minimum standards of
  protection
• 20 years exclusivity on production, sale and
  offer for sale

12
What is excluded?

• States may also exclude the following from being
  patented
• diagnostic, therapeutic and surgical methods for
  the treatment of humans or animals
• plants and animals and essentially biological
  processes for the production of plants and
  animals

13
TRIPs

• What purpose does it serve?
• protection through exclusive rights, in order to
  give adequate returns to the innovators
• exchange disclosure for exclusivity
• monopoly right
• Argument against IPR protection
• innovation will occur whether there is protection
  or not that
• innovation depends largely on a body of publicly
  funded knowledge
• RD spend is lower than marketing spend

14
Discussion point

• Is a discovery an invention
• Is the discovery or rediscovery of a plant
• used by indigenous people capable of being
• patented?
• Is it new or is it novel?
• Who owns this knowledge?
• Can a community own a patent?

15
Dicoveries vs. Inventions

• Can be protected by independent system
• Called sui generis system
• OAU has model law
• TRIPs rights are individualistic
• Indigenous rights are communal
• Need to pass laws to
• prevent biopiracy
• promote informed consent
• Benefit sharing

16
Impact of TRIPs

• Scarcity of Drugs access issue
• Higher prices
• Production of new medicines limited to patent
  holder
• Commodification of drugs

17
Nasty Figures

• Need to dispel some myths in the Pharmaceutical
  industry
• Disease burden 18 Malaria, TB Pneumonia yet
  0.2 RD
• RD prefers Sexual Impotence, Balding Obesity
• More spent on MARKETTING than RD

18
Price Differentiation
19
More Anomalies

• 2001 saw 79 drop in the price of certain ARVs
  in Brazil once generic equivalents produced
• Inter company prices between subsidiaries have
  mark ups of sometimes 3000 to 7000
• The Pharmaceutical business is big business

20
Discussion Point

• Developed countries did not universally protect
  patents on chemicals and pharmaceutical drugs.
• Many only adopted these protections late in the
  20th century.
• Spain did in 1992
• Switzerland in 1978.
• Used it as a developmental policy aimed at
• providing access to drugs, and
• development of a domestic pharmaceutical sector.
  (Chang 2001)
• What positive and negative consequences do
  patents imply for access to anteretrovirals and
  new drugs for TB and Malaria in east and southern
  Africa?
• Do countries in ESA patent their own traditional
  medicines? Why?

21
Flexibilities under TRIPs

• Flexibilities to exclusive monopoly rights exist
  in TRIPs agreement
• Compulsory Licensing
• Government Use
• Practically
• Importation (buying from another country)
• Local production (manufacturing the product
  locally)
• Export (a country with production capacity can
  export it to those who need it).

22
Protecting Policy Flexibilities

• Policy Flexibilities under attack _at_
• WTO
• Regional Agreements
• Bilaterally
• Attack seeks to
• Increase patent protection
• Remove flexibilities

23
Government Use

• If a product is for government use then there is
  no need to respect patent laws.
• Condition public non-commercial use.

24
Compulsory License

• A compulsory license is a non-voluntary license -
  given without the consent of the patent holder
• Is given by an official authority for the use of
  a patented invention
• The reasons include
• national emergencies
• anticompetitive practices by the patent holder
• public health reasons
• to protect national security interests
• local production or
• parallel importation.

25
Parallel Importation

• Countries import a patented product from foreign
  market because it is cheaper
• May be patented or a generic drug still under
  patent (CL)
• Article 31(f) states that production under
  compulsory license will be primarily for domestic
  consumption
• States have flexibility for exhaustion of
  rights

26
Additional Flexibility

• Article 30 of TRIPS provides that
• Exceptions to Rights Conferred
• Members may provide limited exceptions to the
  exclusive rights conferred by a patent, provided
  that such exceptions do not unreasonably conflict
  with a normal exploitation of the patent and do
  not unreasonably prejudice the legitimate
  interests of the patent owner, taking account of
  the legitimate interests of third parties

27
What to do?

• Implement laws to
• Fully use TRIPs flexibilities
• Protect indigenous knowledge
• Resist WTO creep in Bilateral or Regional
  Agreements
• Monitor prices of drugs

28
AU Ministerial Extraordinary Session

• Africa Group Proposal
• Address countries with limited or no local
  production capacity
• Remove asterisk footnote on Chairman's text
• Remove impediments to access
• Workable agreement
• AU meeting
• First'reach expeditious' agreement before Hong
  Kong
• Then 'reach appropriate/workable agreement'
• In terms of para 11 of Doha
• Changed in terms of General Council Decision 31
  Aug

29
Role of big countries

• Wanted a workable solution not only expeditious
• Members added in
• SA/Kenya change to conform to para 11
• Then remove appropriate because duplication
• Then change to General Council Decision
• Implicit retraction of progressive position Not
  explicit