TRADE & HEALTH
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- Title
- TRADE & HEALTH
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Sent:
Community Health Ceii <sochafa@vsni.com>
Thursday. February 19, 2004 6:51 PM
Subject:
Patent battle: Uproar over sale of Indian drug in US
r aiGnt Oatiie: Upi'Oai’ OVei" Sale vf Indian iii'Ug in US
Wednesday, February 18, 2004 (Thinrvananthapiirani):
A medicine could soon become a test case tor a patent battle between India and the United States.
A Kerala government institute, which holds the Indian patent for the anti-fatigue drug, Jeevani has discovered that
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The Ttopicai Botanic Garden Research institute insists that the move is illegal
"All this reflects to a fact that people have just cashed on the fame of Jeevani and tried to put something, which
may not be exactly Jeevani " said G M Nair. Director, Tropical Botanic Garden Research Institute.
Tne institute was getting a two per cent commission from a Coimbatore based pharmacy licenced to manufacture
And according to officials the fact that the US company is not paying the prescribed amount, is a blatant violation
of intellectual oroperty rights.
Kerala government officials say this is a serious violation of the Biological Diversity Act.
‘This act prevents takino awav biolooica! species in whatever form from one countrv to another," said Dr KR.S
Krishnan, Director, Kerala Science and Technology Department.
Tne American company's website however, claims to have rights io sell the arug. But the institute is stiii
considering legal action on three counts, namely misuse of a trademark and manufacturing and using the
formulation without its consent.
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An In'ernstions’ finsnoia' institution floated by the
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T^g!E ORGANIZATION (WTO)
This is an intimations' body composed of a" the
nations of the world who have signed international
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Subject: Re: reader on Globalisation and health
Date: Thu, 24 Oct 2002 17:33:57 +0530
From: Community Health Cell <sochara@vsnl.com>
To: wullTTmedico.de Wulf@medico.de
Greetings from Community Health Cell / Peoples Health Movement,
Banoa.lore'
It was nice to hear from you after a long time. We did not receive your
earlier letter of 3/7/2002 and hence were surprised at the silence. Hope
you received the thank you letter we sent to all of you in Europe as
ticipate in your effort, and will try
PHM - “From Bhonal to JSA ~ the CHC
a skh-? r.-sn ~ c. the Indian name for PHM
ts which will be of interest to you
a\ tf,1ms. and ~ a^e do1 r c a ^HM ■■■ Inda — East Africa solidarity
initiative whicn involves meetings in Nairobi (4th co 3th November);
Kempala ;6th tc 7th November); Uar-es-Salam (Sth to 9th November) and
.Arusha (11th November). A separate not is being forwarded to you. Please
send it tn anv T-iedicos International Contacts in these four cities of
Chowdhury in a PHM input into Forum 6 - Giooa± rorun tor Health Research
at Arusha, Tanzania organized by GFHR / WHO. If you know anyone from
Germanv who is attending Forum 6. please alert them to make contact with
c) From 20th to 23rd November, I attend the PHM core group meeting in
GK-Savar, Bangiadesn where there is a strong possibility that CHC will
take over as coordinator of the PHM International secretariat and take
it to Bangalore. We hone to keen- closer touch with PHM-Germany from then
d) From 2nd to 7th January at Hyderabad, India, a large PHM like event
is being organized - The Asia Social Forum which is a precursor event
to World Social Forum in Brazil (Porte Allegre) at the end of January.
PHM — Indis snd Asis will be orcfsnizincr inany seminars, workshops and we
campaigns,. I" will be a very informative, interactive opportunity. If
PHM - Germany or Medico are keen to send some one in solidarity, please .
do’so. You will get a lot of information and contacts about the Asian
situation and Asian movement in a b day capsule - very very cost
effective. Over '.COCO people are expected for the celebration. I shall
mark some materials to you. Everyone is paying for their own travel to
Hyderabad. Very low cost boarding and lodging facilities will be
available. It will be like a mega-BUKO conference!
Yours sincerely,
Po'r-i
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10/24/02 5.35 PM
WSF Brouchurcflnn!3"l O.doc:
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Name: East Africa Visit - Final Note.doc
Type: Winword File (application/msword);
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10/2-V02 5:35 PM
Subject: Fw: reader on Globalisation and health
Date: Thu. 17 Oct 2002 11:26:42 +0200
From: "Andreas Wulf <Wuif@medico.de>
To: <sochara^vsnl.com>
0s2>r Thelma snci Ravi
may I remind you on our request we sent to you some time ago (see below) and ask if we can still count on you for a
contribution to this report? we would be very happy to use this as a lobby tool in Germany for 25 anniversary of Alma
Ata. We extended the deadline for articles until 1 of December - do you think this would be feasible for you? Thank
you very much for your help
Best regards '
Andreas
— Original Message-----From: Andreas Wulf
To: sochara@vsni.com
Cc: Thomas Seibert
Sent: Wednesday, July 03, 2002 7:31 PM
Subject: reader on Globalisation and health
Dear Thelma and Ravi,
I hope you are all fine and had a good trip back to Bangalore after the Geneva meeting, sorry for not keeping in touch
the last day to say good bye.
Right now, we here in medico are busy to prepare some kind of background reader/'booklet (around 130 pages) for
our health campaign with some basic analysis on Globalisation and its impact on Health and Health Care Systems,
the PHC-Concept and some experiences from countries and projects and presenting the ongoing campaigns around
this topics and we hope we can win some of the PHM-people to contribute to this work so it would reflect some broad spectrum
of whats going on (and what had going on) in this field of struggle.
So may we ask you to participate in this work? We would be very happy to have an article on the Indian Health
movement in this booklet, as we were very' impressed by your brief but thorough presentation you gave us during our
short talk together with Thomas and Jutta at the BUKO-Conference in Frankfurt. We would like to put it into the
section on PHC-Concepts - Experiences - Movements as you can see it in the document attached. (I translated only
the headlines to give you an idea of the report) We think of a not too long paper with around 12.500 letters (5 pages)
that might span the time from the 70ths up to now (from Bophal to the CHC).
O Please don't hesitate to ask for more details I might have forgotten right now.
Hoping to hear from you soon and thank you very much in advance
Best regards
•7^
Andreas Wulf
new e-mail!
medico international eV
Obermainanlage 7
D - 60314 Frankfurt / Main
’ ’
Germany - Allemagne
Tel: +49 - 59 - 944 38 -0 (Ext. -35)
Fax: +49 - 69 - 43 60 02
e-maii: wulf(a)medico.de
www.medico.de
; | <4 Concept report, rtfi
l&/io
Name: Concept report.rtf
Type: Winword File (application/msword)
Encoding: quoted-printable
10/17/02 7:50 PM
Concept: medico international Report on Globalisation and Health
Editorial: Globalisation and Critioue: The example Health and Health Care
Medico’s concept and project of health
Gesundheit ist mehr als die Abwesenheit von Krankheit.
Gesundheit ist nicht das Gegentei! von Krankheit.
Quaiitativer Gesundheitsbegriff. Gesundheit keine Frage von Medikamenten und
medizinischer Hilfe, sondern eines Lebens in Gesundheit. Was “gesund” ist,
bestimmen die Betroffenen, nicht die Experten. Gesellschaftliche Garantie des
Zugangs zu Gesundheit einerseits — Partizipation und Selbstorganisation
andererseits. Die Gefahr der Burokratie einerseits und eines kommunitaren
“Neoliberalismus von unten” andererseits: Wo ist Staatlichkeit notwendig, wo
Selbstorganisation mdglich?
Kampf fur das Recht auf Gesundheit. medico als Knotenpunkt einer
giobalisierungskritischen Weligesundneitsbewegung: OA und PA: Projekie, Netze &.
Campaigning - ein Artikel zum Selbstverstandnis und Hinweis auf den SchluBartikel
(Thomas/Andreas; 5 S., 12.500 Zeichen)
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1.1.) Globalisation a
n
d
Health —
The subject perspective
Globalisierung els Prozess der Freisetzung von Kapital, Waren, Arbeit, Wissen,
Dienstleistung - und, freiwiilig wie gezwungen - von Menschen.
HIV/AiDS ais Krankheit des mobiistenTfiexibilisiertesten" Teiis der global
“Freigesetzten”: “Mister 0, der schwule Flugbegleiter”
Metropolitan ais Krankheit zuerst der homosexuelien und drogengebrauchenden
Subkulturen - freigesetzt aus burgerlich-heterosexueller Familientradition, aus
fortpflanzungszentrierter Sexualitat, aus traditioneller Sittlichkeit, aus Sozialen
Sicherungen etc.
Peripher als Krankheit der aus ihrer landlichen Herkunft, aber auch aus alter urbanen
Erwerbslebensperspektive und naturlich ebenfalls aus der tradifionellen Sittlichkeit
“freigesetzten” township- und favela-Jugend und ais Krankheit der globaien
Arbeitsmigration (tatsachlich zentral fur die Verbeitung, im Suden die Migration ins
sudliche Afrika, sowie naturlich uber alle Sud-Nord-Routen.
Die “Seuchen”-form als Problemanzeige.
Die systematische Ungleichheit der Heilungschancen
Die Repressivitat im Umgang mit der Erkrankung: gegen die “Freisetzung” eine
repressive “Rekonstruktion des Sozialen"
Einsatz: was ware dem gegenuber ein anderer Umgang - mit der Krankheit, aber
auch mit der fur sie ursachiichen “Freisetzung”: ergo: was ware eine emanzipative
“Rekonstruktion des Sozialen” ais Bedingung von Heilung und Gesundung
(Andreas und Thomas S,; 8 S.; 20.000 Zeichen)
1. 2.) Globalisation and Health - perspectives of economy and power (2 Artikel)
1. 2. 1. WTO. GATS, Commodification, Privatisation of Health, Health as a
Commodity
Medizinal-pharmazeutischer Komplex: Medikalisierung des Lebens, die ganze
Palette, “Massenkrankheiten der Armut", wiederum HIV/AIDS als Fokus: alles, was
im AIDS-respect-Heft schon zur Sprache kam. (Heiko Wegmann, Thomas Fritz; 5
S„ 12.500 Zeichen)
1. 2. 2. WTO and TRIPS: Patents and Profits, Access to Healthcare
, aber auch. wenn der Zugang zu Medikamenten & Srztlichen Einrichtungen gesichert
ware, der Zugang zu gesundheiisfordernden Lebensbedingungen:
Erwerb/Einkommen, Hygiene, Wohnung, Lebensmittei; aber auch Partizipation an
Bildung, Wissen, Rechten, TRIPS.
(BUKO-rharmakampagne, 5 S. 12,500 Zeichen)
1. 3.) Globalisation and Health - Social Security Systems
General!: Neoliberale Liquidation von Sozialstaatlichkeit & sozialen Rechten;
spezifisch im Gesundheitswesen: vollstandige Abwesenheit in der Informalitat,
Dereguiierung don, wo wenigstens im Ansatz realisiert: Das “Model! Chile" und die
Umkehr der “nachhoienden Entwicklung’', die angekundigie Gesundheitsreform in der
BRD. Die Ungleichzeiiigkeiten: Versuche der Re-Regulierung. Die Krise des
neoliberalen Modells. Von der Defensive in die Offensive: von der Verteidigung des
Solidarorinzips zu seiner Globalisieruna.
(Jens Holst 8 S„ 20.000 Zeichen )
2.) History of Health Policy and social Security
1. 1.) Globalisation and Health - Historical Perspective
Health Concepts in times of Colonialism, Postcolonialism,
Neoliberalism
Epoche des Koioniaiismus / Koloniaimedizin: Cordon Sanitaire, Seuchenkontroile zur
„Sanierung“ des „Grab des WeiBen Mannes" und zur Produktivitatssteigerung der
kolonial Ausgebeuteten. Hygiene als oKulturimport“ in den „schwarzen (Continent" und
Erziehungskonzept fur die „niederen Rassen”
Epoche der Dekolonisierung & der Grundung der Entwicklungsstaaten: Primary
Health Care als Anspruch auf „Gesundheit fur alia" Oder als symbolische
Gesundheitserziehung fur Arms, etc.
Ende der nachhoienden Entwicklung, ausschlieBende Globalisierung, Staatszerfall,
Biirgerkriegsekonomie, soziale Gewalt, “Freiseizung” in die Gewalt: Verireibung,
Massenmigration, barbarisches Stadium des Kapitaiismus: was heiBt da denn
“Gesundheit”: Interventionistische Strategien gegen die „Rig Killers", Okonomisierung
der Gesundheitsplanung mit cost-effectivness-Analysen, Health Care Packages Einsatz der NGO als r.eue Charity-Strategie , Privatisierung: Public-PrivatPartnerships, Public-Private-Mix.
(Maria Zuhega, 10 S. 25.000 Zeichen)
2. 2.) History of social security in Germany
Worker’s Movement, class-Compromise - Integration - Bismarck’s Reforms
- Die Garantie des Solidarorinzips - Neoliberale Deregulierung/Privatisierung Entsolidarisierung - Widerstand.
(Dietrich Milles, 5 S., 12.500 Zeichen)
3.) Primary Health Care - concepts - experiences - movements ^
•3. 1.) Concept of Primary Health Care
Die Erklarung von Alma Ate. - Alma Ata und die Folgen - Das Scheitern - was bleibt,
wofur Kampfen. wie weiter?
(Andreas' KaPitel ;m 30-Jahre-Tgsxt. 8 S.. 20.000 Zeichen)
3. 2.)Economy of Primary Health
Soziale Sicherung von union - Experimente, Modelle, Grenzen
(•Jens Holst u.a.. 8 S.. 20.000 Zeichen)
Care:
3. 3.) Country-exam pie: Nicaragua
medico-Projektarbeit im Kontext des Sandinismus - Post-Sandinismus: Rio San Juan
- CEPS - Waslala - El Tanque
(Walter/Nathan, 5 S. 12.500 Zeichen)
3. 4.) Country-Example: India
Gesundheitsbewegung von Bophai bis zur Community Health Ceil
(Theima und Ravi Narayan, 5 3., 12.500 Zeichen)
3. 5.) Country-Example: Germany
Gesundheitsbewegung in den 70/80er Jahren: Sozialistisches Patientenkollektiv,
Gesundheitszirkel >n den E)eir>eben, Gesundheitsladen, Gesundheitstage, die
missgluckte Wiederaeburt aut dem Gesundheitstag 2000
(Christine v. Rauch, 5 S. 12.500 Zeichen)
4.) Health Hrojects in Globalised Times
4.1. Guatemala/iviexiko: Gesundheitspromotoren fordern ihre Anerkennung vom
Staat aber verlassen sich nicht auf ihn
(Dieter. 3 S.. 7500 Zeichen)
4..2. El Salvador: PODES - Kriegsversehrte Kombatanten nehmen die Reintegration
ernst und die Prothesen selbst in die Hand
(Waiter, 3 S., 7500 Zeichen)
4. .3. Sudafrika: PSV in KwaZuluNatal, Psycnosoziele Arbeit in gewaitzerrutteten
communities fragt auch nach den gesellschafilichen Bedingungen von Gewait und
Armut.
(Usche, 3 S., 7500 Zeichen)
4. 4. Palastina/lsraei: Kooperation UPMRC - PHR, Basisgesundheitsarbeit ist nicht
neutral angesicnts Krieg, Besatzung und gegenseitigem Haii.
^Andress frscjt sn, 3 S 7500 Zoichsn)
4. 5. Sudafrika: De Kamof urn A!DS-Behand!ung fi'iralle Betroffenen Oder
privatisierle Wasserversorgung. die Cholera-Epidemie und dec Kampf urn 50 Liter
Wasser fur alls Burgerlnnen Siidafrikas
(David Sanders, 3 S. 7500 Zeichen)
5. Polities of PHC internationaiiy/nationaiiy: Health is moving
Q
Globalization is bad for Health
or
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j± ‘•^■ivoniizatioii oats ivr iieaiiiii
or
atioii is bad for your health,
The Alma Ata. conference of 1978 set a goal of “health for al! using the primary health
Cxuc u-pprGuCii as a snate^jr. j.r tlic intervening years, that s^oal has been replaced by liie
reahtv of "health for ail who can nav for it.” Health is no loncer recognized as a human
right, but as just another commodity to be distributed according to the ability to pay. This
is seen most sharniv in the privatization of health services in many countries around the
globe, and the assertion of intellectual and patent rights by pharmaceutical companies
which seal the death sentences of millions of sick people who can't afford life-giving
t—e ^r^sht” ot coroorat*on- to
t lias c!ic-o^aced orev^ous common rishis the
v»evcixii.mM.iiv3 Gi iiv-uivii itic also rupicly lallm^ io the oiisiau^ht of profit. vTater and the
rishi io clean water is obviously a necessity of life; but it is no longer a rishi. The
commodification of water is creating hardship and cholera (and other illnesses) around
the giobe.
As countries are forced io open their markets by World Trade Organization agreements.
subsistence and small farmers arc being increasingly driven off the 'and. Food security is
disappearing irom the agendas ot worid leaders as no longer relevant while malnutrition
and starvation increases for people on every continent.
Toxic poisoniiuz of water, land and air makes people sick, but attempts to hold
corporations responsible are considered restraints on trade and made illegal. The list can
go on and on, but it ail illustrates one thing: what we know as globalization is making us
sick. And its affecting all countries - rich or poor, developed or developing.
Asserting our right to control our own health and the health of our communities through
‘people centered care and preventive measures is our alternative io globalized illness. This
is a common sense approach, wliich was the core of the Alma Ata Declaration:
unfortunately, it now runs counter to the rules of the World Trade Organization and the
corporate desire for the primaev of profits even in Health. We continue to believe that
people should come before profit, and we must reassert the need for primary health care
before the challenges to health become unmeetable. Thavs why we say. “Health for ail.
i nV i copies Health fvlovcmcnt was formed in Savar. Bangladesh in December 2000.
Uniting 1500 representatives from 92 countries, its founding statement underlines the
need to reclaim '•Health for All" in the face of the inability of individual governments to
achieve it, the abandonment of it in principle by the World Health Organization, and the
harmful actions of corporate-led globalization. The Peoples Charter for Health wliich
evolved at the end of the Assembly is now a document for dialogue and advocacy.
Since
meeting, various countries arid regions have setup then PHM circles to work
on specific campaigns. The PHM is most active in India South Asia and Central and
South America. with smaller working groups in North America, Europe, Africa and
xxxxx. The Secretariat for the PHM is currently located in Bangalore. India led by Dr.
Rati Narayan, a community health physician who has worked with civil society,
campaigns and movements for over two decades.
In the United States, Doctors for Global Health (Atlanta, GA) and the Hesperian
Foundation (Berkeley. GA) have taken the lead in beginning to organize a presence in
North A merica Given our strategic location in the United States, various circles of the
PiTM have asked us to locus our initial organizing on providing networking and
promotional support for the various country and regional campaigns of the PHM. and
working to raise consciousness in the United States about the challenges to health around
the world posed by globalization.
We hope io coordinate with already existing organizations to counter the effects of
privatization and the retreat from health here in the United Stales. We have begun to
reach out to Physicians for a National Health Plan and other single-paxet, immigrant and
human rights organizations in the U.S.
Spring 2003 activities
In March 2003. we will be hosting a visit of some PHM leaders from South Asia.
Dr.Zafarullah Chowdhury was the founder director of Peoples Health Center
(jdonoshastiiva Kendra) in Bangladesh, which hosted the first Global Peonies Health.
Assembly. Dr.Ravi narayan is the coordinator of the Peoples Health Movement
Secretariat, currently located at Bangalore and Dr .Thelma Narayan is a well known
Public Health Policy aetvist and researcher, who was deeply involved with the Peoples
Health Movement mobilization in India.Thcy will be attending meetings and events in
California. Washington and Grenon. and in New York, Boston, and Washington, D.(*
Dr. Chowdhury of Gonoslhava Kendra (Bangladesh) will speak about the importance of
primary health care, the training of women health workers, and the production of
csscuticil jlIaCcIioihco to OxOcilx ills sticitiglcljLolci of tile oig plickruicicsLitiCcil companies. .•_>!.
Ravi Narayan will speak about the importance of including health issues in the current
activities against globalization; the paradigm shift in health action which, allows people to
organize around issues oi primarv health care; and campaign to increase access to basic
determinants of health - all of which or constituents of peoples health movement
initiative lii diTicjciii parts oi the world.
Dr. Thelma will speak on effects of globalization on Women’s health; on adverse effects
of inappropriate policies on health of rite poor; and how a participatory people oriented
policy process can belter address health needs focussing on TB control as an example.
For more information about the PHM/Norlli America, contact: Sarah Shannon. Hesperian
Foundation, Mollie Williams, Doctors for Global Health, Visit the PHM
websv ■ ■ wuw.nhmox-cmcnr.org.
Zuirullah Chawdhurj
Zahuiiah Chowdhury has spent decades-bi mging health care to the undeserved rural
population in Bangladesh. Chowdhury founded the non-governmental organization
Gonoshasthava Kendra, or the People's Health Center, in 1972 to provide primary health
care services tor rural communities. Hie organization has trained women with a low level
of Dchnologic-?! expertise to deliver primary healthcare, providing immediate medical
relief to poor people using principles of community medicine and low-cost effective
healthcare. He also pioneered the Gonoshasthva Pharmaceuticals to produce essential
drugs for primary health care in Bangladesh. In 2002 Dr. Chowdhury was honored by the
University of California, at Berkeley, with the Public Health Heroes award, which
recognizes individuals and organizations for their outstanding achievements in the
adv aucemeni oi public health and health care.
Ravi Narayan
Dr. Narayan is Community health physician., who was professor of community health ar
St.jdm s, one of India s most community oriented medical colleges at Bangalore, India.
He then moved bevond academic teachins and research to work at grassroots mspirms of
commumiv health workers and non-medical professionals to be involved in community
health action. Particularly impressive is Ravi's vision and experience working both at the
grassroots to train non-medical professionals to promote the paradigm shift for
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campaign croups within India. Dr. Narayan is joint Convenor of the leading circle of the
People's Health Movement in India and coordinator of the international People's Health
Movement lobby efforts with the WHO. The PHM efforts in India have focused on
grassroots organizing to lobby for changes in health, policy priorities.
;'hc-!.r.,-.! Naraya n
Dr. i.henna Narayan’s an epidemiologist and public health policv researcher has focused
on Public Health Policv Action; in a wide range of areas including Tuberculosis control
and HTV-AIDS; Women's Health Empowerment; Tobacco Control-Demand and Supply
issues; and Globalization and Health particularly Women's Health. She has also been a
Health Policy consultant to Karnataka and Orissa governments, evolving peoples oriented
State liealut policies; and a member oi the Caritas International Aids task f orce and
Poverty and Atos Circle of Peonies Health. Movement. Site is also the coordinator of the
Community Health Cell (CHC), the functional unit of the Socie ty for Community Health
Awareness, Research and Action (SOCHARA), which was one of the active members of
the National Coordination Committee of Peoples Health Movement in India.
GLOBALISATION ANB NEAL™
*
Economic Globalisation, in the process: trade
liberalisation. Financial Speculation, Foreign Direct
Investment and neo-liberalization
*
Globalisation excitement in some and fear in others
Positive : Globalisation will increase the inter
connectedness of countries, people, Ideas, Products And
Services., in turn improve the chances for solving the
current pressing problems of humanity
Negative : Widening gaps between rich and power any
marginalise groups and problems.
* Globalisation could lead to a faster spread of infectious diseases
through, for example, trade in unsafe food.
* Media advertisements and inappropriate marketing of pharmaceuticals
had lead to the widespread distribution and use, increasing the
resistance to a range of diseases.
'= Moving people on normal and. business contributed some extent.
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w j.iv> nas lost its leaciersmp m Health policies aiouno me worm.
rower sinned to wLi. ilvii' and becoming the real health loaders
for developing countries.
Public Health - Services and health care for ail are now perceived
as an obstacle, threatening public finance and wealth of nation
r eduction tn health expenditure has become one of the ton
priorities for all governments.
1 he model of primary health care as fundamental for the
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i'liority is given to costly lecnnoiogies
j_.
community service replaced t>y private insurance
i HC FNCs control 10 percent of the world trade and 80 percent
of ail land growing export crops. Yet TNUs employ only 5
percent of world paid labour, fheir huge nrofit 20 mainly to the
limited owners.
■■■
*
*
*
*
*
*
*
*
*
*
*
*
Reduction in public expenditure on social work, public health.
education and other basic necessities.
Public sector to private sector
Export cash crops etc.
Devaluation of Indian money
Liberlisation etc.
After SAP - Marginalised have increased
over a billion deprived of basic consumption needs
3/5ih deprived of basic sanitation
l/3rd have no access to clean water.
1/4th with no adequate housing
1/5 th do not attend school grade-5
l/5th do not have enough dietary energy or protein.
1 wo bilion are anemic worldwide.
Indian Pattern Act 1970
© Process pattern
© Product pattern
@ GATT & WITO
Globalisation creates new wants (not necessarily needs) by
manipulative advertisements of new' medical technologies.
Cash crops instead of food crops.
~
«
Improve coping strategies short term)
Build networks of Peonies Movements that can have joint action
rjo.Nnst Nohalisation • long term I
® Improve good governance
- involvement or ordinary people in planning or merger
3 W
Q
:
« i A'Oive power to iocai teveis - partciiayatraj
® Decentraiizarion
a Icedeiine public health to community.7 health l local cominunitv at
* Acivocacy i’oie
I i-O 'S A“n »
("s
A. X C4 J.XJIA1 J .*=^ A
* Networking role.
TRIPS AND PUBLIC HEALTH
& ICMR organized a 2-day Consultation on the subject. Amit Sengupta, Dinesh
Abrol and I participated. The Consultation was called by Dr. Suryanarayan with
Mr. S.P. Shukla, former Indian negotiator to GATT and Convenor of Indian
People's Campaign Against WTO and Globalization. Mr. B.K. Keayla, Convenor,
National Working Group on Patent Laws.
I dealt with threat of GATS besides TRIPS and Health challenges.
\£) UNICEF organized a small Consultation of UNICEF, Chief, Carol Bellamy with a
small group of NGOs, child health experts, planning commission health advisors
etc. Presentations were made on child health situation, polio status and the
meeting was chaired by Mr. Hota, Secretary, Family Welfare.
I mentioned the past relationship of VHAI with UNICEF on
•
•
•
•
Baby food issue
Rational diarrohea care, withdrawal of irrational and hazardous
anti-diarroheals.
Iodine deficiency in endemic areas of tribals in Madhya Pradesh
in early 80s in Raigarh.
Sex determination and female foeticide.
Concerns were expressed by me regarding:
(Mark
1.
Withdrawal of UNICEF from drinking
handpumps were popularized by UNICEF.
2.
The problem of availability of ORS packets was presented by
Dr. Paul/Dr. Bhan. I raised the concern that precisely because
of the non-availability of ORS discouraging home made ORS,
calling it unscientific was not in the interest of diarroheal
victims. As dependence on cheap UNICEF/WHO ORS packets
which were not easily available and commercial ORS packets
costing upto Rs. 10/12 per packet, diarroheal deaths continue
to exist and diarrhea is still a major killer of children.
3.
Vit. A in house to house campaign mode to children with no
Vit. A deficiency as was done in Assam where some deaths
following immunization had taken place highlighted the need
for comprehensive approach to nutrition problem where vit. A,
Calcium, Iron, rich foods needed to be encouraged.
water.
II
4.
3J
TRIPS, public health and availability of essential life saving
drugs for children, role of UNICEF in International Trade
Regimes.
5th Ministerial Meeting, Cancun, Mexico
Recognizing that attempts to dilute Doha Declaration was being
systematically diluted and decisions on para 6 of TRIPS ie.,
availability of drugs for LDCs without manufacturing capability with
parallel imports being allowed by U.S. with great reluctance. This
was done with several conditionalities.
o
Both countries should have compulsory license in its National
Act.
•
Size, shape, form and colour of these medicines to be exported
by manufacturers of generic equivalent drugs
•
The TRIPS Council in Geneva was to be informed about every
compulsory license given.
•
In the name of transparency it was to be put on the web page
and this information was also sent.
•
Proof of lack of manufacturing capability of the importing country
had to be given.
The announcement of this from Geneva was mistakenly seen by many as
an achievement for both poor importing countries and the middle income
drug exporting companies of generic equivalents of patented drugs eg.
India, Brazil etc.
The complications and conditionalities unfortunately make the use of this
flexibility of parallel import difficult for both countries full of hurdles and
insecurity. This was hailed in our newspapers as a great breakthrough of
TRIPS. Para 6 negotiations few days prior to Cancun with US allegedly
'having given in the interest of public health of poor nations’ was
projected.
What was conveniently left out from the Cancun draft was any mention of
the TRIPS review which was to take place 5 years after launching of WTO
in 1995.
What was also conveniently dropped in Cancun of what was present in the
Doha Declaration in Article 27.3(b) of TRIPS, the issue of indigenous
2
knowledge and biopiracy. Since any discussion of this would clearly show
the exploitation of indigenous knowledge taking placewithout any
compensation nor acknowledgement of the original source. Patenting of
life forms is in violation of CBD- Convention on Biodiversity (not signed by
U.S.)
TRIPS and Public Health agenda item passed through in Cancun without
much challenge. It was the Agreement on Agriculture (AoA) which divided
the countries in those providing deep subsidies to their farmers, including
hiring export subsidies, making production of farmers from majority of the
world relatively unremunerative. Many farmers caught in the seductive
dream sell of increased 'market access' in developed countries of their
export oriented agriculture - had become paupers as neither they could
compete with subsidized agricultural products of US and EU market nor
their products find domestic procurement and sales as prices were made
very unremunerative. Forced imports of cheap food further displaced
farmers as their own governments lifted the little local subsidies given to
them on one hand and lifting tariff barriers where imports were concerned.
Changes in the non-tariff barriers constituting of regulations etc were also
made.
Massive protests by peasants and farmers and their supporters, anti
globalization groups were held. Mr. Lee a 37 year old Korean farmer, a
father of 3 girl children. He immolated himself in protest on realizing the
hopelessness with US and EU refusing to comply on decreasing of heavy
subsidies given to their own farmers. The Mexican government expressed
its condolences and Cancun Municipality sent flowers as Korean farmers
sat on the site in silent protest. Protest banners were put up on high rise
buildings, creative posters, pins, T-Shirts communicated the mood of the
civil society. WTO was unjust and it killed the poor.
Numerous workshops, seminars, press conferences, material showed that
people had a better understanding of what was going on, as evidence of
the distress~creaTed foF’the pooFby the negative irnpacT of WTO was
'documented by different groups - Activists, researchers, scholars,
sociologists and development workers.
A lot of the analysis was done by scientists, development workers, from
the viewpoint of the 'South1 by the people of the South.
International Forum on Globalization (IFG), RFSTE, TWN JRIS, Focus on
Global South being some of them many NGOs frorrFthe North - Actionaid,
MSFu Oxfam Heinrich Boell Foundation communicated the same concerns
in their various workshops.
3
The fact that the Brazilian delegation and the Indian delegation led by Mr.
Arun Jaitley were speaking in the same tone along with G21 ie. groups of
21 countries eg. Brazil, China, Venezuela was unprecedented. The
desire of these delegations to meet the NGOs and communicate to them
that a joint resistance front constituting of Governments of developing
countries and NGOs of North and Soutyh to resist unjust inernational trade
regimes was needed, was unprecedented^
Earlier many developing
countries tended to defend the 'WTO' obligations so as not be left behind
and as they suffered from 'There is No Alternative' - TINA Syndrome.
Many actually believed that such a market led globalization process would
benefit the world, others said so in return for the heavy consultanicies and
funds received and belonged to the HMV category to replacing HIS
Masters Voice. Many of the individuals and organizations were quite
unprepared for across the Board resistance from developing countries, the
civil society and thousands of marginalized farmers, peasants and
women's groups.
This resistance to the aggressive unilaterally benefiting agenda being
forced on the rest of the world was seen as unjust and also as community
and society destroying people and health destroying exercise being
pushed by Corporate agenda - The main players of course were US and
EU.
Security arrangements
Barricades and Barricades with the entire place dotted with well armed
police was a Cancun site. Many participants had to walk for miles as their
buses would be stopped and not be allowed to proceed as workshops,
briefings and meetings were taking place in different places sometimes in
totally opposite directions and a lot of commuting was required.
Transport
Due to barricades transport was difficult. Most of us took buses. Those
with money used the costly taxis.
Communication
Communication was not easy because of the Spanish language, non
functioning of all phones of most people including those with roaming and
the triband facilities. As these were not compatible, new cell phones had
to be bought by those who could afford them. Absence of phone facilities
did interfere with effective communication. On the day of our drug protest
the local bus for security reasons dropped me almost 1 1/2 km way from
4
the Convention Centre in the pouring rain and I reached the Convention
Centre dripping wet inspite of an umbrella which I took from India.
I managed to join the protest.
The police however were not hostile nor baton and trigger happy.
Many felt that the NAFTA North America Free Trade Agreement had
already been implemented in Mexicoandhadcreated enough distress for
the people and they realized what WTO could further mean. With FTAA Free Trade Agreement of the Americas which is to be extended to 36
American countries in a shape worse than WTO additional concern was
felt by the people in the region. The protests by the 'Campesinas'
peasants from Central American region was massive. They knew where
the shoe punches and they knew what walking barefeet on nails is like.
Drug Action
The drug groups met and gave a joint statement on behalf of MSF, HAI,
GAP act up Oxfam, PHM, IPHC, Diverse Women for Diversity, Third
World Network, Consumer International.
In the Convention Centre where only the registered official delegations
were permitted to go -- on the opening day - anti-WTO activists protested
by putting up placards.
On 11th the drug activists entered the Convention Centre taped
themselves with a red tape, on black clothes - symbolizing empty gift tied
with red tape high lighting the hollowness of the text related to parallel
imports with large number of conditionalities. Slogan shouted was
'medication for all nations1. It is precisely this group of.drug_activists which
had forced US to back off from the dispute case if filed in WTO, it was
precisely this group which had showed the 39 pharmaceutical companies
withdrawing their case against South Africa for wanting to produce“antiretroviral drugs under compulsory licensing. Silent protests were held by
placing flowers on the picture of Mr. Lee in the Convention Centre to
highlight the fact the 'WTO kills farmers".
Sessions attended by me:
Women's Forum
I was asked to speak on TRIPS and public health at the Women's Forum
in Cancun. Besides dealing with the issue, I mentioned about the long
fight of drug activists, role of People's Health Charter and PHM. Women
5
and Trade Network addressed WTO issues, specially water, food and
agriculture.
International Forum on Globalization
I was asked by the organizers to be a panel member on TRIPS and public
health (the request was made the night before the meeting).
I dealt with TRIPS what it meant in the area of pharmaceuticals, TSM etc.
Cost and access to medicines etc., People's Health Assembly.
There seemed to be fear of certain facts, certain information from reaching
the people. The reason that Governments are being pushed to take
EARLY decisions without issues affecting millions IRREVERSIBLY giving
due time for discussions and debates.
Since IFG has played a major role globally in addressing these issues, an
attempt to sabotage their teach-in was made. Repeated Radio
announcements were made that the meeting was cancelled and buses
were barricaded and did not let the participants wanting to attend the
teach-in including the speakers get down and the few vehicles that
reached the gate, were not allowed to stop by a strong contingent of police
force.
In the NGO Forum, several things were going on - on food security,
GATS, Singapore issues, new issues, WTO briefings were done in Hotel
Fiesta near the Convention Centres. It was not possible to travel long
distances in buses which went in real round about way and still be in time.
Weather was very hot, humid with intermittent rain. This added to the
exhaustion of those who had to walk long distance or who went on protest
marches with the peasant farmers. A march in solidarity for the African
people was also held.
Most of the participants were committed and serious people. There
always is a small minority of youth who feel angry and frustrated at the
greed, selfishness, tactics and blatant double standards eg the blatant
double standards in the behaviour of few countries namely US, EU. In
one of the sessions_oji_f.ood security organized by WEMOS, ICCO etc
where the Dutch Agriculture Minister-wasinvited. Her blatant-and
aggressive support of WTO and Tts neoliberal policies' left the participants
shocked with disbelief.
The Cancun Draft
6
No one knows how the drafts are prepared, what is the process, how the
concerns of poorer countries are addressed. The guess is that it is
formulated by the supporters of the corporate interest, The large number
of lawyers and drafting experts in the U.S, delegation are obviously
involvedjn drafting specially at the critical drafting stage. Views””of
countries are taken in an adhoc manner as group.
The Chairman’s draft is supposed to be discussed rather than a draft that
reflects the views of the majority. It was the total overlooking and non
inclusion expressed concerns of G21 that made the G21 more agitated.
The shocking thing is that no-records are kept for ever being able to check
out whether what is communicated later as a consensus draft - is recently
consensus.
The demand for EXPLICIT consensus,by Dr. Musorali Maran in Doha
Nov 2001 hacTbeenTaRefTup by the Indian delegation as well as NGOs of
North and South.
In fact bands of explicit concerns were made by Northern NGOs which
included the word in Hindi as sampoorna, sahmati.
The T-shirts with these words "Explicit Consensus" were in great demand
and were even by official delegates, including Brazil and India.
Monsanto
Monsanto one day attempted to donate genetically modified food for the
community members of one of the rural villages. The anti-GM groups
followed them, demonstrated and told the villagers about the rejection of
GM food by many enlightened consumers as well as governments.
With foreign media brought in by Monsanto to cover the Act of Charity
boom ranged on them, as the media landed up highlighting the protest
against Genetically Modified Foods by protesters. The protestors also
explained to the villagers why they were protesting and how GM foods
resulted in corporate control on agriculture, further marginalising the poor
peasants, besides safety concerns.
Fair Trade
Nobel Prize winner Rigoberto Menchu and Dr. Vandana Shiva
inaugurated the Fair Trade where organic farmers from different parts and
coffee growers, people from Chiapas had set up their little stalls.
7
The demand for Fair Trade over Free Trade was heard over and over
again. Protectionism by rich countries while demanding market access in
developing countries in the name of free market needed to be resisted.
The linking of the consumers and farmers without the middlemen was
seen as very important. (The reminder that farmers produce food and
corporations merely trade in food and not produce it, it must be
remembered farmers made destitutes and with profits of Corporations
increasing it was becoming evident that the rules of the WTO were in the
interest of the Agro industry and the other countries into export oriented
crops, food production is to be affected negatively.) It was also clear that
the national interest could not be safeguarded with National Treatment
which meant that TNCs have to be treated like domestic companies even
if it was based on any understanding. Most favoured nation actually
meant that no country could be given a better treatment than any other.
Government purchase ie all purchase had to be transparent and open for
TNCs too. The loss of national sovereignty is expected and built into
these regimes.
Changes of once our national laws and policies to ensure profitability of
foreign investors and safeguarding them against any losses, with national
governments making up for the financial losses it made.
I did not know Cancun was a tourist spot created 30 years for rich
Americans and other tourists, by creating artificial lagoons that it was so
hot in Cancun in spite of the closeness of the sea. Maya civilization
temples were 2 hours away by air.
Since had to return to work, due to seriousness of the situation and issues
involved due to resource and time constraints, I could not do anything
which in other circumstances one would have done. I did not even get
totouch the sea nor see the Maya civilisation temples two hours by air.
Thanks to the Haldiram peanuts and chana I took as a vegetarian and as
financially constrained participant that I managed in a non-posh hotel
AMOSOL a very small room on shared basis which was changed at the
last minute.
The collapse of Cancun, the formation of G-21, the exposure of the double
standards and increasing protests by civil society and objections raised by
developing country governments clearly shows that the unjust regime can't
be forced down the hearts of poor nations. For a large number of fence
sitters too the message is clear that protests against WTO is not isolated
noise made ’rabid radicals', doomsdayers' , it is by millions of existing and
potential victims of the unjust trade regimes - which will become global
poverty inevitable increasing socio-economic political and gender inequity.
8
Use of military power for control of resources was obvious. The effort to
divide G21 would be expected and also increasing use of bilateral and
regional trade agreements which would be harsher than WTO. It is also
clear that US is failing to get what it wants through WTO regime would do
so by putting bilateral pressure or through the World_Bank and IMF linking
loans to some conditionalities. Opening up of the water sector for
privatisation by E.U. is an example.
Learnings
Plan early confirmation of the programme
Check the weather and carry appropriate clothes.
Lot of glare - acquire numbered sunglasses
Lean to use internet to send your messages
Lean about different ways of communicating by phone
Ensure names, addresses, phone contacts with people or has to work
with.
Carry a camera that works with extra batteries and rolls.
Material picked up
Another Development is Possible - IFG
Social Watch World Trade and Development Report
Word Trade Report Globalization
MFC
TWN Briefings
IFG Kit
Public Citizen Kit
Maude Barlow Kit
9
THE GATS THREAT TO PUBLIC HEALTH
A JOINT SUBMISSION TO THE WHA
THE GATS THREAT TO PUBLIC HEALTH
A JOINT SUBMISSION TO THE WORLD HEALTH ASSEMBLY
MAY 2003
Within just 10 years of its adoption, the General
Agreement on Trade in Services (GATS) has become
of the
one
service sectors they will give up to liberalisation and
which
they
will
protect
from
GATS.
Although
elements
of the
developing countries officially have the right to
and
more
choose whether to commit a sector to GATS, in
countries are becoming aware of the threat posed by
practice they come under intense pressure in these
international
most
controversial
system.
trading
More
the scope of the GATS agreement, and there is a
negotiations to meet the demands of more powerful
growing call for governments to defend essential
WTO members - pressure which the smaller and
sendees from the GATS liberalisation agenda.
poorer countries are often powerless to resist.
This briefing examines the threat which GATS poses
In this way, GATS is primarily a mechanism for the
to health. It looks first at the challenge to health
service
services
themselves,
the
including
potential
for
corporations
of
developed
countries
to
expand their reach into new markets around the
increased inequity, fragmentation of health systems
world.
and further marginalisation of the public sector as a
negotiators: the European Commission has confirmed
This
is widely acknowledged
by official
that GATS is "first and foremost an instrument for
result of the increased marketisation of health care.
the benefit of business, and not only for business in
The briefing also examines the health risks which
general, but for individual service companies wishing
come with liberalisation of other service sectors such
to export services or to invest and operate abroad."
as water and insurance, and reveals the challenge to
national health regulations from current negotiations
GATS and health services
at the World Trade Organisation (WTO).
When GATS was adopted in 1994. few countries
were aware of the challenges it would bring. Very
no
few government departments other than trade and
country should commit its health services to GATS.
finance ministries were involved in the negotiations,
In conclusion, the briefing recommends that
In addition, each country should actively involve its
and several countries committed all or part of their
health ministry and civil society in comprehensive
health services to GATS liberalisation without die
‘healdi checks’ of any GATS commitments proposed
knowledge of their health ministries.
in other sectors before deciding on them.
According to the WTO Secretariat, 42 countries have
How does GATS work?
already committed their hospital services to GATS.
GATS commits WTO members to successive rounds
of
negotiations
“with
a
view
to
achieving
a
In addition, 15 have made commitments under the
category of ‘other human health services', which
progressively higher level of liberalisation” in their
include laborator)', epidemiological and residential
sectors. To achieve this, WTO members
healdi services, as well as podiatry and chiropody
service
make
liberalisation
requests
of
other
member
services supplied in clinics and elsewhere.
countries in secret, bilateral meetings in Geneva so as
to open up to competition those sectors which are of
Health services are also included under the GATS
most interest to their own service providers.
heading of ‘professional services',
which covers
medical and dental services as well as the category of
The current round of negotiations is now entering its
‘services provided by
most intense phase, when countries battle over which
therapists and paramedical personnel'. Already 52
midwives,
nurses,
physio
A JOINT SUBMISSION TO THE WHA
THE GATS THREAT TO PUBLIC HEALTH
countries have made liberalisation commitments in
die former category, and 28 in the latter.
also covers
GATS
services,
insurance
services
those
to
services,
the
where
model
market-based
of
competition threatens the integrity of health systems
including
health insurance, and 78 countries have already
committed
This is of special concern in the case of health
liberalisation
under
GATS. This has caused particular concern in those
countries which base their healdi systems on social
themselves. Health is a human right and a public
good
whose
cannot
externalities
positive
be
captured through market mechanisms. As such it is
not suitable to commit health services to binding
liberalisation under GATS.
insurance programmes, since few health ministries
were
informed
that
their
negotiators
trade
had
committed their health insurance sectors to GATS.
Nowhere is this more clearly seen than in the threat
of competition
from
foreign
where
the
public
countries
Even
hospitals.
sector
from domestic private
already
in
faces
hospitals,
the
The above figures may suggest that many countries
competition
have largely committed their health sectors to GATS
additional challenge of hospital services provided by
already. Yet out of all sectors covered by GATS,
foreign private sector health providers exerts extra
health and education are the two in which fewest
pressure on public health systems which are already
commitments have been made. As a result, the WTO
under severe strain.
sees the current GATS negotiations as an opportunity
to achieve further liberalisation in those sectors.
For those patients who can afford them, high-tech
In fact, many countries have deliberately withheld
health service. They also offer medical personnel an
their health services from GATS liberalisation in
opportunity to practise their profession in the most
recognition of the great uncertainty surrounding what
modern and fulfilling environment, and often at far
a GATS commitment might mean for health care. It
higher rates of pay.
foreign hospitals may offer an unparalleled level of
is
only
now,
in
the
current
round
of GATS
negotiations, that health services may again come
Yet by attracting the most experienced staff and the
under threat of liberalisation.
most affluent patients away from the public sector,
expansion
The GATS threat to health services
of the
private
sector
undermines
the
integrity of the health system as a whole. As WHO
strong
affirmed in its World Health Report 2000, leaving the
government regulation and a proper understanding
public sector to provide services only to the poorest
Providing
services
basic
for all
requires
of where liberalisation may be beneficial, and where
not.
Yet
the
"request-offer"
process
of
GATS
negotiations is designed to open up more and more
and most needy patients undermines the possibility of
cross-subsidisation
and
risk
pooling
on
which
sustainable health systems are based.
service sectors to competition through a series of
trade-offs at the WTO, rather than concentrating on
For the vast majority who are unable to afford the
which type of system is most appropriate for which
high costs of foreign private sector health care, the
particular service.
promise
of
increased
choice
as
a
result
of
THE FOUR GATS MODES OF SERVICE DELIVERY
GATS distinguishes four different "modes' of services, all of which are relevant to health services-
1.
cross-border supply: - where the service is provided remotely from one country to another
telemedicine via Internet or satellite, or international health insurance policies
2.
consumption abroad: - where individuals use a service in another country, such as patients travelling to take
advantage of foreign health care facilities, or medical students training abroad
3.
commercial presence: - where a foreign company sets up operations within another country in order to deliver
the service, such as hospitals, health clinics, insurance offices or water distribution operations
4.
presence of natural persons: - where individuals such as nurses, doctors or midwives travel to another
country to supply a service there on a temporary basis
such as
THE GATS THREAT TO PUBLIC HEALTH
liberalisation
is
therefore
a
hollow
A JOINT SUBMISSION TO THE WHA
one.
Rural
communities in particular risk seeing their access to
‘NECESSARY’ REGULATION?
health care undermined by die expansion of the
private sector, as foreign hospitals draw away their
The
remaining doctors, nurses and midwives to serve the
longstanding ban on tobacco imports shows
urban elite.
how
USA’s
the
1990
WTO
challenge
Thailand's
to
interpret
could
whether
a
domestic regulation is ‘necessary’ or not. WHO
Health risks of other GATS liberalisation
supported the Thai government in its defence
financing of health systems faces a similar
that opening its market to imported cigarettes
challenge from GATS liberalisation. National health
(and the advertising which goes with them)
The
systems
be
undermined
would inevitably lead to an increase in smoking,
by such liberalisation, as competition from foreign
especially among women and young people,
providers threatens the sustainability of programmes
and that the import ban was therefore necessary
insurance
can
seriously
designed to spread costs across society and provide
to protect public health. Yet
affordable health care for all.
dispute panel ruled that the ban was a restriction
Yet it is not only in respect of health systems that
on the Thai government to remove it. The WTO
GATS poses a threat to health. GATS covers a wide
has since cited the decision as precedent for its
range of other service sectors with direct links to
own rulings in similar cases.
the pre-WTO
on trade which was not ’necessary’, and called
health outcomes, and liberalisation poses a threat in
many of these sectors too. Public statements by the
European Commission that the EU is making no
GATS and public health regulation
GATS requests in health services fail to acknowledge
the potential health impact of its extensive requests in
As shown above, GATS has gone further than any
other sectors.
other
multilateral
WTO’s
trade
liberalisation
agreement
to
bring
the
into
the
heart
of
agenda
national policy. This is particularly true of the GATS
For example, the EU is attempting to use the current
round of GATS negotiations to open up the water
rules on domestic regulation, which are still being
sectors of 72 other WTO member states - including
developed at the WTO.
both developing and least developed countries. There
regulations in WTO
that domestic
is evidence from developing countries across Latin
GATS states
America. Africa and Asia that liberalisation of water
member
systems typically raises water tariffs beyond tire
barriers to trade”.
reach of many poor households and can cause severe
Council for Trade in Services to develop new GATS
health problems, especially among children.
rules to ensure that technical standards or licensing
countries
must
not
It also
pose
"unnecessary
mandates
the WTO’s
requirements in WTO member countries are “not
burdensome
than
As a result of such experiences, several developing
more
countries which experimented with liberalisation in
quality of the service”.
necessary
to
ensure
the
their water services have taken tire service back into
public hands. Yet once a sector is committed under
Yet there is widespread concern that these GATS
GATS, punitive rules on tire modification of national
rules will threaten key public health regulations in
commitments make it effectively impossible for a
WTO member countries. The GATS requirement
country to reverse liberalisation in this way.
that regulations must be ‘necessary’ in WTO terms
could expose any domestic health policy to challenge
at the WTO.
This is because WTO agreements are designed to
bind liberalisation commitments for the future so as
to give foreign investors increased security - even if
India’s progressive new regulations on the marketing
this means exposing vulnerable communities and
of baby foods are just one example of the type of
their children to increased levels of risk. Many
‘restrictions’ which could be under threat. The new
mechanism as the
regulations, approved by India’s parliament in May
most dangerous aspect of GATS, since it closes down
2003 in order to support breastfeeding, prohibit the
commentators see this ’lock-in
the possibility of reversing excessive or damaging
promotion of breastmilk substitutes, feeding bottles
liberalisation in the future.
and all foods for babies under the age of two years.
3
A JOINT SUBMISSION TO THE WHA
THE GATS THREAT TO PUBLIC HEALTH
Yet
such
regulations
could
be
interpreted
Conclusion and recommendations
as
‘unnecessary’ if the WTO decided that there were
The current round of GATS negotiations have now
other ways of achieving the same public health
entered their most intense phase, with countries being
objectives - even if there were specialist evidence to
asked to liberalise sectors which they have previously
the contrary (see box on page 3).
kept closed to competition.
This has raised fears that other key public health
Yet the model of binding trade liberalisation at the
controls, such as restrictions on the marketing of
WTO may not be appropriate for services which have
alcohol and tobacco or regulations governing private
a major impact on human health. For precisely this
hospitals, could also be threatened by GATS rules on
reason, several countries have stated that they are not
domestic regulation, once they have been adopted at
going to offer up key service sectors to GATS.
the WTO.
ASEAN health officials meeting in Jakarta in 2002
concluded that developing countries should refrain
WHO officials have openly voiced their opinion that
from making health commitments under GATS, and
the WTO cannot be trusted to uphold legitimate
other
called on all health ministries to ensure that their
organisations have called for a halt to the domestic
health sectors are not traded away at the WTO. The
regulation negotiations at the WTO.
same policy has been adopted by the EU, USA and
GATS and the migration of health personnel
will not offer up their health services under GATS.
public
health
provisions,
and
many
many other countries, all of which have stated they
In
addition
to
the
establishment
of
hospitals,
clinics or insurance offices, trade in services also
There have been similar calls for caution in other
covers the movement of individual people to provide
sectors, with South African officials calling for water
services abroad. In the case of health services, this
to be taken out of GATS altogether. The same
‘trade’ takes place when doctors, dentists, nurses.
caution has been called for in other environmental
midwives or other health personnel move to other
services, as well as sectors such as tourism, energy,
countries in order to practise there. In the GATS
education and cultural services, all of which could be
context this is referred to as ‘mode 4’ (see box on
threatened by GATS liberalisation commitments.
page 2).
In recognition of these dangers, it is recommended
Many developing countries are using the GATS
that all WTO member countries should:
negotiations to argue for greater freedom for their
nationals to work abroad, as they see this export of
1.
make no GATS commitments in the health
sector or other health-related sectors;
2.
conduct a comprehensive ‘health check’ on any
other GATS commitments proposed by WTO
trade negotiators, with the active involvement
of health ministries and civil society;
3.
call a halt to the current WTO negotiations on
rules governing domestic regulation;
4.
call for a change to GATS rules which restrict
countries from retracting commitments
already made under GATS.
labour as an area of comparative advantage for their
economies. Countries such as India, Mexico and the
Philippines already receive over $5 billion per year
each in workers’ remittances, while in countries such
as Tonga, Lesotho and Jordan, workers’ remittances
represent over 20% of national GDP.
Yet the export of labour is not necessarily appropriate
in all sectors. In particular, the migration of health
personnel to richer countries is already a significant
and well attested problem facing health systems
across the world.
Rather
than
pursuit
of balance
promoting
further
migration
of payments gains,
in
the
the vast
majority of developing countries need to find ways of
This
retaining key personnel in their own health systems,
organisations: Equinet, International People’s Health
statement
is
endorsed
by
the
following
where their presence can make an immediate and
Council, Medact, People's Health Movement, Save
lasting difference to the lives of many of the world's
the
most vulnerable people.
Movement.
4
Children
UK,
Wemos,
World
Development
Page 1 of 2
Main Identity
From:
To:
"Benny Kuruviiia, EQUATIONS" <bennyK@equitabletourism.org>
SrcpWTORound (E-mail)" <StopWTORound@yahoogroups.com>; "GATScnt (E-mail)"
<GATScrit@yahoogroups.com>: "Gatstrat (E-mail)" <gatstrat@yahoogroups.com>
Sent:
Subject:
Tuesday. August 26, 2003 10:27 AM
Press Release: India's citizens protest against the Cancun Minist erial
Mass Demonstrations in Tamil Nadu and other parts of India against the
Cancun ministerial.
Ami GATS action in aii districts in Tamil Nadu on 26th August 2003
Press Release
There is a complex dilemma in governance that is ignored, and hence little
understood, by policy makers. The Central government is committed to
pursuing the process of India's integration with the world ostensibly
because this global economic integration (or globalisation) will help boost
India's economy and subsequently its living standards. Politicians and
bureaucrats are increasingly viewing rapid liberalization of international
trade, through various instruments in the World Trade Organization (WTO), as
the undisputable vehicle to achieve development.
But the Indian Constinnion also mandates the central government to adhere
to concepts of a federal democracy while arriving at policies. Democratic
politics are envisaged so that those that are directly affected make crucial
public policy decisions by them- or their representatives. The 73rd and
74thamendments to the Indian constitution are a case in point to ensure that
Panehayats and municipalities are devolved with adequate powers to take
crucial developmental decisions that would reflect their local
specificities.
Our position is that it is extremely difficult to pursue both these agendas
simultaneously, tn other words India’s present agenda of global integration
through centralized trade agreements is, and can be, achieved only at the
cost of local democracy. This conflict between global integration and local
democracy is perhaps best represented in the WTO’s General Agreement on
Trade in Services (GATS) which is the first multilateral trade agreement to
create a legal framework for international trade in services.
The major service sectors like Food, Water, Health and Education are the
fundamental rights of the marginalized people in India. According to the 73
and 74th amendment the above service sectors were given to the local bodies
to serve the local people. So the Government of India move to liberalise
(which will lead to privatisation) these sectors under the GATS without any J
consultation with local bodies is violating the powers of the local bodies c
and the veiy spirit of the Indian Constitution
-i.
8/26/03
Page 2 of2
The 5th Ministerial mcctin'’ of the WTO is scheduled to be hdld at Cancun.
Mexico next month (10-14 September 2003). Various commitments will be made
by India at this crucial ministerial and a sanction for deepening of
commitments wider the GATS is high on the agenda of developed countries like
the European Union and United States of America .
In the past two months peoples organisations and local bodies federations
all over Tamil Nadu have come out in protest against India's undemocratic
engagement in the GATS negotiations. More than 200 groups, including
presidents of rural local governments have written to the Prime Minister of
India calling for a standstill in negotiations and assessment of GATS
impacts before new sectors are opened up to foreign entry.
At these meetings it was decided that these groups would organise
demonstrations on 26 August 03 in all district headquarters in Tamil Nadu as
a sign of their serious disagreement with die GATS process.
Also on the same day as part of the peoples campaign against WTO we are
mobilising signatures from citizens to send it to the Prime Minster by way
of protest and requesting that we withdraw our country’s commitments in the
GATS which have been made surreptitiously by the Commerce ministry in 1994
without the consent of parliament, state legislatures and local governments
Benny Kuruviila
EQUATIONS
PO BOX 7512
NEW THIPPASANDRA
BANGALORE 560075 INDIA
TEL- & FAX: 91.80. 5244988/52471277.5247128
bennyk@equitabletoiuism.oig
8/26/03
ec-vPage 1 of2
*v*ain Identity
Cc:
"Benny Kuruviila, EQUATIONS" <bennyK@equitabletourism.org>
Benny Kuruviila, EQUATIONS" <bennyK@equitabletourism.org>; "StopWTORound (E-mail)"
<StopVVTORound@yahoogroups.com >: "GATScrit (E-mail)" <GATScrit@yahoogroups.com>;
"Gatsirat (E-mail)" <gatstrat@yahoogroups.com>
"Benny-Travel" ~<benkuru@yahoo.com>
Sent:
Thursday, August 28, 2003 2:29 PM
Subject:
02 Press Release: India's citizens protest against the Cancun Ministerial
From:
To:
- PRESS RELEASE Stop the GATS Attack!
"Moratorium on ail commitments under General Agreement on Trade in Services
(GATS)" is the demand of more than 650 signatories including Panchayat
Presidents and representatives, trade unions, farmers groups, mass
organizations, NGOs and a large number of individuals in the country. They
have voiced this demand by endorsing a letter prepared by EQUATIONS
(Bangalore). MANTHAN (Badwani) and Focus on the Global South (Mumbai). This
letter, which will be presented to the Prime Minister and Commerce ministry'
officials signals the beginning of a peoples campaign against the GATS.
Among the trade unions and mass organizations that have made this demand are
the Ail India Trade Union Congress (AITUC), National Alliance of Peoples
Movements, Mumbai Grahak Panchayat, Shahar Vikas Manch of Mumbai, Kokan
Vikas Sangharsh Samiti, KRRS (Karnataka), the Niinad Malwa Mazdoor Kisaan
Sangathan (Madhya Pradesh.) and others. Significantly, more than 200
Panchayat representatives from Tamil Nadu and Andhra Pradesh have already
written to the Prime Minister.
As a part of the "built-in-agenda" of the World Trade Organisation (WTO),
the GATS was reopened for negotiations by the beginning of 2000. From the
arduous negotiations on modalities emerged a non-multi lateral mechanism
known as a "request-offer" approach for proceeding ahead with negotiations
under the GATS. Member countries of the WTO were asked to make "requests" to
other Member countries, which include: (a) the sectors that they want the
other Member(s) to open up to liberalisation; (b) the mode of service supply
to be opened up under that Sector; and (c) the quantum of liberalization
that needs to be carried out under each mode of supply within that sector.
The Members are responding to these requests by making "initial offers."
This has overwhelmed most developing countries, at a time when they have
been pushing the WTO to implement an assessment of impacts of services trade
liberalization.
i 'Jb '
Why Moratorium on GATS offers?
GATS covers more or less all the essential public and private services
supplied and consumed by society. In spite of this fact, the Government of
India is not carrying out a public debate in any forum, including the
Parliament, to discuss how its commitments under GATS would impact the
developmental fabric of Indian society. Irrespective of the fact that a
number of services get covered under the State and the Concurrent List of
the Indian Constitution,.several-State-Ia<eLdfficials.are completely
unaware of the GATS itself. If this is the apathy shown by the Centre
towards States, nothing better can be expected in the context of Panchayats
8/29/03
Page 2 of 2
\
and Municipal Corporations. Panchayat Presidents and representatives were
shocked when they were confronted with the experiences of liberalization in
essential services such as health, education, sanitation and water in other
developing countries.
The lack of transparency associated with the existing liberalization agenda,
the undermining of federalism and the lack of competence within the Commerce
ministry7 are some of the several issues highlighted inthe letter, and
underline the need for a standstill in the negotiations.
The upcoming Fifth WTO Ministerial meeting in Cancan is expected to provide
the mandate for further negotiations and a deadline for final commitments.
The demand from Indian civil society is that instead of accepting this
process as a fait accompli the Government of India should lead the
developing countries in calling for the much-needed assessment of GATS and
removal of all essential services from the ambit of the GAI S.
The signatories to the letter believe that the right to essential sendees
is inalienable to all citizens of India. Further, equity, justice and
dignity in the delivery of essential services is integral for long-term
societal stability and equality. Signatories to the letter call upon the
Indian Government to respect the Indian Constitution and fundamental
principles of democracy, and act upon the concerns expressed in the letter.
For further details kindly contact:
Benny Kuruviila (EQUATIONS) - benkuru@vahoo. com <maiito:benkuru@.yahoo.com>
SEalmali Guttal (Focus on the Global South) - S.Guttal@focuswcb.org
<mailto:S.Gutral@focusweb.org> (Mobile Number: 09886020362)
Benny Kuruviila
EQUATIONS
PO BOX 7512
NEW THIPPASANDRA
BANGALORE 560075 INDIA
TEL & FAX: 91.80. 5244988/5247127/5247128
bennyk@eouiiabletouiism.org
8/29/03
X. V-X X.
Gt- 'S
Page 1 of 2
223 6S90~nr e-mail nandn@vsnl.com
main icar.i.ry
From:
To:
Subiect:
"Benny Kuruvilia EQUATIONS" <bennyK@equitabletourism org>
"Amit Srivastava (E-mail)" <amit@.igc org>: "Ancheri Sreekumar -GU (E-mail)”
<sreeancheri@yahoo.co.uk>; "Ashish Kothari (E-mail)" <ashishkothari@vsnl.com>; "Ashok
Rao (E-mail)" <karao.geo@yahoo.com>; "3 khadria -JNU (E-mail)" <bkhadria@yahoo.com>;
3 L Das (E-mail)" <bldas^^vsnl.com>; o o czhimni-JNU (E-mail) <bschimni(§;hotmail.com>;
"B. K. Keayia (E-mail)” <wgkeayia@dei6.vsnl.net.in>; "Bharat J (E-mail)”
<bharatmadhu@vsnl.com>; "Biswajit Dhar 2 -IIFT (E-mail)” <bdhar97@hotmail com>;
"Biswajit Dhar -IIFT (E-mail)" <bisjit@bol.net.in>; "Chakravarthi Raghavan (E-mail)"
<raghav3n@iprolink.ch>; "Dinesh Abrol 2 (E-mail)" <ap1Q66@hotmail.com >; "Ekbal (E-mail)"
<ekbal@vsnl.com>; "G D Sharma (E-mail)" <sharmagd@vsnl.com>; "Jayati Ghosh (E-mail)"
<jayati@ndf.vsni.net.in>; Kalpavnksh (E-mail) <kalpavriksh{@vsnl.net>; h/leena Menon (Emaii)" <ivb@vsnl.com>; "Muchkund Dubey (E-mail)" <csdnd@.dei2.vsni.net.in>; "Nina/Ashok
Rao (E-mail)" <theraos@vsnl.com>; "PPatnaiK (E-mail)" <ppat@del3 vsm.net.in>; "Raghav
Narsalav 3 (E-mail)" <focusind@vsnl.net>: "S Janakarajan (E-mail)" <janak@mids tn.nic.in>:
"S Nsrayanan (E-mail)" <ambnarayanan(@yahoo.com>; S P. Shukla (E-mail)
■-spshukia@sth.net>; "Sanjay MG -NAPM (E-mail)" <sansahi!@vsnl.net>; "Seema Bhatt 2 (Emaii) <seema1@nda vsnl.net.ii*>>; oethu k F ^c-maiiy <se»iukp^^yanoo.com>: SeihuiiatliFE (E-mail)" <seihunaih@express2.indexp.co.in>; "Shefaii 3 - IATP (E-mail)"
<sshefali@yanoo.com>; "Shripad 1 (E-mail)" <snripad@narmada.org>; "Shripad 2 (E-mail)"
<manthan_b@sancharnet.in>; "Thelma/Ravi-CHC (E-mail)" <sochara@vsn!.com>: "Thomas
Kocherry (E-mail)" <n“@md2 vsnl net.in>; "TT Sreekumar 2 (E-mail)" <sosk@ust.hk>;
"Shaimali Guttai (E-mail)" <s.guttai@focusweb.org>
Monday, October 13, 20C3 1:58 PM
India finalises initial GATS offers
Piease see the news item below. For your information and. of course, action
1 wonder what the Indian negotiating strategy will be as die article
mentions thst cxccnt sen/iccs 311 nesotistions si*e tcmnorsrilv li<iltsd. The
1x3.02 cii, os ’'Vc mi Icnow, usee to no 11x3x1x213CC2SS lor services oy
developing countries in exchange for aaricuitural concessions and Mode 4
opening by developed countries. Neither is likely to happen.
Any suggestions/ comments etc would be much appreciated
2^31(1^
UCiaxiy
it
Benny Kuruvilia
IsQ U A1 lOi*4 S
PO BOX 7512
NEW THtPPASxANDRA
BANGALORE 560075 INDIA
TEL & F.AX : 91.80. 5244988/5247127/5247128
bennyk@eciuitabletourism.ore
Mondav. October 13. 2003
r he Financial express
The Indian Express
India Readies Sendees List For WTO Talks
10/14/03
10/14/03
Z CI
NEW DELHI, OCT 12: The commerce ministry has finalised its initial offers
list for ilic on-soms services negotiations at the World t rade Organisation.
The list is being vetted by India’s WTO office in Geneva and is expected to
be submitted soon.
Even as all negotiating group meetings have been suspended at the World
Trade Organisation following the failure ol the Cancun ministerial meet in
Mexico last month, the Committee on Trade in Services is the only group
v» iUcii is continuing to meet.
According to sources. India is submitting offers in most areas except
accountancy, legal services, post and courier services, retail and wholesale
trading and franchising activities. Areas where offers are being made
include communication, environment, health, education, recreation, culture,
sports, business & professional and tourism.
1 he team led bv India's ambassador and permanent representative to the WTO K.
M Chaadrashekhar is going through the offers list finalised by the commerce
ministry and giving it a final shape before submitting it to the CTS,
officials said.
Interestingly, the date ilxed by WTO lor submission ol initial oilers was
March 31. 2003. Till date onlv a handful of members includin'* the HU and the
ub nave submitted their oners.
Services can be supplied through four modes which include cross-border trade
iii services (Mode 1), consumption of services abroad (Mode 2), establishment
of commercial presence (Mode 3) and movement of natural persons (Mode 4).
While India is mostlv interested in Mode 4 and Mode 1 and to an extent in
ivrodc 2, officials said that it could consider making otters in Mode 3 if
there were substantial otters in .Mode 4 from developed countries.
India is disappointed with the offers made by developed countries in the
area of movement of natural persons (Mode 4). While the US has totally
ignored the area, the EU has said that it would impose numerical
restrictions on it.
On the other hand, both the EU and the US have made requests in Mode 3 as
they have enough capital to establish commercial presence in other
countries.
Although, all negotiating group meetings have been put on hold by WTO
director general Supachai Panitchpakdi till he finishes consultations with
stakeholders, meetings of CTS began on September 29.
In a special session ol C A held on October G. a proposal on movement of
natural persons jointly submitted bv 13 countries including India China.
South Africa and Argentina submitted in July this year was discussed at
length.
The services negotiations at WTO are taking place through a request-offer
approach. Under this, ail members have io submit requests to other countries
in the areas where they are interested and make offers in response to the
requests they nave received from other members.
1 he offers being made have to be on a multilateral basis.
10/14/03
Main identity
"Benny Kuruvills. tuUA'l IONS" <bennyK@equitabletounsm.org >
"Amit Srivastava (E-mail)" <amit(8)iqc org->’ ".Ancherl Sreekumar ~GU (E-mail)"
<sreeancheri@yahoo.co uk>; "Ashish Kothari (E-mail)" <ash>shkothari@vsnl corns-; "^JyOp'7/(
B i_ L>as \c-iT<o>i.) <Oiuas\;xiVSt'n.coiVi>; L> 3 CI'iimni-vNU (e-mail)" <bschinirn@hotmail.com >;
B. K. Keayia (E-maii)" <wgkeayla@cei6.vsnl.net. in>: "Bharat J (E-mail)"
<bharntmadhij@vsni com>: "Biswajit Dhar2 -HFT (E-mail)" <bdhar97@hotmail com>:
"Biswsht Dhsr -IIFT (E-msil)" <bisi!t(a)bcl nst in> "Chskrsvsrthi Rsahsvsn (E-msil)"
<ragh3v^n@iproHnk ch>; "Dinesh Abrol 2 (E-mail)" <ap^ 966@hotmail.com>; "Ekbal (E-mail)"
<skb2i(^vsnl ccm^*' "G 0 Snarm.Q (E-maii)" <sh2’’m2gd(@vsp! com-' Joysii Gbo^b f
^joyau\CLji'iGt’. v'SiTi.i ica.ii l>, ixSipa Vi‘iKoi'1 (L-iTiciii) <ka{paVi'ik5n@VSrH.i'liSt>. MccTiS iricnOi'i (L~
maii)" <ivb@vsni.com>; "iviuchkund Dubey (E-maii)" <csdnd@dei2.vsni.net.in>: "hiina/Ashok
Rao (E-mail)" <tneraos@vsm.com>: "RPatnaiK (E-maii)" <ppat@del3.vsni net.in>: “Raghav
Moraoiaw 3 (E-m3i!)" <focusind{3)vsnl nst> "S Janakaraian (E-mail)" <ian3k(S)mids tn nic in>’
S Narayanan (E-mail) <amhnarayanarii@yahoo.c<jm>; 'S P. Shukia (E-mail)1
maiij ‘'Sac.Mia3@riC»a.vsiii.i ict.in>) Sethu K r (E-rriail) <5cti-iuKpi@yaHOO.com>: S&thunatl'iFE (E-maii)" <seihunaih@express2.indexp.co.in>: "Shefaii 3 - iATP (E-maii)"
<ssnefali@y$hoo.com>: “snripad 1 (E-maii)" <shripad@narmada org>; "Shripad 2 (E-mail)"
<manthan b(S),sancharnet.in-”*: "Thelma/Ravi-CHC (E-mail)" ^sochara(5)vsnl com>' "Thomas
Kocberry (F-mail)" <rrff@md2. vsnl.net in>; "TT Sreekumar 2 (E-mail)" <sosk@ust.hk>;
"Shalmaii Guttal (E-mail)" <s.g'j;;al@focuswsb.org>
Subject:
i i'iui Sviov, Oc'iOboi i O. z.003 4,3/ riMi
Inaia forsaxes VVi O for onateral tree trade deals
IN irKNAi ION AL ECONOMY: INDIA FORSAKES WORLD iRAuE uRGANISA i ION FOR
1 K-idjj, 1 KALIL, LzEALS WILLI NLTGL LL>(JUrLS
Bv Edward Luce
Financial Times' Oct 16 2003
India - unfazed by the. coiiap.se of the world Trade Organisation meeting in
Cancim last month - has signed three bilateral trade agreements with other
Asian partners in ns aftermath, writes Edward Luce in New Delhi, in spite
of accusations from some that it was one of the more intransigent
participants ai x-aiicun. iiiGiari iiiiiiistcrs say tusy arc iiappy to pursue
separate deals in the absence oi consensus at the WTO. Indeed, manv suspect
Nev. Delhi is consciously pursuing such deals as a substitute for progress al
the multilateral ibrum.
l ast week Ata’ Bchari Vajpayee, the prime minister, signed a free trade
aglCcliiClii \r i A/ Wi'ui i liciilaitd. 11'1 WifiCii iuC IWO CviilililcS pi’OliilSCd tO 1’CUUCC
tariffs to zero bv 2005 on un io 80 nroducis. Mr Vaioavee also signed a
nc4.xi.iv,».oiiv
tviiiJui \*itn me ^Yssociaticn ox SoutnEosi xukSian iNaiions ^/kseaix^
m ir$ summit in Baii last week and recently concluded a similar TTA. with
C; itu-r,rr-
— -i-a'-t-
India and Asean agreed io sei up a free trade area - within a decade. Senior
aides to Mr Vajpayee also announced moves to set up a joint studv group with
j^cijiiig tG vizxpiGiC a oiiAiiivLi itiraiiScmciii wim Cmina. Fia<le Oeiwceii nic two
is set to exceed S7bn (EUR6.4bn. £4.2bn) this year, almost double the level
of Iwo y ears ago. “In spile of the stalemate al Cancan ... regional trading
arrangements oner us im-mediate advaniagcs.'1 Mr Vajpayee said in Bangkok.
"The}’ can provide nar domestic industry and agriculture with a valuable
ieariiuig pciiod. beioie oeuig exposed to global liee hade."
Some observers accuse India of precisely the same double standards that it
said was shown by the US and die European Union at the Cancun meeting.
7310/17 03
Av CidgC iaiiiiS iii IlKiici ai'C aiilOi'ig the highest ill the WOfld at about 30 pCi'
cent. -md it mmntsins hichcr average duties on imports from developing
countries than on those from developed countries. New Delhi has also
singularly failed to make a success of the South Asian Association for
ion?.l f?O“OpermiOiij vhich cvinprises Tndia? .Prihistaiij Nfep"!!., I3hur?.n
Bangiauubh. Sii Lanka and the Tvlaidives,
prQfrr^cc towards a south Asian nrete^eiitial trade area has almost stalled
mOccusc or amugomsm oci\vccri lUGia ano I'alrrstan. critics also point out
that unlike brazil or Soinn Africa, India has done verv little to reform its
domestic agricultural sector to prepare for lower farm barriers. Rural
infrastructure in India remains abysmal. Almost naif the country's roads
lack all-weather surfaces. India's fanners, who make up two-thirds of its
population, arc required to sell their produce to sovciniucin-appointcd
middlemen who nenerallv pav much less than a free market system would allow.
Such restrictions keep India's farm sector uncompetitive. "India is still in
the habit of empty moral posturing rather than pursuing a serious quest for
a better multilateral trading system," said an Indian trade economist. "If
India was serious about getting a better free trade system then it would be
preoarinn its economy for such an eventuality."
Benny Kuruviiia
EQUATIONS
PO BON 7o12
N E W 1 HIP PA. SA.N DRA.
lEL&FAX : 91.80. 5244988/524/ i27/5247128
bennyk'^ecmit able tourism.org
10/'i7/03
50.000
Basic Capabilities Index 2011
The boom and the busted
A lost decade in the fight against poverty
WORLD TRADE
TOTAL WORLD EXPORTS MULTIPLIED ALMOST FIVE
TIMES IN TWENTY YEARS, GROWING FROM A TOT/
VALUE OF 781 BILLION US DOLLARS IN 1990 TO 3
TRILLION IN 2010
i TH CAPITA INCOME
WORLD AVERAGE INHABITANT M.'
1 LED HER INCOME FROM 4.07c ■
0 9.116 DOLLARS A YEAR
World trade and per capita income grew faster in
the first decade of the XXI century than the decade
before, but progress against poverty slowed down. A
gap widened, due to the unequal distribution of the
benefits of prosperity. Now the boom years seem to
give way to a bust. The vulnerable did not benefit from
the accelerated growth in the economy, but they will
undoubtedly suffer the most with a new contraction.
The Basic Capabilities Index computed by Social
Watch looks at basic social indicators. The 2011
figures show that economic performance and well
being of the people do not go hand in hand. Progress
BASIC CAPABILITIES INDEX
THE WORLD AVERAGE IN THE INDEX OF ESSENTIAL
SOCIAL INDICATORS COMPUTED BY SOCIAL
WATCH ONLY GREW 10% IN TWENTY YEARS,
FROM 79.3 TO 87.1.
on education, health and nutrition was already too
slow when gross income was growing fast. While
using the latest available figures, the Index does not
capture yet the whole impact of the global financial
and economic crisis that started in 2008, because
social indicators are gathered and published much
slower than the economic numbers. Yet, Social Watch
is receiving evidence from its members on how the
crisis is burdening the most those already vulnerable
and that situation can only become worse if the big
industrialized countries enter into prolonged stagnation
or recession.
55
PROGRESS AND REGRESSION TOWARDS BASIC SOCIAL GOALS
The Basic Capabilities Index 2011
--2011.................. >
Afghanistan
Albania
Algeria
Angola
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzeg.
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Rep.
Chad
Chile
China
Colombia
Comoros
Congo, Dem. Rep.
Congo, Rep.
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Rep.
Ecuador
Egypt, Arab Rep.
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran, Islamic Rep.
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Dem. Rep.
Korea, Rep.
■Z
CT
80
87
99
88
99+
99
99+
99+
99+
91
99
97
98
98
98
86
95
99
90
99+
99+
93
90
97
99+
93
99+
96
86
81
97
91
97
99
99+
93
96
97
96
99+
99+
99+
97
99+
98
97
92
95
97
99+
BCI
VV
80
99
95
99
97
49
84
99
99
98
98
99
99+
99
99+
89
97
99
99
97
99
18
95
99+
99
99+
95
99+
98
78
88
72
71
92
95
99+
99
95
94
98
98
99+
99
99+
54
99
83
34
83
44
91
59
85
99+
99
78
97
53
83
21
79
99+
99
96
98
96
98
62
qn
.-.7.-74'-^
86
99
57
99+
99+
99+
99+
99+
93
99+
98
80
79
84
99+
6
99+
99
86
57
98
99+
59
99
51
46
39
83
26
67
99+
99+
47
73
97
80
99+
99
99
98
99+
99
99+
44
65
97
99+
99+
88
82
61
96
91
92
90
94
55
97
92
94
56
70
84
89
80
89
93
94
36
69
64
73
79
38
17
95
97
84
7?
40
51
92
40
94
97
96
91
96
30
87
71
82
80
79
53
38
96
33
97
76
44
97
95
61
97
70
42
32
90
79
94
98
62
87
89
76
97
97
98
76
91
95
78
98
SOCIAL WATCH
BCI values for 2011 were computed for 167 countries where data are
available out of the 193 member states of the United Nations. The BCI
96
92
67
98
96
99
99
93
97
97
70
98
98
96
76
81
86
96
90
95
98
98
62
66
73
73
99
89
62
48
98
97
94
78
64
75
97
68
98
99
99
98
99
75
96
90
90
90
91
66
72
99
58
99
99
86
70
97
99
77
99
80
64
56
92
67
86
98
99
76
88
94
87
99
99
99
92
99+
96
96
77
84
95
99
Regions
BCI
BCI
■HtnHSSHBEBK
East Asia & Pacific
97 I
86
98 . 98
93 n 95
top performing countries having the highest BCI are mostly from the
Central Asia
Latin America & Caribbean
90
85
92
95
nsi£94 .
developed countries of Europe, North America and East Asia/Pacific. In
Middle East & North Africa TO. 85
contrast, the countries with the lowest BCI values are mostly from
South Asia
values for 2011 ranged from 47.9 to 99.5 with Japan, along with Norway,
Netherlands, Switzerland and Iceland, occupying the top five positions. The
Europe & North America
Sub-Saharan Africa and South Asia, with Chad at the bottom, along with
Sub-Saharan Africa
Sierra Leone, Niger, Somalia and Guinea Bissau.
World
Basic
] BCI values 98 and over
Medium | BCI values from 91 to 97
As in previous Social Watch
reports, the countries are
categorised into five:
Low
BCI values from 81 to 90
Very Low
BCI values from 71 to 80
Critical
BCI values below 70
Countries with basic BCI level are close to the maximum possible values of
the indicators that constitute the Index and are very likely to have met the
MDG targets way ahead of the 2015 deadline. Countries in this group are
providing essential social services required to ensure a minimum dignity
level and are thus able to further improve the well-being of their people.
BCI Trends, 1990 to 2011 - Slowing Down
The global BCI has progressed between 1990 and 2011, altough, in general, there
has been a slower rate of progress between 2000 and 2011 than between 1990 and
2000. In 1990, the average BCI value (population weighted) for countries with
^ailable data was 79.4. In 2000, BCI increased by 4.9 points to 84.3. BCI further
WPeased to 87.1 by 2011, but ata lower increment of 2.8
- lower than the
increment posted in the previous decade.
Global BCI Trend, 1990-2011
Year
1990
Change
(1990-2000)
2000
Change
(2000-2011)
2011
BCI Value
79.4
4.9
84.3
2.8
87.1
Looking at the regional trends, it is noted that in the past 20 years from 1990 to
2011, more countries have achieved basic and medium BCI levels. During the same
period, the number of countries with critical BCI level has decreased from 42
countries in 1990 to only 28 by 2011. Some of these countries advanced to the next
level while a few have actually moved two levels higher.
The number of countries with medium BCI levels increased from 44 in 1990 to 52 in
2011. Countries that have scaled up their BCI levels from low/very low to medium
include the following: Algeria, Iran, Kuwait, Saudi Arabia, Syria and Tunisia (Middle
East and North Africa); Azerbaijan, Tajikistan, Maldives and Vietnam (Central, South
and East Asia); and Belize, Brazil, Colombia, El Salvador, Mexico, Paraguay, Peru and
Suriname (Latin America). El Salvador registered the highest increment in BCI in this
group accounting for a 17 point increase for the period 1990 to 2011. In contrast,
countries such as Ukraine, Bosnia and Herzegovina, and Thailand have moved down
from basic BCI to medium level.
Nineteen (19) countries registered low BCI levels in 2011. Countries such as Bolivia,
Honduras and Nicaragua in Latin America, and Cape Verde, Zimbabwe, and
Swaziland in the Sub-Saharan Africa region, improved their standing from very
low/critical BCI level to low BCI. Within this group of countries that registered low
BCI levels, Bhutan in South Asia recorded the highest increase of 28 points, climbing
up from critical to low BCI level.
The number of countries in the critical BCI list has declined since 1990 to only 28 by
2011. Countries such as Benin, Cameroon, Eritrea, Ghana, Kenya, Malawi, Rwanda,
Tanzania and Togo in Sub-Saharan Africa; Guatemala in Latin America; Djibouti,
Egypt, Morocco and Yemen in the Middle East and North Africa; Laos and Myanmar
in East Asia; and Bhutan and India in South Asia, have moved up from their previous
critical BCI levels. Nonetheless, the number of countries in the critical list remains
substantial especially if one considers that many poor countries with no reliable
Countries
Japan
Norway
Netherlands
Switzerland
Iceland
Slovenia
Spain
Korea, Rep.
Italy
New Zealand
United Kingdom
Canada
Finland
Austria
France
Ireland
Australia
Greece
Cuba
Israel
Sweden
Cyprus
Singapore
Denmark
90
87
i 98 ii 99 ]
99+
EWE 99 I
99 .
99 ’.
! 99 ]□».&£]
ms™
99
99 J
L&S1L99Z1LO-1
L92JL593L^ZJ
I 97~IE 98 IF 99 1
E95 II 98 II 99~~l
F~99'~irT9~l
r9inr99+!r99~]
r~9~5~ir98~ir99~i
United States
l 96 T 99+1 L99~]
Portugal
Latvia
I” 99+H: 99
Germany
r~99~jr~98 .i
Luxembourg
Montenegro
Lithuania
Poland
Belarus
Slovak Rep.
Croatia
Serbia
Chile
Hungary
97 I 98 ][ 981
Russian Fed.
' 96 . 99 JL98J
Brunei Darussalam
•96 K 9611 98 1
Argentina
Belgium
97
99 998.
99 II 591JL98J
Czech Rep.
E97:iEM98
Uruguay
Bulgaria
Malaysia
Libya
Qatar
Bahrain
Costa Rica
Ukraine
China
United Arab Emirates
Malta
Kuwait
88
93 IlJ97 J
97 ir$n
Romania
Maldives
84
90 ; 97 ,
Bahamas, The
Georgia
Moldova
Bosnia and Herzeg.
■Hil 94
96
Kazakhstan
r^nrw~i ran
Belize
Dominica
Mauritius
Thailand
Albania
Lebanon
Sri Lanka
Mexico
Armenia
Jordan
Mongolia
Brazil
im
yrgyz .ep.
JO
Laos PDR
94
99+
Latvia
98
99
Lebanon
62
99
Lesotho
92 . 46
Liberia
89
99+
Libya
98
99+
Lithuania
99
99+
Luxembourg
99+
44
Madagascar
54
94
Malawi
99+
89
99 f 95
Malaysia
Maldives
99
49
Mali
99+
81
Malta
99
61
Mauritania
88
99+
Mauritius
98
94
; Mexico
98
99+
Moldova
98
99+
Mongolia
97
99
Montenegro
99
63
55"]
Morocco
96
Mozambique
86
37
Myanmar
93
81
Namibia
95
19
Nepal
95
99+
Netherlands
99+
99+
New Zealand
99
74
Nicaragua
97
33
Niger
84
39
Nigeria
86
99+
Norway
99+
99+
Oman
99
39
Pakistan
91
89
Panama
98
53
Papua New Guinea
93
97
Paraguay
98
83
Peru
98
62
Philippines
99
97
Poland
99
99+
Portugal
99+
99+
Qatar
99
99
Romania
99
99+
Russian Fed.
99
52
Rwanda
89
99+
Saudi Arabia
98
52
Senegal
91
99
Serbia
99
42
Sierra Leone
81
99+
Singapore
98
99+
Slovak Republic
99
99+
r
.
Slovenia
99+
Somalia
82
91
South Africa
94
99
Spain
99+
99
Sri Lanka
99
49
Sudan
89
90
Suriname
97
74
Swaziland
93
99+
Sweden
99+ L99+
Switzerland
99+
95
Syrian Arab Rep.
98
88
Tajikistan
94
51
89
99
Tanzania
99
Thailand
62
Togo
90
98
Trinidad & Tobago
97
95
Tunisia
98
91
Turkey
98
99+
Turkmenistan
96
42
Uganda
87
99
Ukraine
99
99+
United Arab Emirates 99
99+
United Kingdom
99
99
United States
99
99
Uruguay
99
99+
Uzbekistan
96
95
Venezuela, RB
98
88
Vietnam
98
36
Yemen, Rep.
93
46
Zambia
86
60
Zimbabwe
91
61
97
88
62
47
95
94
59
57
92
94
46
88
42
90
93
90
91
67
51
70
85
46
99
60
28
45
98
83
41
90
83
86
81
96
95
91
91
96
57
85
44
95
96
98
81
99
87
49
80
75
96
87
98
76
88
68
94
87
89
62
93
89
96
93
91
89
53
67
87
S'
71
99
96
77
68
97
98
98
75
72
98
97
61
97
69
96
96
96
96
98
82
68
75
89
68
99
99
84
57
64
99
95
68
94
77
94
92
86
98
99
97
97
98
71
95
70
98
58
99
98
99
57
89
99
96
69
91
83
99
99
95
92
76
96
77
95
94
94
94
69
97
97
99
97
98
95
95
93
72
70
82
fall in the critical BCI levels.
BCI Level by Region, 1990, 2000 & 2011
100
□ Central Asia
|
| Europe and
North America
□ Sub-Saharan
Africa
□ East Asia and
the Pacific
Latin America
& Caribbean
ffl South Asia
Middle East &
North Africa
2000
1990
2011
By region, the trend also reflects the global slowdown in terms of increases in the
BCI level.
There is only marginal change in BCI level for Europe and North America in the last
20 years. For the regions of Latin America and the Caribbean, East Asia and the
Pacific, and the Middle East and North Africa, the trend shows a significant slowing
down of progress in BCI during the period 2000 to 2011 compared to the previous
decade.
On a positive note, the regions of Central Asia, South Asia, and Sub-Saharan Africa
registered slightly higher increments in BCI levels in the period of 2000-2011
compared to the previous decade. Despite the higher momentum for the poorer
countries in the Sub-Saharan Africa and South Asia, it must be noted that this two
regions have the lowest BCI recorded. Both these regions started from very low
levels, and they need to accelerate even more if they are to reach average basic
levels in the next decade. South Asia is progressing faster than Sub-Saharan Africa.
BCI Trends by Component Indicators
The child mortality index has the highest values across countries and regions. The
reproductive health index and education index have similar values which are
(^ificantly lower compared to the child mortality index. Gl Ally, the 2011
population weighted average value of the child mortality indSris computed at 95.7.
In comparison, the corresponding value for education is 78.5 and 75.7 for
reproductive health. That means more efforts are needed to address the gaps and
^tificantly improve education and reproductive health.
The table below shows the average values of the component indicators for years
1990, 2000 and 2011 and by region weighted by population.
BCI by Component Indicators
Child Mortality
Reproductive Health
Education
1990
2000
2011
1990
2000
2011
1990
2000
2011
92.0
94.2
2.2
96.4
2.2
96.5
93.3
-3.2
97.5
4.2
93.7
93.7
00
93.0
-0.7
East Asia & the Pacific
95.1
97.8
1.4
84.7
89.7
5.0
90.5
0.8
74.7
85.8
11.1
93.3
I
Variance
Europe and North America
96.4
1.3
7.5
;
98.0
98.7
0.7
99.2
0.4
97.0
96.5
93.2
94.4
93.0
-1.4
Central Asia
Variance
Variance
Latin America & Caribbean
-0.5
98.9
2.5
1.2
IS
.w
95.0
96.8
1.9
97.9
1.1
75.5
87.5
12.0
92.3
4.8
72.2
92.7
94.2
1.4
97.0
2,9
55.3
72.6
17.3
84.6
12.0
55.7
South Asia
87.9 :
93.4 .
2.7
30.5 j J37.3
Variance
Sub-Saharan Africa
90.7
2.8
82.7
84.4
87.5
3.0
48.0
45.4
-2.5
48.0
2.5
38.6
49.7
11.1
52.8
3.1
95.7
68.2
73.3
75.7
2.37
65.5
72.2
6.66
78.5
6.33
Variance
Middle East & North Africa
Variance
1.7
Variance
Average
Variance
92.6
94.2
1.54
1.53
6.9
5.12
43.2 I 52.9
5.8
Eg
88.4
5.5
80.3
-3.2
53.5 ■ 59.1
0.6
5.6 I
Notes:
1) All values are weighted by population
2) There may be some discrepancies in the average values of the component indicators due to the
rescaling process that was used to correct for distortions due to missing data, particularly for year 1990
It should be noted that the global trends in the last twenty years for all three component indicators show
a similar pattern of increases from 1990 to 2000 and 2011. However, reflecting the same pattern as the
BCI, the progress is slower during the period 2000 to 2011 compared to the previous decade. That means
that there is a noted slowdown in the progress achieved by countries starting 2000. This pattern is also
seen in most of the regions, indicating quite a consistent trend of slowing down over the past decade.
99+ refers to a value above 99.5. It is not rounded up
to "JOO" as that would imply a perfect accomplishment
which is impossible to achieve in reality.
The basic capabilities index is a non-monetary way
to measure poverty, based on indicators for health, nutrition
and education. See the methodological details
and further information at: www.socialwatch.org
Uzbekistan
Trinidad & Tobago
Oman
Syrian Arab Rep.
Saudi Arabia
Korea, Dem. Rep.
Iran, Islamic Rep.
Tunisia
Turkey
Kyrgyz Rep.
Colombia
Turkmenistan
Panama
Paraguay
Vietnam
Azerbaijan
Algeria
Tajikistan
Peru
Jamaica
Guyana
Suriname
El Salvador
Dominican Rep.
Ecuador
Egypt, Arab Rep.
Botswana
Namibia
South Africa
Cape Verde
Indonesia
Iraq
Honduras
Bolivia
Gabon
Philippines
Nicaragua
Kiribati
Swaziland
Morocco
Zimbabwe
Bhutan
Guatemala
Comoros
Ghana
Papua New Guinea
Togo
Kenya
Lesotho
Benin
Tanzania
India
Congo, Rep.
Myanmar
Madagascar
Djibouti
Cambodia
Cameroon
Eritrea
Malawi
Yemen, Rep.
Rwanda
Laos PDR
Senegal
Gambia, The
Zambia
Bangladesh
Sudan
Mauritania
Uganda
Nepal
Liberia
Cote d'Ivoire
Mozambique
Pakistan
Angola
Haiti
Burundi
Equatorial Guinea
Guinea
Congo, Dem. Rep.
Nigeria
Burkina Faso
Central African Rep.
Mali
Ethiopia
Sierra Leone
Niger
Somalia
Guinea Bissau
Chad
Afghanistan
I. 94 : ; . 95 j
81
84
7S
can
85
82
92 '
86
89
89
89
88
[Wl
‘ 74. !
82
83
82
87
86
86
86
86
84
80
' 86
84
83
82
82
...
______ 81 |
^^[¥731880 1
83
86
84
w
CO2 emissions ►
Y
(in metric tons per capita)
<3
I ii
flOO
_____ > OC
1 99
98
97
oco
8 sg
Hi
96
95
3
loll
o
— c
Q.a-
5
o o<
■g .j
O
94
93
92
o
|O
“
/. 91
‘ WORLD AVERAGE BCI LEVEL
89
88
87
j 86
° 85
11
■
-------- 1--------
O
q
SOCIAL PROGRESS
AND ENVIRONMENTAL DAMAGE
THE BASIC CAPABILITIES INDEX
ANDCO2 EMISSIONS
____
BCI and CO2 emissions by regions
The vertical axis shows the situation in the BCI (infant moitulity, primary
education, attended births), which has a maximum value of 100, The
emissions of CO2 in tons of coal equivalent
The world turns right instead of moving up
With carbon dioxide emissions of three tons of per capita a year, Costa Rica and Uruguay have
managed to lower their infant mortality to the same level of a country that emits twenty tons a year: the
United States. At the same time, with the same level of emissions than Norway, South Africa has a set of
social indicators similar to that of Indonesia, which consumes five times less fossil fuels.
The notion that eradicating poverty and reaching basic dignity for all requires a model of development
that destroys the environment is wrong. The leaders of the world made that point in Rio twenty years
ago at the "Earth Summit” and stated that "the major cause of the continued deterioration of the global
environment is the unsustainable pattern of consumption and production, particularly in industrialized
countries (...) aggravating poverty and imbalances".
Between 1990 and 2000 the world's index of basic capabilities improved five points (from 79 to 87)
while the world per capita emissions of CO2 actually decreased from 4.3 tons to 4.1. In the first decade
of the XXI century, world CO2 emissions moved up to 4.6 tons per capita but the social indicators only
moved up 3 points. In spite of the declared commitment with poverty eradication and the Millennium
Development Goals, the year 2000 was a turning point for the worse: social progress slowed down while
environmental destruction accelerated.
World
El North America
European Union
Latin America & Caribbean
Sub-Saharan Africa
South Asia 13 Arab Region
China
East Asia and the Pacific
30.000
35.000
The Basic Capabilities Index:
It is not about money
The Basic Capabilities Index (BCI) was designed by
Social Watch as an alternative way to monitor the
situation of poverty in the world. Most of the available
poverty-measurement is based on the premise that
poverty is a monetary phenomenon and they measure,
for example, how many persons live with an income
of less than one dollar a day. The BCI is an alternative
non-monetary measure of poverty and well-being
based on key human capabilities that are indispensable
for survival and human dignity. The indicators that
make up the BCI are among the most basic of those
used to measure the Millennium Development Goals
(MDGs).
theoretical maximum value in infant mortality is 100,
which would mean that all children born alive survive
until they are five years old. Reproductive health takes
the maximum value 100 when all women giving birth
are attended by skilled health personnel. Similarly, the
education indicator registers 100 when all school age
children are enrolled in education and they all attain
five years of schooling. These three indicators are then
averaged, so the total value of the index will vary
between 0% and 100%.
The BCI assigns equal weight to three basic
capabilities: (1) the capability to be well-nourished;
(2) the capability for healthy and safe reproduction;
(3) and the capability to be educated and be
knowledgeable. The index is computed as the average
of three indicators: 1) mortality among children
under five, 2) reproductive or maternal-child health
(measured by births attended by skilled health
personnel), and 3) education (measured with a
combination of enrolment in primary education, the
proportion of children reaching fifth grade and adult
literacy rate).
Countries with basic BCI level have reached a
reasonable level of human development and have
basically met the MDG targets way ahead of the
2015 deadline. Countries with medium BCI level have
achieved a certain level of momentum to address key
human development concerns and have a fair chance
of meeting the MDG targets by 2015. Countries with
low BCI level are still struggling to provide basic
services for their citizens and will more likely miss the
MDG targets by 2015. Countries with very low and
critical BCI levels will certainly miss the MDG targets.
Most of these countries, particularly those with critical
BCI level, are experiencing severe economic difficulties,
social unrest or wars. Some have just emerged from
armed conflict and are still transitioning to normalize
government operations and public services.
All the indicators are expressed in percentages and
they range from 0 to 100. Under-five mortality, which
is usually expressed in number of deaths per thousand
children born alive, is expressed as 100 minus that
value. So that, for example, a value of 20 deaths per
thousand becomes 2% and, when deducted from
100, yields a basic indicator value of 98. Thus, the
BCI for 2011
40.000
GLOBALISATION: EFFECT ON HEALTH
Late. Dr. CM Francis, President of SOCHARA
Globalization is defined as the process of increasing economic, political and social
interdependence and integration.
The spectacular break-through in 'Information
Technology' has made the process of globalization significantly different, quantitatively
and qualitatively.
Globalization also means / or seems to be occurring:
When multinational corporations locate themselves anywhere they wish;
Western Financial Institutions influence and guide patterns of 'development'
everywhere; and
a)
b)
ifc
National Governments cannot match the power of Transnational capital
The Labour of all regions is to be set in a competitive race with each other;
c)
d)
Then:
It is not through any existing forms of International Organizations that the poor are going
to be able to defend themselves
(Adapted from Jeremy Seabook's article in Third World Network Features)
Positive implications
♦ Information sharing: There is the possibility that more and varied information will be
available, which can be put to use by other countries. Such information will be useful
in improving.
❖
❖
❖
❖
❖
Services, standards and quality of care;
Policies;
Legislation;
Exchange of ideas;
Appropriate technology
♦ Increased awareness among people of issues and activities elsewhere;
♦ Better practices by health care professionals and workers.
Negative Implications
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While there can be some such positive influences, the possibility of harmful effects on
health and health is much greater.
Health technologies
Competition in industries often brings down the cost. But this does not happen among
health care providers. It will induce the spread of newer but not fully tested technologies.
This will lead to increasing investments in expensive, sophisticated technologies, which
may not be appropriate for Kerala.
Public sector
To remain competitive in global markets, public expenditure has to minimize. World
Bank and IMF insist that there should be a contraction of the public sector in the health
care services. In India (and more so in Kerala) the public expenditure on health is
already very low.
Global factors and their consequences
•
'Downsizing' and structural adjustment policies, leading to unemployment.
Marginialization, increased poverty decreased social safety nets leading to higher
morbidity and mortality rates.
■
Increased promotion of tobacco, alcohol and psycho-active drugs, dumping of unsafe
Increased addiction, ineffective and harmful treatment;
■
Promotion of cash crops at the expense of food crops;
Food security threatened; food shortage and increase in grades of malnutrition;
■
Environmental degradation and unsustainable consumption by the rich;
Resource depletion; water and air pollution; ozone depletion; accumulation of
greenhouse gases; and global warming.
■
Possible epidemics of respiratory disorders; immunosuppression, skin cancers;
cataracts; effects of floods and storms.
Patents
The GATT agreement on Trade Related Intellectual Property Rights (TRIPS) is meant to
protect intellectual property rights (IPR). It concerns mainly patents, which have serious
implications on health care.
There are two types of patents:
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Products patents
These patents give the holder the exclusive right to use the patented invention for a
specified period of time. GATT allows a product patent for 20 years from the date of
filing the patent application.
Process patents
These patents grant the holder the right s to use the process and product obtained by that
process.
Indian Patents Act, 1970, recognized only process patents. IPA star, dial the patent
should not be used as an important monopoly. It required making available tin- process
for manufacture of the product within the country recognizing the patent. I RIPS
agreement confers the right to import and does not require the production of the patented
invention in India.
TRIPS provisions
Inventions in all field s of technology, including drugs, chemicals, foods, agricultural
products, animals, plants, and micro-organisms are entitled to product and process
patents. We have witnessed the patenting of'basmati'.
The Indian Patent Act provided a duration of 14 years for patent protection. A patent for
process of manufacturing substances used or capable of being used as food, medicine or
drugs has a duration of seven years from the date of filing and five year.; fiuin the date of
sealing of the patent, whichever is shorter.
GATT requires 20 years patent protection for all inventions in the field cf technology,
17-20 years for pharmaceuticals, which can be further increased as process patent when
the product patent expires.
There is an obligation to set up production facilities in the country granting the patent.
Article 29 dilutes this provision. Patentee would be allowed to import the product in the
countries granting the patent; this is to be taken as on par with the obligation for
production in the country that grants the patent. This would make Third World Countries
merely markets for Transnational Corporations with no obligations.
According to all legal norms, when there is alleged violation, the accused is considered
to be innocent until proved otherwise. But in the new Patent rules, (lie burden of proof is
shifted to the accused. If a company files a suit against another of violati :m of copyright,
the accused will have to prove his / her innocence.
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Patenting plant varieties
There are many herbs which have been traditionally used in India and other tropical
countries as medicines. Now, these are being taken by the affluent countries. When
genetic resources are taken from the tropical countries to the affluent countries, they are
treated as freely usable and knowledge of their characteristics is seen as belonging to all.
When the same is processed by mixing the traits, they are treated as private intellectual
property attached to them.
The same thing happens to food crops seeds. This has resulted in a few companies in the
North controlling the whole of the world seed markets and genetic resources. This can
affect food security.
Farmers' exemption had allowed them to keep seeds form the harvest for the next sowing.
In the revised system, the farmers' exemption has been removed. If a farmer is found
using a patented variety of seeds, which he does not buy, all that the agent of the patent
holder has to do is to file a complaint with the concerned authority.
Farmers will be forced to buy new seeds for every sowing. The local plant breeders will
have to pay royalty for using the patented variety.
TRIPS and pharmaceuticals
According to Article 70.8, pharmaceuticals and agro-chemical firms can file applications
for product patents within one year of signing the GATT accord. The applicants will be
given monopoly of marketing rights for five years from the date of application.
Drug prices in India were among the highest in the world before the Indian Patent Act,
1970. IPA reversed the trend. Indian companies have now become major bulk drug
producers. There are about 10,000 units engaged in the production of bulk drugs and
formulations. The producers could bring down the price drastically. But this situation
will change drastically with the new legislation.
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