Globalisation: Effect on Health

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Title: Globalisation: Effect on Health
extracted text: Globalisation: Effect on Health
Globalisation provides threats and opportunities to the health of the people. As it is
practised today, globalisation has more threats than opportunities. This is because
the competition far outstrips collaboration. The impact on health and health care
systems is broad and profound. Globalisation is the process of increasing economic,
political and social interdependence and global integration. Capital, goods, persons,
concepts, ideas and values diffuse across the boundaries of the countries.

Positive implications
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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
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services, standards and quality of care
policies
legislation
exchange of ideas
appropriate technology

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Increased awareness among people

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Better practices by health care professionals and workers

While there can be many positive influences, the possibility of harm to health and
health is much greater.
Health technologies

Competition among health care providers will induce the spread of newer and not
fully tested technologies. This will lead to increasing investments in expensive,
sophisticated technologies, which may not be appropriate for the developing country.
Public sector;

To remain competitive in global markets, public expenditure has to minimized.
World bank and IMF insist that there should be a contraction of the public sector in
the health care services.

Dr.C.M.Francis and Dr.V.Benjamin

To be Published in forthcoming issues of People* s Reporter

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Global factor and their consequences

‘Downsizing’ and structural adjustment policies, leading to unemployment.
Marginalization, increased poverty, decreased social safety nets leading to
higher morbidity and mortality rates.
(X Increased promotion of tobacco, alcohol and psycho-active drugs, dumping of

unsafe pharmaceuticals.
Increased addition, ineffective and harmful treatment
ex Promotion of cash crops at the expense of food crops.
Food security threatened; malnutrition increased
ex Environmental degradation and unsustainable consumption by the rich: resource
depletion; water and air pollution; ozone depletion; accumulation of greenhouse
gases and global warming.
Epidemics; respiratory disorders; immunosuppression, skin cancers; cataracts;
effects of floods and storms; food shortages and malnutrition.
ex Patents

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:
Product 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 exclusive rights to use the process and product
obtained by that process.

Indian Patents Act, 1970, recognised only process patents. IPA states that the patent
should not be used as an impoil monopoly.
TRIPS agreement confers the exclusive right to import and does not require
commercial production of the patented invention in India.

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TRIPS* provisions

Inventions in all fields of technology, including dings, chemicals, foods, agricultural
products, animals, plants, and micro-organisms are entitled to product and process
patents.
Duration of patent protection : Industrialized countries: 17-20 years
Indian Patent Act: 14 years.

According to IPA, 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 ol
filing and five years from the date of sealing of the patent, whichever is shorter.
GATT requires 20 years patent protection for all inventions in the field of
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 impoil 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, the burden of
proof is shifted to the accused. If a company files a suit against another of violation of
copyright, the accused will have to prove his/her innocence.

Patenting plant varieties
There are many herbs which have been traditionally in India and other tropical
countries as medicines. Now, there are being taken by the affluent countries. When
genetic resources are taken format he tropical countries to the affluent countries, they
are treated as free 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 renewed. 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 io buy new seeds for every sowing. The local plant breeders
will have to pay royally for using the patented variety.
TRIPS and pharmaceuticals
According to Article 70.8, pharmaceuticals and agro-chemical firms can file
applications for products patents within one year of signing the GATT accord. The
applicants will be given monopoly 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. IP A 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.

According to the new rules, the products need not be produced here. They can be
imported and sold at very high prices; the Government will not have any control over
its price.

Values
Globalisation brings about changes in values. Profit-at-any-cost becomes the guiding
mantra (free market economy replacing the mixed economy). Consumerism spreads
itself, bringing on the newer fashions and technology. Craving for them depletes the
purchasing power. The amount available for the purchase of food materials becomes
reduced substantially.

lunk foods
A craze for junk foods is created, reducing the intake of wholesome food. This affects
the nutrition which is even otherwise poor.

Commercial crops
Cash crops are replacing food crops. Farmers in Punjab are growing tomato and
potato for Pepsi.
Karnataka shifted to sunflower cultivation to satisfy the
requirements of Cargill. Andhra Pradesh shifted to prawn and shrimp cultivation.
Kerala has been using its land more and more for the production of rubber, whose
price has come down. All these affect cerea
cereal production and food security.

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Public Distribution System
The millions of the poor in India were being helped through the Public Distribution
System. GATT demands slashing down of the subsidies to the PDS. This would
result in the prices of food and other essential commodities going up beyond the
purchasing power of the poor.

Industries

Trade liberalisation is often accompanied by “decentralisation” in
industrialised countries.

the less

“In India which has only in recent years opened up fully to the global
economy, international competition has already led some sectors if industry to
seek an advantage by recruiting cheap child labour---Increased child.labour is reported in sericulture, fish processing and genetic
engineering of seeds (UNICEF, 1996)”
With the competition due to globalization, many industries and business houses are
reducing their staff. Unemployment is staring at these people and the number of
people below poverty line is increasing.

Dumping 'duty' industries
Hazardous industries and poor technologies will be relocated in the developing
countries, leading to health hazards.

India has become a dumping ground for hazardous waste. The Supreme Court, on
February 6, 1998, directed the Customs and other authorities in charge of the
Tughlaqabad Container Depot and the Bombay Port Trust to neither auction nor
release till further orders several containers of hazardous waste (Indian Express,
February 7, 1998).

Supportive environment for health
The physical, social and economic environment must be supportive to health.
Globalisation threatens to damage the environment. The inequities are increasing
The ‘have’ resort to wasteful consumption of the world resources. There is need lor a
more equitable distribution and utilization of the earth’s limited resources.

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Globalisation has provided an important new argument in favour of off-loading public
funding as well as publicly operated provider institutions on to private sector and
household budgets.
Earlier efforts of multinationals to establish production operations in different local
markets - contemporary decisions to base production on exports from wherever
manufacturing can be done most cheaply.

Globalisation is the growing integration of the world economy, linked together by
large and increasing private sector financial and trade flows.
Desire of developing countries to attract multinational corporations and new jobs for
their people - increasingly fierce effects of developed countries to retain a larger share
of available investment capital and thereby to increase their own share of both jobs
and international trade - invest less in developing countries, provide fewer jobs in the
developing world but help developed countries fund jobs for their own unemployed.

“When barriers between advanced and backward economics
are destroyed, a new form of human exploitation can follow,
resembling that of colonialisom in the 19th and early 20th
centuries, complete with new forms of indentured labour”
- Plaff, 25 September, 1997
Equity
Equity will be absent when there are unequal players : the rich and the poor in the
country and the rich and poor nations. Action is needful for
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equity in health and health care services;
access for all to essential health care;
reduction in the burden of diseases and suffering.

Lifestyles
Health requires healthy life styles. Globalisation often promotes harmful lifestyles
through advertisements and trade. One such is the promotion of tobacco.

Cost of health care
Globalization tends to bring costly,'sophisticated hospitals, beyond the capacity of the
people; so also the cost of diagnostic tests. Yet, by advertisements through various
media, people are made to go for these costly procedures, which may be standard in
affluent countries, whose per capita income is 100 or more times that of India.

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People
The transnational movement of people is restricted by Visor regulations. 1 here is
selection. Well-trained personnel of the developing countries are attracted by better
remuneration and working conditions in the affluent countries. This causes a drain of
qualified health personnel, who have been trained at great expense.
Many of the health personnel go to the richer countries to get better training but do
not return. Further the training there may not match the needs of the home country.
If they do return, they derm and a duplication of the health care facilities found in the
affluent country.

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