global governance for health: equinet experiences in southern and eastern africa rangarirai...
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Global Governance for Health: EQUINET experiences in Southern and Eastern Africa
RANGARIRAI MACHEMEDZEEQUINET/ SEATINICape Town, South Africa6-11 July 2012
EQUINETa network of professionals, civil society members, policy makers, state officials in east and southern Africa that aims to advance and support health equity and social justice through:
• sharing information and experience
• research
• building critical analysis and skills
• networking and building strategic alliances.
Visit www.equinetafrica.org
Introduction
The nature of global health has changed dramatically in the past two decades, bringing in many actors to expand responses to global health needs: service delivery, prevention, and research and development
Besides governmental activities, the involvement in health of non governmental organizations, non-state providers of health, industry, faith-based organizations and civil society has increased.
Global Health Governance Architecture
Source: Rekacewicz P Le Monde Diplomatique, September 2005
Limitations
This increasingly complex architecture: has led to concern about the lack of effective co-
ordination across UN policies and the inadequate machinery for monitoring
implementation of the hundreds of multilateral treaties, which although sectoral in character, also impinge on global public health.
The dominant economic paradigm that our countries have been forced to follow in the past two-three decades is neo-liberalism
Emphasises the free market ideology (washington consensus principles)
Trade liberalisation, financial deregulation, cuts in government spending, IP rules (US model), binding membership of WTO regulations, compliance with IMF and international financial institutions rules etc
African experiences
Trade liberalisation - negative outcomes for Africa IMF/World Bank Structural Adjustment Programmes
entry point to economic liberalisation Resulted in structural changes in virtually all sectors Social services sectors: health, education negatively
affected Health sector effects included commercialisation (fee
charges), public sector cuts, freeze or cuts health worker employment, fall in real wages for health workers
African experiences
African experiences: the global context
US-Africa US-Africa (AGOA)(AGOA)
US-NAFTA US-NAFTA US-FTAAUS-FTAA US-APECUS-APEC
IMF &
World Bank WTO
- PRSPsPRSPs- Debt Relief & Debt Relief &
HIPCHIPC- Aid, LoansAid, Loans- Economic Economic
Reforms (SAPs)Reforms (SAPs)
US EU
EU-SA FTA EU-SA FTA Cotonou/EPAs Cotonou/EPAs EU-MED FTA EU-MED FTA EU-EU-
MERCOSUR MERCOSUR
- Binding Binding AgreementAgreements s
- DSBDSB
Trans National Corporations
African Governments
Economic and Trade Reforms Lock in
Washington Consensus
Policies
World Trade Organisation Agreements and Health AoA
Liberalising agric Removal of tariffs (revenue) Food sovereignty/food
security nutrition
TRIPs Access to medicines Farmer’s rights GMOs
GATS Privatisation of health
services User fees
SPS/TBT-health issues, infectious disease control, food safety, environment, food security, biotechnology
EQUINET experiences and struggles for better governance in Health
EQUINET is officially recognised by governments in ESA and by SADC and ECSA health community
Works with governments over the years in SADC, ECSA to build regional solidarity, integrity and political coherence to: Engage globally in these processes Resist unfair and unjust policies
EQUINET experiences
Participates in official processes and meetings
-doing advocacy on different issues e.g. reclaiming the economic resources for health from unfair global policies
-demanding equitable health systems
Demanding national governments to implement laws at national levels to
◦ Fully use flexibilities in trade agreements particularly GATS and TRIPs
◦ Protect indigenous knowledge systems◦ Resist WTO plus obligations in bilateral or regional agreements◦ Regulate the movement of goods and services (domestic
regulatory framework)
EQUINET Experiences
Participating in Global Health Governance working on: Supporting regional integration on health related issues
especially demanding fairness in economic partnership agreements
Collaborating with other institutions and networks beyond the governments and intergovernmental bodies
Publications on different areas Newsletter Policy briefs Discussion papers Reports
Available on: www.equinetafrica.org