Counterfeit Medicine, Climate Change and the Financial Crisis- Chatham House Day Two
Panel for Session Five of ‘Rethinking Global Health’
‘Counterfeit Medicines and Health Security’ was the topic of discussion for the first session of the second day of Chatham House’s Conference on ‘Rethinking Global Health’. Chairing the panel was Andrew Jack of the Financial Times, who illustrated the contrast in counterfeit medicines between the developed and undeveloped world. Essential medicines for treating HIV/AIDS and malaria are the most commonly counterfeited in Africa while in the U.S. counterfeit drugs treat high cholesterol, cancer and heart disease. Pharmaceutical markets in developing countries may be directly unregulated while in developed nations the internet provides anonymous access to counterfeit drugs.
Questioning the illegality of generic alternatives in light of intellectual property laws, Dr. Mohga M Kamal-Yanni of Oxfam stressed the crucial separation of public health from commercial interests. Africa can not compete in pharmaceutical innovation and its people need immediate affordable access to medicines. “We’re not against industry,” Dr. Kamal-Yanni stated, “we’re against treaties that will punish poor people in the end.” As sufficient anti-counterfeiting laws are not in place it was concluded that a global consensus is necessary to address this issue. Particularly among bordering countries in Africa international cooperation is crucial in enforcing counterfeit legislature. Consolidating quality control testing regionally and utilizing a single import source would work effectively to combat counterfeiting. One panellist confirmed that “unity, not fragmentation” is needed and that community awareness is also key- the public must know that ”not every drug is a good drug.”
‘The inter-linkages between climate change and the global health agenda’ was the theme for the session chaired by Richard Black, Environment Correspondent for BBC News. It was put to the panel to determine how governments, private businesses and NGOs are approaching the interrelatedness of climate change and worldwide human health and what the greatest impact of climate change on human health will be. Ambiguity regarding the projected effects of climate change has stalled preventative progress; it was asserted that uncertainty should promote action not inaction.
Thus far 150,000 deaths due to climate change have occurred and it is estimated the number will double by 2030. Rising malaria rates due to increases in temperature and heat related deaths are the primary health risks resulting from climate change. Panellists urged the health community to step forward within their governments as advocates in climate change discussions. Strengthening of health care systems is crucial in protecting impoverished peoples from the effects of climate change. Inequity is apparent between the developed world, which is the source of most greenhouse gases; and the undeveloped world, which will feel the effects of global warming most strongly. Lack of understanding and response from the developed world can be reversed if wealthy governments see climate change as a threat to their own well being. Combining these two issues was seen as both an opportunity and a risk- climate change can carry global health and move it forward, or bury it.
Andrew Jack, Rhona MacDonald
Rhona MacDonald of The Lancet acted as chair for the session addressing the ’Impact of Financial Crisis on Health’. This discussion attempted to determine impending risks to health and human security due to the current economic downfall. Steve Wright, Executive Director of the European Centre for Health Assets and Architecture Netherlands, provided an outline of the onset of the current crisis caused by an “asymmetry of incentives in the U.S.”. Subsequently this imbalance led to bad investing in the sub-prime housing market and a general misconception of uncertainties by the banking sector. Increased conservatism and debt deflation spread to the global market. Andrew Jack highlighted some of the effects of the economic crisis on the health sector; in the U.S., for example, as job loss rises, the unemployed lose their access to health care. Governments halt growth in health care spending and smaller biotech research firms are shut down thus resulting in a decrease in pharmaceutical development. Professor Stephen Matlin, Executive Director for the Forum for Health Research, asserted that “research shouldn’t be seen as a luxury but as an essential way out of the crisis.”
At one point in the session Rhona MacDonald turned the focus towards the upcoming G20. She stated the fact that “for every 1% decrease in growth twenty million people are pushed into poverty” and asked the delegates what they would tell Gordon Brown to advocate at the finance minister’s summit. This prompt elicited an enthusiastic and energetic response from the audience. Adesina Iluyemi, NEPAD: “Have multi-national corporations extend benefits to local communities.” Dr. Kamal-Yanni, Oxfam: “We can not say that because of the financial crisis we can not increase aid. This will debilitate developing health care systems.” Dr. Pongpisut Jong-Udomsuk, Ministry of Public Health Thailand: “Ask how will the system maintain or improve quality of life and not just how will it ensure economic growth.” Anne Christine Miriko, London College: ”Cancel or reduce existing debts and try to encourage fair trade promotion.” Warner Anderson, U.S. Defense Department: “Allow receiving nations to establish their own infrastructures.” Wol M Ariec, Government of Southern Sudan: “From an Africa perspective, move towards financial independence to support health services locally.” Steve Wright closed with the conclusion that “having good health is good for your wealth; good health increases productivity, decreases absenteeism and increases retirement savings.”
“Meeting our Commitments” was the theme of the final session chaired by Dr. Robin Niblett, Chatham House Director. Keynote speaker Ivan Lewis MP called for better understanding of the interrelatedness of foreign policy and global health. He stated that an effectiveness assessment is needed and affirmed that “health is a non-negotiable part of building successful states.” In many ways the conclusions of the conference were an exposure of the obvious. Poor countries with weak health care systems will be hardest hit by climate change and the global economic burden. The real value in this gathering came from the stimulus of discussion and inception of communication between international governments and across the public and private sector.
K Lee