Health care for all

The health news - with major implications for Africans living on the continent - that made the headlines in 2011.

In November came the news that the Global Fund to fight Aids, TB and Malaria was in a financial crisis, because of declining donor commitments and failure by donors to honor existing commitments. The Fund’s board cancelled Round 11 of its funding applications, which was supposed to provide money for 2011 to 2013.

The Global Fund crisis and the threat to continuity and expansion of ARV treatment is particularly tragic, because in May came the news that early treatment of people with HIV massively reduces their infectiousness – for the first time, pointing the way to a potential end to the HIV epidemic. This emerged from the results of a trial which found that sex with an HIV positive person on ARV treatment with an undetectable viral load is as safe as using condoms.

On World Aids Day came some better news – US President Barack Obama announced the U.S. would double the pace of scale up for funding for ARV treatment through PEPFAR, the President’s Emergency Plan for AIDS Relief. This followed an encouraging speech by Secretary of State Hillary Clinton in November, on US commitment to fighting AIDS.

While it is happening outside the continent, the ongoing case by pharma giant Novartis in the Indian Supreme Court is of vital importance to health in Africa and across the globe. Novartis is challenging Indian patent law over the patentability of an anti-cancer drug. Indian law does not allow patents for trivial changes to an existing drug. Making minor changes to the form of a patented drug is a tactic big pharma companies commonly use elsewhere, to extend the life of patents indefinitely: so-called ‘ever-greening’ of patents. If Novartis succeeds, India may end up granting far more patents than required under international trade rules, with huge implications for the availability of affordable medicines for billions of people worldwide.

This year saw increased focus on Non-Communicable Diseases, with a UN summit on NCDs held in New York in September. Shortly before the summit, research reports released by the WHO and World Economic Forum put the cost to Africa of NCDs at nearly $500-billion a year. There was huge lobbying around the summit by business interests – particularly by the food industry, seeking to limit disease prevention measures that would harm their profits.

A case brought against the Namibian government by HIV positive women claiming they were sterilized against their will, wrapped up in Windhoek earlier in the year, although judgment is still pending. Meanwhile, several reports emerged in countries such as South Africa and Kenya, indicating the practice of forced or coerced sterilization of HIV positive women is widespread.

Also in November, the Malawian Parliament finally recognized that women have the right to inherit from the marital estate. In the past, after the death of her husband, a woman and her children were often left with nothing, no matter the length of the marriage and contributions to the estate. This is a huge health issue not only because many women have been left destitute after the death of male partners from AIDS – but also because the resulting economic insecurity leaves women much more vulnerable to contracting HIV.

The deaths of two women during childbirth in hospitals in Uganda focused attention on the dire lack of basic maternal care in Uganda, and in Africa as a whole. A Ugandan NGO took the government to court, in what may be the first legal test of an African government’s obligation to provide basic maternal care.

November 14 was the tenth Anniversary of the Doha Declaration. NGOs used the occasion to highlight the Declaration, which aimed to establish a balance between WTO pharmaceutical patent rules and public health. The fight to preserve the Doha Declaration’s safeguards is crucial, as a range of free trade agreements (FTAs) under negotiation behind closed doors threaten to impose stricter patent rules at the expense of public health.

Finally, the campaign for a small levy on financial transactions gained ground as several world leaders expressed their support for the so-called ‘Robin Hood tax’ — South Africa’s Jacob Zuma among them. If it is adopted, the challenge will then be to ensure that a good chunk of the billions of dollars generated by the tiny tax get is spent on global health and development. European leaders seem to want to use it to plug domestic deficits.

Further Reading