PHM-Exch> Fwd: On global health, Biden needs to achieve more than just a reset

[Sulakshana Nandi]

Dear All

Sharing an important piece co-authored by Siddhartha Mehta who represents
PHM in the Covid-19 Response Working Group of the Progressive International.
The article is pasted below and available at this link On global health,
Biden needs to achieve more than just a reset
<https://www.aljazeera.com/opinions/2020/11/27/on-global-health-biden-needs-to-achieve-more-than-just-a-reset/>
.

with regards

Sulakshana

--------- Forwarded message ---------

On global health, Biden needs to achieve more than just a reset

Reversing Trump’s policies would benefit global health, but returning to
business as usual is also not the answer.


Earlier this year, Joe Biden won praise in mainstream policy circles in the
United States for making the case for “why America must lead again”. In the
wake of his victory in the presidential election, some health experts hoped
this would include making the US “a global health leader again”.

You can understand why these experts yearn for a different approach from
the White House. Donald Trump’s four-year rule occasioned a destructive
disengagement from the global health system, most evident in his withdrawal
of the US from the World Health Organization (WHO) amid an unprecedented
pandemic. In contrast, Biden has already promised to rejoin the
organisation, with his newly released COVID-19 plan hailed by insiders as
“a big reset”.

While reversing President Trump’s global health policies would benefit
global health, we should also challenge Biden’s back to the future approach.

Today’s global health architecture has its roots in the International
Sanitary Conferences, organised in the 19th Century to protect Europeans
from diseases brought home by armies returning from brutal colonising
campaigns abroad. In the modern era, global health governance has evolved
into an arena for advanced economies to manage public health in the Global
South. It is no surprise then that the US has been the dominant player.

The transition of power that we should care about is not just one from
Trump to Biden, but from the US to the rest of the world.

Well before Trump, the global health system was failing. It entrenched
inequalities in access to healthcare and, all too frequently, placed the
lives of people across the world at the mercy of American domestic politics
and trade policy.

Take the WHO for instance, the leading global organisation mandated with
coordinating public health across the world. The WHO is kept on a tight
financial and policy leash. It receives less than one-fifth of its funding
from mandatory contributions. The rest is funded through voluntary
contributions, before the Trump presidency, the majority coming from the US
government. Voluntary funders influence WHO priorities, sometimes in
conflict with the priorities negotiated by its appointed decision-making
body, the World Health Assembly.

The consequence is that global health policy ends up reflecting US domestic
policy: curtailed access to medicines, contraception, and abortion
treatments, and blocked access to generic treatments to protect the profits
of pharmaceutical companies, instead of the health of millions. A
particularly egregious example of this undue influence is the so-called
“global gag rule”. The policy has been enforced by every Republican
administration since Reagan, prohibiting US-funded organisations from
providing women with legal abortion services, leading to an increase in
unsafe abortions.

Sure, Biden might suspend this policy for the years he is in office, but
the underlying system would remain intact under his plan. The pro-corporate
global health agenda would continue to drive organisations such as the
World Trade Organization (WTO) and World Intellectual Property Organization
(WIPO) to create an unequal playing field in health and trade agreements,
prioritising the interests of American companies over public health. In the
most recent iteration, the WTO member states voted to reject the
application for a waiver on intellectual property rights for the
coronavirus vaccine advanced by India and South Africa to allow local
manufacture of vaccines for faster and cheaper provision to citizens.

Beyond this undesirable past, consider Biden’s COVID-19 response plan’s
anti-Chinese flavour: To “expand the defenses … to predict, prevent, and
mitigate pandemic threats, including those coming from China”. Not content
with continuing Trump’s new cold war rhetoric, Biden’s transition team
seems to be embedding it into an aggressive approach to “global health
security”.

Some might dismiss such statements as mere political posturing, yet the
recent past demonstrates the destructive power of the US presidential whim.
One result of the US administration withdrawing from the Iran nuclear deal
in 2018 and imposing increased sanctions was to reduce Iran’s ability to
access essential medicines. When the pandemic hit, this lack of medicines
and treatments increased the country’s death toll, which had already
reached a shocking 42,000 by the end of March.

A return to the past, perhaps with a more aggressive anti-China twist,
would damage global health. However, there are alternatives. Even as the US
failed to provide global leadership during the COVID-19 pandemic,
individual countries built innovative and effective ways to manage local
responses. With a population of 95 million, Vietnam, which shares a long
border with China, has suffered only 35 deaths from COVID-19. In fact,
countries ostracised internationally at the behest of the US played a
crucial role in supporting the global pandemic response. Cuba, for example,
sent doctors to countries across the world to support strained health
workforces.

The burden of death, ill-health, and destitution brought on by the pandemic
has fallen on the historically marginalised peoples of the world. This
unfair impact has its roots in racial and colonial hierarchies that have
yet to be eradicated from their origins found in the days of the first
international sanitary conferences. The enduring impact of this history
makes recent calls to “decolonise global health” particularly critical.

As it returns to the global health stage, the US could play a vital role,
but only if it radically changes course, not only from the Trump era but
the policies that came before it. That would mean putting collective health
outcomes first, through allowing the pursuit of universal healthcare around
the world, undoing sanctions and corporate welfare regimes that restrict
access to essential medicines, and sharing vaccine technology to end this
pandemic.

The WHO and other global health organisations need to claim their autonomy
so they can truly act in the interests of global health. That means
pressuring donor governments to commit to unrestricted funding and
compelling pharmaceutical companies to transfer technology to qualified
vaccine manufacturers around the world. Countries in the Global South can
aid this process by investing in their own innovation and health systems as
well as advocating loudly for a more equitable global health system.

As Trump leaves the White House, merely resetting to what came before him
is not the answer. Global health was in desperate need of reform four years
ago, as much as it does now. Rather than returning to business as usual, we
must democratise global health, based on solidarity, and respond in an
equitable and just manner, to the challenges of COVID-19. Global health
governance does need new leadership, and progressive activists around the
world are already showing us the way.
-- 
Website: https://phmovement.org
Twitter: @PHMglobal
Facebook: @peopleshealthmovement
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