Facing Up to the World’s Health Crises….and the TPP Would Make Matters Worse

Yves here. This post is yet another reminder of how short-sighted the elites in the US have become. For instance, the UN regards universal health care as a critical first line of defense against impending health disasters. Yet the wealthy appear to operate from the delusion that they can isolate themselves from the rest of society. Even if they repair to compounds with their own butlers, nannies, cleaning and maintenance staff, they would still want services from people they would not have as employees, like trainers and medical professionals, and they’d need to get deliveries of food and supplies, or have their staffs procure it. Any option puts them in contact with the larger community, which means communicable diseases. Similarly, if they have an accident, medical emergency, or need surgery, they will have to go to a hospital. Even if their room is in a wing for the rich, they will still be cared for by nurses and orderlies that go back to modest income neighborhoods…again meaning they cannot isolate themselves from communicable diseases. Remember that even now, infections like pneumonia and MRSA contracted in a hospital are a major cause of death. In 2010, a conservative estimate was 48,000, 50% more than died in car accidents that year.

By Martin Khor, Executive Director of the South Centre, Geneva. Originally published in The Star

The global health situation is facing many critical challenges, and urgent action is needed to prevent crises from boiling over. This is the impression one gets from this year’s World Health Assembly (WHA) in Geneva last week.

The WHA is the world’s prime public health event, attended by 3,500 delegates, including Health Ministers from most of the 194 countries.

In her opening speech, World Health Organisation director-general Dr Margaret Chan gave an overview of what went right and what is missing in global health.

First the good news: 19,000 fewer children dying every day, a 44% drop in maternal mortality, the 85% cure rate for tuberculosis, and 15 million people living with HIV now receiving therapy, up from just 690,000 in 2000.

Then Chan described how health has become a globalised problem, with air pollution becoming a transboundary health hazard, and drug-resistant pathogens being spread through travel and food trade.

The recent Ebola and Zika outbreaks showed how global health emergencies can quickly develop. The world is not prepared to cope with the dramatic resurgence of emerging and re-emerging infectious diseases.

Chan said the global health landscape is being shaped by three slow-motion disasters: climate change, antimicrobial resistance and the rise of chronic non-communicable diseases.

She described these as man-made disasters created by policies that place economic interests above health and environmental concerns.

Unchecked, these disasters will reach a tipping point where the harm done is irreversible. For antimicrobial resistance, “we are on the verge of a post-antibiotic era in which common infectious diseases will once again kill”.

On moving ahead, Chan pinpointed universal health coverage as the target that underpins all others in the health-related Sustainable Development Goals.

The assembly agreed that the WHO set up a new Health Emergencies Programme to enable it to give rapid support to countries and communities to prepare for, face or recover from emergencies caused by health hazards including disease outbreaks, disasters and conflicts.

On anti-microbial resistance, many developing countries stressed the importance of funds and technology to help them develop national action plans by 2017.

The WHO produced a paper on options to set up a global stewardship framework to support the development, control and appropriate use of new antimicrobial medicines and diagnostic tools.

Another paper showed the secretariat has made quite a lot of progress, but action on the ground seems to be slow. For example, in the two Asia-Pacific regions, only six countries have completed their national plans and another five have plans being developed.

WHO’s Keiji Fukuda said the next steps were to make progress on the global action plan adopted in 2015, further develop the global stewardship framework and involve political leaders on the issue.

Two issues on childhood nutrition highlighted the need to put health concerns above corporate interests. The first was childhood and adolescent obesity. In 2014, an estimated 41 million children under five years were affected by overweight or obesity.

The marketing of unhealthy foods to children was identified by the WHO Commission on ending childhood obesity as a major problem. It proposed actions to reduce the intake of unhealthy foods and sugar-sweetened beverages, including imposing taxes on sugar-sweetened beverages and curbing the marketing of unhealthy foods.

The WHA called on the WHO to develop an implementation plan and urged governments to develop national policies.

On the second issue, the WHA welcomed WHO’s guidance on ending the inappropriate promotion of foods for infants and young children. The marketing of “follow-up formula” and “growing-up milks” – targeted for babies aged six months to three years – should be as strictly regulated as infant formula.

Foods for infants and young children should be promoted only if they meet strict standards, and doctors should not accept gifts or free samples from companies.

On access to medicines and vaccines, the WHA agreed on measures to address the global shortage of medicines and vaccines, including by improving affordability through voluntary or compulsory licensing of high-priced medicines.

An interesting side event was organised by India on behalf of the BRICS (Brazil, Russia, India, China and South Africa) on the effects of free trade agreements on access to medicines.

South Africa’s health minister stated that patents pose a barrier to access to medicines.

The main speaker, American law professor Frederick Abbot, gave reasons why the Trans-Pacific Partnership Agreement would create new difficulties for members to have access to affordable medicines.

His warning was complemented by the head of UNAIDS Michel Sidete, who estimated that the US$2bil (RM8.18bil) annually now spent to treat 15 million AIDS patients could jump to US$150bil (RM613bil) if there were no generic drugs and patients had to use originator drugs at US$10,000 (RM40,875) a person a year.

Two environment-related health issues were discussed. Air pollution accounts for eight million deaths worldwide annually – 4.3 million due to indoor and 3.7 million to outdoor air pollution. The assembly welcomed a new WHO road map for actions in 2016-19 to tackle the health effects of air pollution.

Another 1.3 million deaths worldwide are caused by exposure to chemicals such as lead and pesticides.

The WHA committed to ensure chemicals are used and produced in ways that minimise adverse health and environmental effects by 2020, with the WHO asked to develop a road map.

A controversial issue is how the WHO should relate to “non-state actors”. After two years of negotiations, the WHA adopted the Framework of Engagement with Non-State Actors (FENSA), which provides the WHO with policies and procedures on engaging with non-governmental organisations, private sector entities, philanthropic foundations and academic institutions.

On one hand there is the aim to strengthen WHO’s engagement with organisations; on the other hand is the need for WHO to avoid conflicts of interest that may arise when corporations and their foundations and associations wield large and undue influence if they are allowed to get too close to WHO.

Whether the adopted FENSA strikes the right balance will be seen in future years.

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  1. Liah

    The whole TPP thing is as embarrassing as heck. But, what is not lately…
    Just generally, this is not humanity’s best period.
    Thanks for all you do, Yves. A bit of objective reality in a sea of foolishness.

  2. JacobiteInTraining

    I would absolutely LOVE to be optimistic about the future, but in watching the elites reactions to crises, the decline of Corporate ‘responsibility’ and ‘ethics’ to levels no longer perceivable short of a scanning electron microscope, and the inattentiveness of Government to anything other then the Almighty Dollar – and only their constituents who still have access to plenty of these semi-mythical Benjamins – I have resigned myself to a future that looks more like what I heard from my Grandfather who grew up in the teens and twenties.

    i.e., though we still have a farm on which to grow our own food, and a nearby river to catch salmon and trout (while they last) if I get sick I presume i will simply need to self-medicate. if I injure myself, I may have to trade food or labor for some form of local ‘medics’ attentions.

    And in the end, when all else has failed, apparently I must simply become comfortable in the knowledge that my otherwise treatable disease or injury may lead to my death.

    And I am supposed to ‘Bend The Knee’ to my government….why exactly?

    1. Disturbed Voter

      The Union won the short war but lost the long war. Welcome to the wage slave/debt slave plantation. Eminent domain can take that awkward real estate off your hands. The exponential increase in health care costs will be resolved thru rationing, not thru exponential expansion of fiat. Our parabolic course will take us back to the 19th century, as you say.

  3. James Levy

    I often speak of Oligarchy when I talk about how things are arranged in the modern world, but one facet of Oligarchy is sorely missing today: a sense of continuity. It used to be that you set stuff up so that your sons and your grandsons would retain your power and privileged and maybe even expand them. The actions of elites today seem to negate such a classic norm. For whatever reason, planning for the future is out. Their actions defy any sense of permanence or continuity. They just want it all, now, and screw their progeny or the future. They simply don’t seem to matter. I can’t understand how or why we’ve reached this awful stage, but the evidence is overwhelming that we have.

    1. tegnost

      As I in work cross many paths, the wealthy I know, and also the a little less wealthy, we’ll say top ten here as that is roughly 150k a year, are alll very concerned for their kids, and student loans create the conditions where only those people can afford to pay for college, for everyone else it’s student loans, a de facto head start. The computer guys actually don’t expect their kids to work because they see their wealth as sacrosanct, i.e., they won’t lose their pile (QE as policy may have something to do with that), and robots robots robots 24/7/365 and with bonds providing no cash, real estate is where they’ve gone and if you’re renting out several houses that has also been quite lucrative and instilled in our upper classes a sense that this is the best of all possible worlds, we down here can gripe about people dying of starvation but we’re not giving credit to them for the situation in which they only were able to die of starvation because we “saved” them from HIV. The TPP and the ACA and student loans and their evil progeny the “basic income guarantee (if you can’t buy our stuff we’ll make you buy our stuff, the hypothetical 13,000 bucks will be divided up among cronies before it touches a consumers hands) are all top down structures designed to expand the current oligarchy’s grip on the populations of the globe. And who are these people who don’t want babies drinking sweetened milk like formula. Babies know instinctively that it is the best of all possible worlds and they like sweet milk like product and who’s so mean to say they can’t have it. An obese child is simply a finely tuned consumer. and if it kills them, it will only be after they imbibed in the great pleasure of consuming products similar to those seen on tv.

    2. Tony Wright

      I blame Reagan, Thatcher and the other Friedman acolytes in the 80’s for starting it- ‘Greed is Good’ and all that. Since then it has just kept rolling at increasing speed fired by the digital age technologies.

      1. Tony Wright

        Oh, and as an Australian I hereby apologise for the contributions made by ‘Citizen Murdoch’……

  4. Steve H.

    – Yet the wealthy appear to operate from the delusion that they can isolate themselves from the rest of society.

    Assumption of passive epidemiology insufficient. High-end escorts could be the new smallpox-infected blankets.

    1. flora

      See Edgar Allen Poe’s story “The Mask of the Red Death.”

      summary from Wikipedia:
      “”The Masque of the Red Death”, originally published as “The Mask of the Red Death: A Fantasy” (1842), is a short story by Edgar Allan Poe. The story follows Prince Prospero’s attempts to avoid a dangerous plague, known as the Red Death, by hiding in his abbey. He, along with many other wealthy nobles, hosts a masquerade ball within seven rooms of the abbey, each decorated with a different color. In the midst of their revelry, a mysterious figure disguised as a Red Death victim enters and makes his way through each of the rooms. Prospero dies after confronting this stranger, whose “costume” proves to contain nothing tangible inside it; the guests also die in turn.”

  5. Steve in Flyover

    I hate to ruin your fantasy, but elites already have the template for isolating themselves from society.

    Private jets for travel

    Physically isolated enclaves (think Palm Springs, Jackson Hole, Aspen/Vail)

    Personal Assistants to deal with the wretched refuse (with decent health insurance)

    Unlimited budgets for personal health care.

    Not a bulletproof plan. But a lot better one than most of the wretched refuse have. At a fraction of the cost (to them) of single-payer

    1. James Levy

      If they think that will protect them from a Spanish Flu or Pneumonic Plague scenario then they are insane.

      1. reslez

        True but keep in mind we’re talking about techno-utopians. The rich believe science will save them from everything, all it takes is money. (The rest of us are surplus to requirements.)

        1. Ruthmarie Hicks

          I think they will find rather quickly that you actually have to fund science for it to continue to pull off new miracles in the new “sharing economy”. These fields have been starved for funds for over a decade now. There are no new magic bullets, because it takes investment to create them.

    2. Yves Smith Post author

      Private jets have pilots that sit not far from the cabin, they have their food delivered to the plane, are services, and the bigger ones have a stewardess.

      All those “enclaves” have service personnel too. Do you think these people tend their own yards? Wash their own cars? And what happens when they have plumbing or electrical problems?

      Personal assistants go home to lower income communities.

      Per my discussion of health care, they still have to go to hospitals which are already disease vectors.

  6. Tony Wright

    The three consequences of overpopulation as apply to any species are increases in conflict (for humans this means war), disease and famine – we humans have also added anthropogenic climate change via our profligate use of fossil fuels. Unless we voluntarily curtail global population growth these factors will increasingly become catastrophic and do the job for us. Advances in medical science can only ‘kick the can down the road’. And the wealthy will not be immune – who will they make money from if all the working stiffs die?

    1. Optic

      Do the rulers of the world have any plans or ideas for running/maintaining the world economy without depending on continuous world population growth? Isn’t this the ultimate Ponzi scheme, and are we perhaps reaching its limits? I’m not as well-educated or as well-informed as many of you fellow commenters, so perhaps I’m just not aware of any such plans or ideas.

  7. Tony Wright

    Certainly reaching the ecological limits; we are creating the sixth great extinction of the geological history of the planet and this process continues unabated because the decision makers and politicians are beholden to the one percent and ignore the warnings of the biologists

    1. Synoia

      The warnings are ignored because there is no plan, credible or incredible which does not involve chaotic change, thus the response is to put off the action until one is forced to live with the consequences.

      In addition any plan would result in more Government control, significant loos of profit, and elimination of classes of business.

      It not that were are hopeless or incapable, it is that we are stuck – victims of our own success.

      I’ll repeat: there is NO plan, there is NO program. If you know of one, that is specific and complete with a set of action and a time line, POST A LINK.

      I’d add that I have given much thought to a familial or personal survival plan, as I live in a desert (Southern California) which is inimical to the current concentration of humans in this locale (aka: en-mass – Can’t move, can’t stay, can only die in place).

      Individually, I personally cannot conceive of a safe locale – there are none in N America, the climate is too fierce. One need a combination of land, mild climate, ample rainfall, and friendly low density population.

  8. Synoia

    Facing Up to the World’s Health Crises….and the TPP Would Make Matters Worse

    In the face of the determination to get these trade treaties, I must ask: Who promised Obama billion in donation for his after presidential career?

    There appears a consensus that this inflexible regime is somehow beneficial, and I look at the statement of UK “establishment” figures on stating Sovereignty is their reason for supporting Brexit, and I have to wonder where is their opposition to the “new world order?”

    Evans-Pritchard, Ambrose! Where are your essays on this topic?

  9. financial matters

    Another reason to push for better education and medical care is that it may reduce population growth due to demographic transition.

    Some of the most important economic and social changes that lower birth rates include female education and empowerment of women as they tend to have fewer children as they have more economic and social choices. Families will also have fewer children as the probability of survival for an individual child increases. Also many people rely on their children to support them when they can no longer work.

    To increase education levels, it will be necessary build schools and train teachers. Reducing infant and child mortality will require investment in public health. Increasing economic security in old age means public pensions. (Weisbrot in Failed)

  10. Erwin Thomas

    The elephant in the room is the fact that although you might have parts of WHO which are working in an ethical manner to address issues (such as the part of WHO which rightly determined the glyphosate is a probable carcinogen), the majority of the organisation is dominated by political and corporate hacks who are looking to insure that the gravy train for big pharma doesn’t stop in the future. An egregious example being the decision by WHO to change the definition of an epidemic from being both contagious AND deadly to being contagious OR deadly in order to facilitate declaring bird flu a epidemic and enabling big pharma to make millions with worthless vaccines. Until that is addressed the reality is that one cannot expect WHO to do a great deal to improve the health situation in the world.

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