Sustainable Agricultural Productivity Growth and Bridging the Gap for Small-Family Farms: Interagency Report to the Mexican G20 Presidency

In 2011, G20 leaders committed to sustainably increase agricultural (production and) productivity (paragraph 43 of the Cannes Declaration). They "agree(d) to further invest in agriculture, in particular in the poorest countries, and bearing in mind the importance of smallholders, through responsible public and private investment," they "decide(d) to invest in research and development of agricultural productivity. Early in 2012 Mexico, as G20 President, invited international organisations to examine practical actions that could be undertaken to sustainably improve agricultural productivity growth, in particular on small family farms. The preparation of this report, co-ordinated by the FAO and the OECD, responds to this request. It is a collaborative undertaking by Bioversity, CGIAR Consortium, FAO, IFAD, IFPRI, IICA, OECD, UNCTAD, Coordination team of UN High Level Task Force on the Food Security Crisis, WFP, World Bank, and WTO. We, the international organisations, are pleased to provide you with this joint report and look forward to continuing collaboration within the G20 framework to further elaborate and, as appropriate, implement the recommendations that it contains

Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

<p>Abstract</p> <p>Background</p> <p>The global burden of cardiovascular disease (CVD) continues to rise. Successful treatment of CVD requires adequate pharmaceutical management. The aim was to examine the availability, pricing and affordability of cardiovascular medicines in developing countries using the standardized data collected according to the World Health Organization/Health Action International methodology.</p> <p>Methods</p> <p>The following medicines were included: atenolol, captopril, hydrochlorothiazide, losartan and nifedipine. Data from 36 countries were analyzed. Outcome measures were percentage availability, price ratios to international reference prices and number of day's wages needed by the lowest-paid unskilled government worker to purchase one month of chronic treatment. Patient prices were adjusted for inflation and purchasing power, procurement prices only for inflation. Data were analyzed for both generic and originator brand products and the public and private sector and summarized by World Bank Income Groups.</p> <p>Results</p> <p>For all measures, there was great variability across surveys. The overall availability of cardiovascular medicines was poor (mean 26.3% in public sector, 57.3% private sector). Procurement prices were very competitive in some countries, whereas others consistently paid high prices. Patient prices were generally substantially higher than international references prices; some countries, however, performed well. Chronic treatment with anti-hypertensive medication cost more than one day's wages in many cases. In particular when monotherapy is insufficient, treatment became unaffordable.</p> <p>Conclusions</p> <p>The results of this study emphasize the need of focusing attention and financing on making chronic disease medicines accessible, in particular in the public sector. Several policy options are suggested to reach this goal.</p

International service trade and its implications for human resources for health: a case study of Thailand

This study aims at analysing the impact of international service trade on the health care system, particularly in terms of human resources for health (HRH), using Thailand as a case study. Information was gathered through a literature review and interviews of relevant experts, as well as a brainstorming session. It was found that international service trade has greatly affected the Thai health care system and its HRH. From 1965 to 1975 there was massive emigration of physicians from Thailand in response to increasing demand in the United States of America. The country lost about 1,500 physicians, 20% of its total number, during that period. External migration of health professionals occurred without relation to agreements on trade in services. It was also found that free trade in service sectors other than health could seriously affect the health care system and HRH. Free trade in financial services with free flow of low-interest foreign loans, which started in 1993 in Thailand, resulted in the mushrooming of urban private hospitals between 1994 and 1997. This was followed by intensive internal migration of health professionals from rural public to urban private hospitals. After the economic crisis in 1997, with the resulting downturn of the private health sector, reverse brain drain was evident. At the same time, foreign investors started to invest in the bankrupt private hospitals. Since 2001, the return of economic growth and the influx of foreign patients have started another round of internal brain drain

Growth in Environmental Footprints and Environmental Impacts Embodied in Trade: Resource Efficiency Indicators from EXIOBASE3

Most countries show a relative decoupling of economic growth from domestic resource use, implying increased resource efficiency. However, international trade facilitates the exchange of products between regions with disparate resource productivity. Hence, for an understanding of resource efficiency from a consumption perspective that takes into account the impacts in the upstream supply chains, there is a need to assess the environmental pressures embodied in trade. We use EXIOBASE3, a new multiregional input-output database, to examine the rate of increase in resource efficiency, and investigate the ways in which international trade contributes to the displacement of pressures on the environment from the consumption of a population. We look at the environmental pressures of energy use, greenhouse gas (GHG) emissions, material use, water use, and land use. Material use stands out as the only indicator growing in both absolute and relative terms to population and gross domestic product (GDP), while land use is the only indicator showing absolute decoupling from both references. Energy, GHG, and water use show relative decoupling. As a percentage of total global environmental pressure, we calculate the net impact displaced through trade rising from 23% to 32% for material use (1995¿2011), 23% to 26% for water use, 20% to 29% for energy use, 20% to 26% for land use, and 19% to 24% for GHG emissions. The results show a substantial disparity between trade-related impacts for Organization for Economic Cooperation and Development (OECD) and non-OECD countries. At the product group level, we observe the most rapid growth in environmental footprints in clothing and footwear. The analysis points to implications for future policies aiming to achieve environmental targets, while fully considering potential displacement effects through international trade

Urbanization and international trade and investment policies as determinants of noncommunicable diseases in Sub-Saharan Africa

There are three dominant globalization pathways affecting noncommunicable diseases in Sub-Saharan Africa (SSA): urbanization, trade liberalization, and investment liberalization. Urbanization carries potential health benefits due to improved access to an increased variety of food imports, although for the growing number of urban poor, this has often meant increased reliance on cheap, highly processed food commodities. Reduced barriers to trade have eased the importation of such commodities, while investment liberalization has increased corporate consolidation over global and domestic food chains. Higher profit margins on processed foods have promoted the creation of ‘obesogenic’ environments, which through progressively integrated global food systems have been increasingly ‘exported’ to developing nations. This article explores globalization processes, the food environment, and dietary health outcomes in SSA through the use of trend analyses and structural equation modelling. The findings are considered in the context of global barriers and facilitators for healthy public policy.Department of HE and Training approved lis

The gravity of China's African export promise

Africa’s largest trade partner, China, criticised for exchanging resources for manufactures, has promised to increase imports and optimise the structure of trade with Africa. Using a gravity model of China’s imports for the years 1995- 2009, we explore potential dynamics for this promise, uniquely accounting for market economy recognition and Taiwan recognition. The former is associated with increased imports, while the latter effect is ambiguous and statistically insignificant. Comparison of projected against actual imports across three growth-path-aligned economic geography typologies - resource-rich; landlocked and resource-poor; coastal and resource-poor – sets out China’s imports trends in an abstract framework of African export potential. We find not only ‘under’ importing across a majority of resource-poor countries. We also find that current trade policy is the least applicable to these comparatively poor exporters’ trade with China. If the latter are to serve a broader catalytic role in Africa’s regional industrial transformation as compared to the role of coastal and resource poor countries in regional economic transformation in Asia and Latin America, China-Africa trade and investment policies may need additional thinking

Global plagues and the Global Fund: Challenges in the fight against HIV, TB and malaria

BACKGROUND: Although a grossly disproportionate burden of disease from HIV/AIDS, TB and malaria remains in the Global South, these infectious diseases have finally risen to the top of the international agenda in recent years. Ideal strategies for combating these diseases must balance the advantages and disadvantages of 'vertical' disease control programs and 'horizontal' capacity-building approaches. DISCUSSION: The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) represents an important step forward in the struggle against these pathogens. While its goals are laudable, significant barriers persist. Most significant is the pitiful lack of funds committed by world governments, particularly those of the very G8 countries whose discussions gave rise to the Fund. A drastic scaling up of resources is the first clear requirement for the GFATM to live up to the international community's lofty intentions. A directly related issue is that of maintaining a strong commitment to the treatment of the three diseases along with traditional prevention approaches, with the ensuing debates over providing affordable access to medications in the face of the pharmaceutical industry's vigorous protection of patent rights. SUMMARY: At this early point in the Fund's history, it remains to be seen how these issues will be resolved at the programming level. Nevertheless, it is clear that significant structural changes are required in such domains as global spending priorities, debt relief, trade policy, and corporate responsibility. HIV/AIDS, tuberculosis and malaria are global problems borne of gross socioeconomic inequality, and their solutions require correspondingly geopolitical solutions

Cross-Sector Review of Drivers and Available 3Rs Approaches for Acute Systemic Toxicity Testing

Acute systemic toxicity studies are carried out in many sectors in which synthetic chemicals are manufactured or used and are among the most criticized of all toxicology tests on both scientific and ethical grounds. A review of the drivers for acute toxicity testing within the pharmaceutical industry led to a paradigm shift whereby in vivo acute toxicity data are no longer routinely required in advance of human clinical trials. Based on this experience, the following review was undertaken to identify (1) regulatory and scientific drivers for acute toxicity testing in other industrial sectors, (2) activities aimed at replacing, reducing, or refining the use of animals, and (3) recommendations for future work in this area

Sugar trade and the role of historical colonial linkages

Past colonialism has shaped current policies and patterns relating to sugar trade. To examine the effects of historical colonial linkages on sugar trade, the gravity model is estimated for a panel of raw sugar imports into 25 OECD countries from the rest of the world over the 1961-2016 period. Colonial linkages in a North-South direction increase sugar trade, but colonial linkages in a North-North direction decrease it. Several distinct North-South colonial channels are identified. Sugar trade is enhanced by the major empire shipping routes, rail infrastructure, cultural proximity and preferential market access