Groups lament weak health systems
By Carisa A. Paraz, MD, Contributing Writer
Forty-five percent of illnesses in less developed countries (LDCs) are caused by poverty and are preventable, according to a top official of Britain-based International Policy Network (IPN).
Speaking at a recent symposium on intellectual property, innovation, and health, Philip Stevens, IPN director for policy, said that respiratory infections are the single biggest killer of children under five and are caused by burning dirty fuels indoors. This could be easily nipped with access to electricity, he said.
The event was jointly organized by IPN and a local group called Minimal Government, which both agree that certain government policies, such as taxes on medicines, work against the interests of the sick and hinder LDCs from attaining health for their populations.
Stevens also noted that diarrhea, the second biggest killer of children, may be easily treated using inexpensive oral-rehydration formulas; childhood vaccines are cheap no longer covered by patents; while drugs that combat common diseases like malaria, tuberculosis, and HIV/AIDS are available. Also, 98 percent of the World Health Organization's Essential Medicines List are off-patent drugs.
Why then do 30 percent of the world and an overwhelming 85 to 90 percent of Filipinos lack access to essential medicines, Stevens asked.
Weak health-care systems, corruption in health care, inadequate insurance systems, taxes and tariffs, nontariff barriers, and counterfeit medicines are all to blame, said the editor of the book Fighting the Diseases of Poverty. His solution? Economic growth.
"Economic growth translates to better health care," argued Stevens. This generates a cycle wherein "improved health care accelerates economic growth because people are more productive." Advocating free trade Stevens said it perpetuates the cycle by increasing incomes, driving down costs, and accelerating the spread of technology.
Prof. Bibek Debroy of the India's International Management Institute, lamented that despite India's impressive growth in terms of gross domestic product (GDP) it is still beset with health problems, which he blamed on "bad governance."
Debroy said that in India, health is not a "public good." Four percent of India's GDP is spent on health, but the private sector accounts for 75 percent of these expenditures and the government, only 25 percent. Resources are inefficiently spent, he said, and it is easy to blame scapegoats such as intellectual-property systems. It is not just a matter of the cost of drugs. He estimated that the Indian government spends only 20 to 30 percent of its budget on medicines, while the rest goes to salaries and medical equipment. In his opinion, the most important disease in India is government failure.
Nonoy Oplas, president of Minimal Government, suggested that that if the government wants to bring down the prices of medicines, food, and other essential needs, the first thing it can do is to "abolish or drastically cut import, value-added, and other taxes."
He said that to improve access to medicines, they should be made more affordable through free trade, zero import and related taxes, and zero nontariff barriers.
IPN and Minimal Government are among 25 groups from around the globe that submitted a commentary to the WHO Intergovernmental Working Group on public health, innovation, and intellectual property.
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