Environmental Engineering Reference
In-Depth Information
an initial question serves as a backdrop to this chapter: is globalisation a positive
phenomenon in terms of its impact on the pharmaceutical market? Globalisation is
not being criticised as such, as that is a losing proposition. but globalisation can
mean the imposition of standards and designs that may be inappropriate or vastly
different from local ones. In this case, often there is a push-pull dynamic between
global and local standards, which may lead to very different results depending on the
incentive structure and institutions the individual must navigate. Dani rodrik (1997,
82) argues that multilateral institutions need to encourage a greater convergence of
policies and standards with 'deep integration' only among those countries that are
willing to do so in order to reduce tensions from the differences in national standards.
they must also allow for selective disengagement from multilateral standards for
countries that need breathing room to satisfy domestic requirements that conflict
with liberalising trade.
International agreements that have the potential to affect, directly or indirectly,
the health of populations, particularly those in the poorest countries, must be
structured with safety valves that can enable a country to maintain good international
standing if it decides not to commit to standards that are too costly in terms of health
objectives. It may be difficult to determine when countries are cheating, but this
should not impede efforts to infuse international agreements with inclusions that can
help protect the health of populations. this concept is not novel. efforts have been
made in the past to ensure that there are inclusions for health in trade agreements. but
are these provisions adequate for ensuring equitable access to pharmaceuticals?
methodology and organisation
this chapter is restricted to documentary analysis, which includes the interpretation
of the trIPS agreement, international statements, and other pertinent documents.
It first examines how globalisation has been dominated by economic paradigms and
how the primacy of economic models is challenged by alternative social paradigms
such as those that view access to medicines as a basic human right. next is an
examination of the trIPS agreement and its implications for pharmaceutical access
as well as possible policy levers, which a state can apply and which can ideally
mitigate the harshest impact of the trIPS agreement. then discussion deals with
select international statements, considering the value of health and the implications
of these for the imposition of trade agreements. Finally, the chapter concludes by
discussing the relative merits of the health inclusions and proposes changes. as
Sabina alkire and lincoln chen (2004, 1074) point out, 'appeal to moral values will
motivate people to support a set of actions'. the infusion of ethical considerations,
such as ensuring that everyone has fair access to essential medicines, into international
governance structures has been aided by the growing focus on health as a human
right. Given that human rights are universal, health squarely takes primacy over
any trade agreement. but how does one ensure this happens given the hegemony of
commercial concerns?
