Inter Press Service - December 20, 2001
Gustavo Capdevila

That argument constitutes the basis of a new plan drawn up by an international group of prominent economists and leading experts from other areas, presented Thursday to World Health Organisation (WHO) Director-General Gro Harlem Brundtland.

The authors maintain that "the links between health, poverty reduction and economic growth are much more powerful than has been generally understood." Based on "clear scientific evidence," the experts argue that improved health is an essential requisite for the economic development of poor countries, by contrast with the traditional view that health will automatically improve as a consequence of economic growth.

The plan, the result of two years of work by the Commission on the Macroeconomy and Health set up by Brundtland, presents a new model of development assistance, said WHO spokeswman Daniela Bagozzi.

"By helping to control the diseases of the poor, wealthy countries will also benefit from the resulting political and social stability amd faster economic growth in the developing countries," say the authors.

The report notes that a large proportion of avoidable deaths in poor countries are caused by a limited number of health problems.

With well-designed measures based on existing technologies, eight million lives a year could be saved, and more than 360 billion dollars in economic benefits could be produced in the 2015- 2020 period.

But to achieve such results, basic health coverage would have to be expanded in low-income countries, at an annual cost estimated at 66 billion dollars.

The funds would come from high-income donor countries as well as the recipient nations themselves, said the chairman of the commission, US economist Jeffrey D. Sachs, speaking at the ceremony held for the presentation of the new plan, in London.

Donor countries' official development aid for health currently stands at six billion dollars a year, but would rise to 27 billion by 2007 according to the plan, which entails a new "health pact" between donor and recipient countries, based on "mutual trust" and the monitoring of performance, said Bagozzi. Aid provided by high-income countries would rise to 0.1 percent of Gross National Product (GNP), while developing countries would increase health spending by around one percent of GNP by 2007 and two percent by 2015.

Spending would focus on fighting the main poverty-related diseases: malaria, tuberculosis, childhood diseases and HIV/AIDS.

The plan also addresses health questions that have triggered loud international controversy in recent years, such as access to essential medicines by people in poor nations.

The commission proposes a new international framework for access to life-saving medicines, with norms that have raised an outcry from the pharmaceutical giants, such as differential pricing schemes, which would lead to different prices for the same medicine, based on the purchasing power of the populations of poor nations.

Under that system, rich countries would foot the bill for the costs of research and development of new drugs, while poor countries would only pay the "baseline" costs of production, said Bagozzi.

Another of the authors' recommendations refers to the granting of licences to producers of high-quality generic drugs, to allow them to manufacture medicines for use in poor countries.

That concession would be granted when the pharmaceutical industry chose not to supply those markets themselves, or when manufacturers of generic medicines could demonstrate their capacity to produce high quality drugs at a significantly lower cost.

The plan constitutes a more transparent and responsible mechanism for helping developing countries not only with regards to health, but through other areas of society as well, said Bagozzi.

Developing countries, for their part, "would need to commit additional domestic financial resources, political leadrship, transparency, and mechanisms for community involvement and accountability to ensure that adequately financed health systems can operate effectively and address the key health problems of the poor."

The commission is made up of Sachs, Paris-based Economy Professor Daniel Cohen, former economy minister of India Manmohan Singh, World Bank official Eduardo Doryan, and Supachai Panitchpakdi, the future director-general of the World Trade Organisation.

Other members are Associate Administrator of the United Nations Development Programme Zephirin Diabre, 1993 Nobel Economy laureate Robert Fogel, and Nora Lustig, president of the University of the Americas in Puebla, Mexico.

Also serving on the commission are K.Y. Amoako, Executive Secretary of the UN Economic Commission for Africa, International Monetary Fund Deputy Managing Director Eduardo Aninat, and Dean Jamison, director of the Programme on International Health and Education at the University of California, Los Angeles.

The list is completed by Isher Ahluwalia, director of the Indian Council for Research on International Economic Relations, Richard Feachem, of the Institute for Global Health in San Francisco, Anne Mills, a professor at the London School of Hygiene and Tropical Medicine, and Harold Vermus, 1989 Nobel prize-winner for Physiology and Medicine.
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