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The wider health context | D2 in 2003, but it was again used to promote policy proposals in favour of the corporate sector. Trade agreements also seek to reduce government control over domestic water supplies. Under the General Agreement for Trade and Services (GATS), discussed in more detail in part A, WTO member states, under pressure from the EC in particular, are agreeing to liberalize their public water services and open the water sector to corporate investment. GATS also allows federal, state and local water regulations to be challenged as barriers to trade, and makes it extremely difficult to reverse failed privatization experiments. Social, public health and environmental considerations clash with the imperatives of trade and commerce. That is why 146 NGOs from all over the world issued the Evian Challenge at a G8 summit, calling on the EU to withdraw its water requests of other WTO members immediately and to withdraw its proposal to bring ‘water for human use’ into the current GATS negotiations (Public Citizen 2003a). Corporations have already started to sue governments to gain access to domestic water sources. For example, the US company Sun Belt is suing the government of Canada under the North American Free Trade Agreement because British Columbia banned water exports several years ago. The company says this law violates several NAFTA-based investor rights and is claiming US$ 220 million in compensation for lost profits (International Forum on Globalization 2005). Under cover of these international trade agreements, companies are setting their sights on the mass transport of bulk water, for example by towing icebergs, diverting rivers and transporting water in super-tankers, and developing technology to tow huge sealed bags of fresh water across the ocean for sale. The US Global Water Corporation, a Canadian company, has signed an agreement with Sitka, Alaska, to export 18 billion gallons of glacier water a year to China, where it will be bottled in ‘free trade’ zones to take advantage of cheap labour (see part A, and Barlow and Clarke 2002). The company brochure entices investors ‘to harvest the accelerating opportunity...as traditional sources of water around the world become progressively depleted and degraded’. Commodification and privatization in practice Given the importance of water to health, and the reshaping of relationships between government, business and civil society in the water sector, the commodification and privatization of water naturally cause concern in civil society worldwide – but have received surprising little attention in health policy circles. 212
16 Protesting against the privatization of water in Cochabamba, Bolivia. WHO says governments hold the ‘primary responsibility’ for ensuring the realization of water rights (WHO 2003). Yet government bureaucracies are being shrunk to make way for private sector ownership and control, and responsibility for ensuring access to water is being transferred to individual Water 213
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About this book Today’s global he
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Global Health Watch 2005-2006 An al
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Contents Boxes, figures and tables
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C2.1 The facts about disability 180
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Illustrations 1 Medicine cannot dea
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Acknowledgements The following indi
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London School of Hygiene and Tropic
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Victoria, Canada; Centre for Health
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Foreword New reports on different a
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Introduction Origins The Global Hea
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Child malnutrition, death and disab
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Human rights and responsibilities A
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impacting on health. The Watch hope
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part a | Health and globalization T
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Health and globalization | A1 and h
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Health and globalization | A1 in 20
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Health and globalization | A1 is gl
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Health and globalization | A1 peopl
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Health and globalization | A1 numbe
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Health and globalization | A1 and p
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Health and globalization | A1 econo
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Health and globalization | A1 Box A
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Health and globalization | A1 half
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Health and globalization | A1 appro
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table a1 Key health concerns with W
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Health and globalization | A1 Healt
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Health and globalization | A1 merci
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Health and globalization | A1 thems
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Health and globalization | A1 Even
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Health and globalization | A1 • A
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Health and globalization | A1 non-v
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Health and globalization | A1 27-28
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Health and globalization | A1 Jenki
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Health and globalization | A1 Satte
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Health and globalization | A1 WHO (
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and regulatory authorities mandated
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Health care systems | B1 4) selecti
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Health care systems | B1 • And si
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Health care systems | B1 • declin
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Health care systems | B1 user charg
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Health care systems | B1 focus on t
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Health care systems | B1 for health
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Health care systems | B1 their cont
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Health care systems | B1 health car
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Health care systems | B1 ing servic
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Health care systems | B1 Box B1.7 G
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Health care systems | B1 many of th
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Health care systems | B1 the lack o
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Macro-economic factors Impoverished
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Health care systems | B1 HALE 2000
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Health care systems | B1 But improv
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Health care systems | B1 high-incom
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Health care systems | B1 Structural
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Health care systems | B1 the high t
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Health care systems | B1 and histor
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Health care systems | B1 norms (Loe
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Health care systems | B1 Foster M,
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Health care systems | B1 Toole M et
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B2 | Medicines Introduction Essenti
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Health care systems | B2 of new med
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Health care systems | B2 chapter re
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Health care systems | B2 the fourth
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Health care systems | B2 agenda thr
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Health care systems | B2 nonetheles
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Health care systems | B2 decision o
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Health care systems | B2 for the an
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Health care systems | B2 expenditur
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Health care systems | B2 Medawar C
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Health care systems | B3 between he
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Severe shortage Low density Moderat
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Health care systems | B3 sector and
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Health care systems | B3 to the US,
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Health care systems | B3 500 400 30
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Health care systems | B3 have been
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Health care systems | B3 to underta
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B4 | Sexual and reproductive health
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Health care systems | B4 10 Policy-
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Health care systems | B4 women and
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Health care systems | B4 of funding
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Health care systems | B4 debate on
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Health care systems | B4 the sexual
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Health care systems | B4 perspectiv
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Health care systems | B5 genome res
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Health care systems | B5 drugs base
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Health care systems | B5 Complete f
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Health care systems | B5 when a tes
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Health care systems | B5 are allowi
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Health care systems | B5 of life sc
Page 179: part c | Health of vulnerable group
Page 182 and 183: Health of vulnerable groups | C1 me
Page 184 and 185: Health of vulnerable groups | C1 pr
Page 186 and 187: Health of vulnerable groups | C1 Th
Page 188 and 189: Health of vulnerable groups | C1 Ca
Page 190 and 191: Health of vulnerable groups | C1 Bo
Page 196 and 197: Health of vulnerable groups | C1 Pa
Page 200 and 201: Health of vulnerable groups | C2 DP
Page 206 and 207: Health of vulnerable groups | C2 di
Page 209 and 210: part d | The wider health context T
Page 211 and 212: D1 | Climate change Introduction En
Page 213 and 214: increasing quantities are now causi
Page 215 and 216: development, local availability foo
Page 217 and 218: 14 Droughts threaten the food secur
Page 219 and 220: Protocol can meet their targets by
Page 221 and 222: 15 Transport and travel are major d
Page 223 and 224: • Redesign trade rules. Governmen
Page 225 and 226: D2 | Water Access to enough clean w
Page 227 and 228: water consumption worldwide. Each p
Page 229: table d2.1 Top corporate players in
Page 233 and 234: Box D2.3 Regulating private water c
Page 235 and 236: The private sector overestimates th
Page 237 and 238: Box D2.7 US citizens told to boil t
Page 239 and 240: to water. Worse still, it does this
Page 241 and 242: References Barlow M, Clarke T (2002
Page 243 and 244: D3 | Food Undernutrition is by far
Page 245 and 246: Functional and Productive Capacity
Page 247 and 248: table d3.1 Corporate control of US
Page 249 and 250: keting and processing means that sm
Page 251 and 252: average Indian family of four reduc
Page 253 and 254: Bank’s US$ 93.5 million loan to C
Page 255 and 256: Avery N, Drake M, Lang T (1993). Cr
Page 257 and 258: D4 | Education Some 135 million chi
Page 259 and 260: ledge about health-care practices a
Page 261 and 262: 2005, and on present trends about 4
Page 263 and 264: Box D4.3 Programmes that aim to emp
Page 265 and 266: • per capita public spending fall
Page 267 and 268: unable to recruit 9000 badly needed
Page 269 and 270: Gordon D et al. (2003). The distrib
Page 271 and 272: D5 | War War has an enormous and tr
Page 273 and 274: 19 Chechnya destroyed. War has wide
Page 275 and 276: initiated a ‘war on terrorism’.
Page 277 and 278: an explosive force equivalent to ab
Page 279 and 280: the risk of their misuse and divers
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Box D5.3 An agenda for peace The Ha
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Machel G (1996). Impact of Armed Co
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part e | Holding to account: global
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E1 | World Health Organization The
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The sources consulted worldwide in
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Box E1.1 Milestones in WHO history
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aised by his attempts to revitalize
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• stronger internal focus on perf
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21 WHO - up in the clouds? Reaction
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in favour of so-called ‘vertical
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to speak openly, while bullying and
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velop a unified, purposeful health
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to medicines, and the mobilizing ro
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Recommendations WHO’s core purpos
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doctors, and more people with exper
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E2 | UNICEF In 2005, Carol Bellamy,
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In sum, for almost a decade, childr
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prompted a global debate on how to
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E3 | The World Bank and the Interna
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22 World Bank: the centre of world
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approach to conditionality is being
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tal policies should explicitly refe
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E4 | Big business This chapter deal
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23 The Marlboro Man was described b
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dedicated funding [Articles 5.6 and
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grass roots in building government
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24 A pack of Cerelac cereal food pu
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USAID has also funded work on breas
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(from whatever its source, and howe
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These trends in taxation are underp
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Norway Denmark Netherlands Luxembou
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Global aid trends - allocation Wher
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weapons, vehicles and military trai
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table e5.1 Value (in £) of new DFI
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OECD (2005). Development Co-operati
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25 Breaking the chains of debt: pro
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Box E6.1 Zambia: inflation or death
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have met the Fund’s conditions, a
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E7 | Essential health research Rese
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Developing national health research
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for African Medical Editors (Certai
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Neither the consultations leading u
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Box E7.4 Asking the social-politica
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• global architecture for health
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part f | Conclusions Global Health
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current debt relief mechanism - the
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agreement, and taking health and he
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ity of the now-developed countries
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tion and water are experiencing sim
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