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Holding to account | E3 House, University of Oxford (http://www.eurodad.org/uploadstore/cms/docs/ WbevalMay03.pdf). Structural Adjustment Participatory Review Initiative Network (SAPRIN) (2004). Structural adjustment: the policy roots of economic crisis, poverty and inequality. London, Zed Books. UNCTAD (2002). Economic development in Africa: from adjustment to poverty reduction, what is new? Geneva, UNCTAD. World Bank (2003). The Global Poll: multinational survey of opinion leaders 2002. Washington DC, World Bank. 306
E4 | Big business This chapter deals with the regulation of big business in the interests of health through legal restrictions and financial taxation. Corporate power is growing – of the 100 largest economic entities in the world, 51 are corporations. The combined sales of the top 200 businesses are 18 times that of the combined income of the poorest quarter of the world’s population (Anderson and Cavanagh 2000). Assessing their impact on health, and trying to prevent negative consequences, is therefore an urgent public health responsibility. The case studies below suggest ways in which successful regulation can occur and where more action is needed. The examples of control of tobacco and breast-milk substitutes are described as positive instances of global regulatory arrangements which support health. It is important to learn lessons from these successes and to note the continuing battles that need to be fought. A third case study looks at the declining tax burden on corporations and suggests that a global campaign needs to be fought to defend taxation as a key source of public expenditure for health and health-sustaining services. Case study 1: The Global Tobacco Treaty Irresponsible and dangerous corporate actions threaten people’s lives around the world every day. With so much at stake, people from many backgrounds are coming together to use a range of strategies to challenge corporate abuses, and working together toward a world where major decisions affecting people and the environment are based on the public interest, not on maximizing corporate profits. Corporations often cause and get away with serious damage to people and the environment because of their political influence. They typically use this influence to block or eliminate proposed public protections, and to promote and enact policies and regulations that benefit their bottom line at the expense of the public good. As part A of the Watch showed, they are assisted by a variety of trade-related agreements and rules that reduce government power to regulate and protect public health and the environment. Transnational corporations in particular operate globally with few limits on their power and influence or strong, enforceable standards. This section looks at the global challenge to Big Tobacco, one of the most 307
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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
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part c | Health of vulnerable group
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Health of vulnerable groups | C1 me
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Health of vulnerable groups | C1 pr
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Health of vulnerable groups | C1 Th
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Health of vulnerable groups | C1 Ca
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Health of vulnerable groups | C1 Bo
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Health of vulnerable groups | C1 Pa
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Health of vulnerable groups | C2 DP
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Health of vulnerable groups | C2 di
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part d | The wider health context T
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D1 | Climate change Introduction En
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increasing quantities are now causi
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development, local availability foo
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14 Droughts threaten the food secur
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Protocol can meet their targets by
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15 Transport and travel are major d
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• Redesign trade rules. Governmen
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D2 | Water Access to enough clean w
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water consumption worldwide. Each p
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table d2.1 Top corporate players in
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16 Protesting against the privatiza
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Box D2.3 Regulating private water c
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The private sector overestimates th
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Box D2.7 US citizens told to boil t
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to water. Worse still, it does this
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References Barlow M, Clarke T (2002
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D3 | Food Undernutrition is by far
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Functional and Productive Capacity
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table d3.1 Corporate control of US
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keting and processing means that sm
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average Indian family of four reduc
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Bank’s US$ 93.5 million loan to C
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Avery N, Drake M, Lang T (1993). Cr
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D4 | Education Some 135 million chi
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ledge about health-care practices a
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2005, and on present trends about 4
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Box D4.3 Programmes that aim to emp
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• per capita public spending fall
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unable to recruit 9000 badly needed
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Gordon D et al. (2003). The distrib
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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
Page 281 and 282: Box D5.3 An agenda for peace The Ha
Page 283 and 284: Machel G (1996). Impact of Armed Co
Page 285 and 286: part e | Holding to account: global
Page 287 and 288: E1 | World Health Organization The
Page 289 and 290: The sources consulted worldwide in
Page 291 and 292: Box E1.1 Milestones in WHO history
Page 293 and 294: aised by his attempts to revitalize
Page 295 and 296: • stronger internal focus on perf
Page 297 and 298: 21 WHO - up in the clouds? Reaction
Page 299 and 300: in favour of so-called ‘vertical
Page 301 and 302: to speak openly, while bullying and
Page 303 and 304: velop a unified, purposeful health
Page 305 and 306: to medicines, and the mobilizing ro
Page 307 and 308: Recommendations WHO’s core purpos
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Page 311 and 312: E2 | UNICEF In 2005, Carol Bellamy,
Page 313 and 314: In sum, for almost a decade, childr
Page 315 and 316: prompted a global debate on how to
Page 317 and 318: E3 | The World Bank and the Interna
Page 319 and 320: 22 World Bank: the centre of world
Page 321 and 322: approach to conditionality is being
Page 323: tal policies should explicitly refe
Page 327 and 328: 23 The Marlboro Man was described b
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Page 331 and 332: grass roots in building government
Page 333 and 334: 24 A pack of Cerelac cereal food pu
Page 335 and 336: USAID has also funded work on breas
Page 337 and 338: (from whatever its source, and howe
Page 339 and 340: These trends in taxation are underp
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Page 343 and 344: Global aid trends - allocation Wher
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Page 347 and 348: table e5.1 Value (in £) of new DFI
Page 349 and 350: OECD (2005). Development Co-operati
Page 351 and 352: 25 Breaking the chains of debt: pro
Page 353 and 354: Box E6.1 Zambia: inflation or death
Page 355 and 356: have met the Fund’s conditions, a
Page 357 and 358: E7 | Essential health research Rese
Page 359 and 360: Developing national health research
Page 361 and 362: for African Medical Editors (Certai
Page 363 and 364: Neither the consultations leading u
Page 365 and 366: Box E7.4 Asking the social-politica
Page 367 and 368: • global architecture for health
Page 369 and 370: part f | Conclusions Global Health
Page 371 and 372: current debt relief mechanism - the
Page 373 and 374: 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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