Global Health Watch 1 in one file

of these transactions dwarfs the total foreign exchange reserves of all governments,
reducing their ability to intervene in foreign exchange markets to stabilize
their currencies, manage their economies and maintain fiscal autonomy
(UNDP 1999). Each country experiencing a ‘currency crisis’ has seen increased
poverty and inequality and decreased health and social spending, with women
and children bearing the burden disproportionately (Gyebi et al. 2002).
The establishment of binding rules, primarily through the World Trade Organization.
WTO (the successor to GATT) and other regional or bilateral trade
agreements such as the North American Free Trade Agreement (NAFTA) have
established enforceable supranational obligations on states, and have expanded
to include services, investment and government purchases.
Countries have also entered into multilateral covenants and treaties on human
rights and environmental protection. Notably, the 1948 Universal Declaration
on Human Rights purportedly protects individuals and groups against
state repression or discrimination, while obliging states to take ‘progressive
measures, national and international, to secure… universal and effective recognition
and observance’ of a package of rights including ‘a standard of living
adequate for the health and well-being of [oneself] and of his family, including
food, clothing, housing and medical care and necessary social services,
and the right to security in the event of unemployment, sickness, disability,
widowhood, old age or other lack of livelihood in circumstances beyond his
control’ (Article 25). The 1966 International Covenants on Civil and Political
Rights and on Economic, Social and Cultural Rights expanded these goals.
Even though the latter are treaties and therefore binding on signatory countries
that have ratified them (in the case of Economic, Social and Cultural
Rights, conspicuously not including the US), they are unlike trade agreements
in that no economic interests drive their enforcement through the limited
mechanisms that are available.
Reorganization of production across national borders. This third trend is one
of the most significant characteristics of the contemporary global political
economy. Multinational enterprises (MNEs), several of which are economically
larger than many nations or whole regions, are central to it (Anderson and
Cavanagh 2000). At least a third of global trade is intra-firm trade between
affiliated companies (WCSDG 2004), in which an MNE subsidiary in one country
sells parts or products to a subsidiary in another country (Reinicke 1998).
MNEs can now locate labour-intensive operations in low-wage countries (often
in exclusive export processing zones); carry out research and development in
countries with high levels of publicly funded education and investment in
research; and declare most of their profits in low-tax countries. The result
Health for all in a ‘borderless world’?
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