Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Thank You G8 for The Global Health Fund
- Idris Mohammed (21 July 2001)
-
FRAMEWORK CONVENTION ON TOBACCO CONTROL (FCTC)
- Nurul Islam (22 July 2001)
-
The Global Health Fund: a global bluff
- Eduardo Missoni (24 August 2001)
|
|
|||
|
Idris Mohammed, Chairman National Programme on Immunization, Abuja Nigeria
Send response to journal:
|
The decision by the most industrialised countries (G8) to set up the Global Health Fund shows that they are at last ready to assume moral and political leadership in addressing the health needs of the poorest nations, particularly those in Africa. By targetting HIV/AIDS, malaria and tuberculosis, they have shown unique understanding of what must be done to rescue poor nations from a potential health and economic catastrophe. I thank the G8 most sincerely for their magnanimity, and hope that the funding will be sustained for long enough to ensure success in the shortest possible time. The GAVI proposals for supporting immunisation programmes is a very welcome development, and we in sub-Saharan Africa will remain grateful to this new body. However, in cajoling developing nations to introduce new or under-used vaccines, GAVI must understand that unless the Alliance takes into account individual nations' peculiarities, the initiative may do more harm than good. As for representation on the Global Health Fund, I hope that developing countries will get not less than one-third of the seats because, although they would be mere receipients of aid, their input is crucial to the success of this laudable initiative. |
|||
|
|
|||
|
Nurul Islam, 21/07/2001 Bangladesh
Send response to journal:
|
FRAMEWORK CONVENTION ON TOBACCO CONTROL (FCTC): The way out ___________________________________________________________ Throughout the world around 4 million people die from tobacco-related illness each year. This is the equivalent of twenty-seven 747 aeroplanes full of passengers crashing every day. By the year 2030, 10 million people will die each year from tobacco use1. Approximately 80000 to 100000 young people around the world become addicted to tobacco each year2. Many of tobacco's future victims are today's children. If current trends continue, 250 million of them will eventually die from tobacco-related disease. The future consequences are frightening. Based on current smoking trends, tobacco will soon become the leading cause of death worldwide, causing more deaths than HIV, maternal mortality, automobile accidents, homidic and suicide combined3. From all we know about tobacco two undisputed facts emerge: * Tobacco kills * It is a global problem Therefore (i) the killer must be killed and (ii) the global problem must be solved globally. FCTC enunciated by the WHO under the direction of Dr Gro Harlem Brundtland will promote a coordinated international response to one of the most deadly epidemics of our time. WHO has initiated negotiations on FCTC in October 2000. A Framework Convention is a type of multilateral treaty, which allows states to proceed incrementally by establishing first general framework. This is followed by specific protocols. Tobacco is truly a global problem and a global killer. Actions against tobacco all over the world range from legislation to litigation. Restriction of production and sale of tobacco to minors, limitations of smoking in public places, warning signs, publicity and propaganda effectively implemented in the developed countries through law enforcing authorities results in success ranging from minor effects to significant changes. In developing countries like Bangladesh regulation and legislation are not difficult to formulate and even enactment is not impossible, but implementation is very difficult. The law enforcing authorities are weak, morally and ethically. They are purchasable and the tobacco companies are always ready to give small gifts or even costly helicopters. Alluring advertisements with glamorous models easily tempt young people to take up smoking. Concerts and sports are also fully utilized for the young adults and teenagers who take up cigarettes as a symbol of their personality and glamour. Although it is not easy to fight against the tobacco industry, some basic facts about tobacco cannot be challenged: * As long as there is tobacco there will be tobacco users * The tobacco industry will not easily give up * There would be no tobacco consumers if there were no tobacco. The ultimate solution therefore lies in tobacco elimination rather than limitation. FCTC has a moral responsibility to find ways and means to eliminate the availability of tobacco. America, Britain and Japan have the largest tobacco companies. If they join hands and decide to eliminate tobacco the task should not be too difficult. Bold steps by political leaders for the elimination of nuclear weapons have proved quite successful. If it is possible to eliminate nuclear weapons there is no reason why we cannot eliminate tobacco use. If the major powers make a determined effort it is possible to create a tobacco free society. In FCTC we believe that we are seeing the beginning of that great end. The Director General of WHO should not be alone in her efforts. Every government has a moral and ethical responsibility to safeguard the health of their people. Non-government organizations need to come forward and encourage their respective governments to join with FCTC. Working together we can certainly win the battle against tobacco - the greatest silent killer of mankind. The FCTC convention opens the door to a tobacco-free world. N Islam D.Sc, FRCP, FRCPE Founder-President, ADHUNIK BANGLADESH References: 1. World Health Organization, NOTE TO TEK, World Health Report, Geneva:WHO, 1999. 2. World Bank, Curbing the Epidemic: Governments and the Economics of Tobacco Control. Washington: World Bank, 1999 3. Howard Barnum. The economic burden of the global trade in tobacco. In:Slama K, ed. 9th World Conference on Tobacco and Health, October 1994, London:Plenum Press, 1995. |
|||
|
|
|||
|
Eduardo Missoni, Former President of G8 Health Experts Group Rome, Italy
Send response to journal:
|
The Global Health Fund: a global bluff Eduardo Missoni Former President of G8 health experts group Rome, Italy Correspondence to: missoni@mclink.it Though expressing some serious doubts, Ruarì Brugha and Gill Walt in their article on the BMJ (2001; 323:152-154), conclude substantially approving the launch of a Global Health Fund at the G8 summit in Genoa last July. They applaud the idea that – thanks to the Fund – Malaria, Tuberculosis and HIV “are finally receiving the degree of attention they deserve”, recognise “goodwill and commitment” behind the G8-Annan initiative and consider “good governance” as the first step to be achieved. Regarding governance of the fund, it is peculiar that the UN Secretary General himself in promoting the idea of a Global Fund underlined that it should be "governed by an independent board", and external to the UN "because I want it to attract others to join the fight". One may ask: Why an “independent” board to decide about the use of resources for public global health and not WHO which has the mandate and the legitimacy for it? Why shouldn’t resources be collected and administered by existing UN organisations? Growing “external” interests are evidently pushing to delegitimate the UN system (though undoubtedly to be reformed in terms of democracy and efficiency) and to gain control of significant spaces of global governance, while the G8 governments – not willing to contrast those interests, and being in some cases their direct expression - seem to be supportive of a UN role reduced only to a forum for debate and advocacy, with relevant “global” decisions taken some where else. It is sad to realise that UN leaders themselves, accept or even promote that view. In any case, no UN representative would have legitimacy to represent members states collective interests, in a board where some of those countries autonomously represent themselves. Without considering that rich countries’ view will already be strongly represented in the board by the World Bank, in whose hands will be also the management of the Fund. Do Brugha and Walt really think that “good governance” of the global fund may at all be possible with an evident conflict of interests determined by the presence of a representative of industry (including pharmaceutical, as it is stated in the G8 Presidency document) sitting in a board which may decide about drug purchasing strategies? About “goodwill and commitment”, it is hardly to be found with: G8 countries’ ODA at a poor 0.2% of their GNP, compared with the 0.7% target agreed upon since over two decades; a high probability that resources they will destine to the Global Fund will not at all be additional to existing flows and a declared initial commitment to the Global Fund of only US$ 200 millions per G8 country, where the minimum need to face HIV/AIDS alone is considered to be US$ 7 billions (UN estimates). On the other side, there has been no commitment to correct macroeconomic factors that have been causing growing inequalities and avoid policies that may have secondary negative effects on health (as it has been the case with Structural Adjustment Programmes), whereas only such a preventive approach could ensure long term sustainability to any intervention. Finally the fact that three important communicable diseases receive specific attention (in the sense of earmarked resources, possibly even in competition with the existing “plethora of recent global public-private partnerships”), could just be another step to definitely abandon the idea that health “is not only absence of disease”, for a new era of vertical, undemocratic, unsustainable, centrally determined, donor and – now - profit driven programmes. |
|||