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close this bookThe Courier N 184 - Jan - Feb 2001 - Dossier: Press and Democracy - Country Reports: St Kitts and Nevis (EC Courier, 2001, 96 p.)
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Round Table on communicable diseases - Disease and poverty: breaking the vicious circle

by Penelope Aral

Round table on HIV/AIDS, malaria, tuberculosis and poverty reduction

Every day, communicable diseases kill some 10,000 people in Africa. A few years ago, malaria seemed close to being eliminated, yet today it is still the most common cause of death in sub-Saharan Africa, and statistics show that it is affecting more and more people. Tuberculosis is still the most widespread disease in the world, while AIDS is far from being eradicated. All these health problems are closely linked to poverty.

The time has come to summarise the advances achieved until now in the field of development cooperation, and to identify the outstanding problems concerning research into and prevention and treatment of communicable diseases. It was this that prompted the European Commission, in conjunction with the World Health Organization (WHO) and the United Nations Joint Programme on HIV/AIDS, to organise a summit conference on HIV/AIDS, malaria, tuberculosis and poverty reduction. The round table also offered the participating health professionals an opportunity to develop a consistent Europe-wide policy and to set up an action framework for the struggle against AIDS, malaria and tuberculosis.

Poor people most at risk

These diseases are still slowing down human progress, and adversely influencing mortality rates and life expectancy in developing countries. Communicable diseases are paralysing not only the health sector but also the overall economic development of the regions concerned.

Dr Peter Piot, Director of the United Nations Joint Programme on AIDS, believes that “disease produces a negative synergistic effect with poverty, either causing it or making it worse.” The epidemic has had tragic repercussions on education and the entire economic sector, and so has compromised all the advances achieved on the development front.

The Commission has therefore undertaken to support the acceleration of the campaign against communicable diseases. Since 1990, more than 100 developing countries have benefited from the €3.4 billion which the Commission has invested in its Health, AIDS and Population (HAP) programmes. The Commission will increase its level of support to the health sector, with emphasis on disease prevention, health promotion and improving care systems.

Three main lines of action

The first vital step will be to optimise the impact of the activities, services and basic products already available by establishing partnerships. The diseases in question can to a large extent be prevented and/or rapidly treated by effective and inexpensive means. The problem is that help does not always reach the most vulnerable people. It is thus essential to develop new and more effective partnerships in every sector of development to reinforce the aid provided. In his opening address, Romano Prodi, President of the European Commission, emphasised that, despite the substantial aid provided by Europe in the campaign against poverty and disease, results have been inadequate. As he sees it, there is only one remedy for this situation: the development of new partnerships and the setting up of a comprehensive worldwide action policy.

A young mother in a DRC maternity ward “Illness comes with poverty; it causes it, or makes it worse”

The second line of action will be to increase the availability of pharmaceutical products to those who need them most. At present, poor countries are still being denied access to essential services and affordable medicines. The European Commission is becoming more and more involved in the international debate on improving this access to healthcare. European industry is supplying over 60% of the vaccines used in developing countries and is among the leading producers of medicines for the prevention of infection. Europe can play an important role by reducing the prices of medicines. Development Commissioner Poul Nielson believes that the private sector and the NGOs must work more closely together, and that price reductions for pharmaceutical products are indispensable.

Possible options for making essential medicines more accessible and affordable include resorting to differential price fixing, voluntary licensing agreements, a parallel trade system, transfer of technologies associated with the development of local production capacities, combined use of generic and patented products, and a study of tariff and tax options at national level.

Banking on research

The third option is to redirect the results of research.

The pharmaceutical industry gears its research activities to demand from the industrialised countries. As a result, it is neglecting research into those diseases that are most widespread in developing countries, where the market is considered too restricted. In future, incentives must be designed to direct research towards the diseases that hit poor countries. Efforts should also be made to intensify investment in the resources of the scientific and technological institutions of developing countries and their personnel.

The cost of programmes like these may be high, but so is the price of failure to eradicate these diseases. Dr Gro Harlem Brundtland, Director-General of WHO, believes that these diseases both generate and perpetuate poverty.

Health and poverty are closely linked, and the repercussions of these on diseases are incalculable. It is essential to consider aid in a global context, looking beyond the boundaries between different sectors. The international environment is favourable, and the new partnership with the WHO, with closer collaboration between the parties concerned - the World Bank and UNAIDS - offers an opportunity that must be seized. The Community intends to make a substantial contribution to this international initiative, using the various instruments available to it. The round table organised in Brussels last September provided the framework for this contribution. It must be properly directed and a more effective campaign waged against the problems of health and poverty.