If developing countries don’t push for greater influence in global health organisations, they will face even greater health crises, like less affordable access to vital medicine, says Dr Aquina Thulare, technical advisor on National Health Insurance, South Africa who presented at the 10th BRICS Academic Forum in Johannesburg
This is certainly not a new challenge where developing countries are concerned – begging the question: why have we not yet seen innovations that could help us put an end to TB and other prevalent epidemics?
This was an important discussion placed under the spotlight at the 10th BRICS Academic Forum held in Johannesburg last month.
While the BRICS platform has looked to the development of diagnostic tools and vaccines to address this challenge, multi-drug resistant TB (MDR-TB) has undermined many of these efforts.
Disease control is about more than drugs
A major part of the problem is that we haven’t looked at the root causes of MDR-TB. And the reality is that if BRICS countries continue to accept the drugs foisted on them by large, transnational pharmaceutical companies as solutions to the TB epidemic, all we will achieve is people who are resistant to the drugs currently used to fight MDR-TB.
The biggest issue of all is that though BRICS countries bear the burden of epidemics like TB, they are not empowered to propose solutions to these problems. This is highly problematic because global health governance platforms like the World Health Organisation are focused largely on disease control rather than management of social determinants of health.
What’s more, global pharmaceutical production does not favour developing countries. This has major repercussions.
Global drug production doesn’t favour developing nations
As MDR-TB becomes increasingly resistant to the drugs used to treat it, so more innovative solutions will be needed – solutions such as biopharmaceuticals. Globally, the biopharmaceutical market is growing at a rapid pace with the promise of more effective results in the fight against diseases like TB.
But biologicals require sophisticated manufacturing capabilities, making them very expensive and potentially inaccessible within the developing countries where they are so desperately needed.
The situation may well become dire should BRICS countries not find ways of creating their own capacity and research towards biopharmaceutical production.
Brazil has already shown that moneyed countries don’t always have the answers needed, especially when it comes to health matters that concern developing countries.
The Latin American country has a Unified Health System, meaning it offers free, universal coverage. Initially, the World Bank advised Brazil against the system before it was implemented in 1988, saying it would prove unsustainable, leading to explosive growth in demand for healthcare.
However, the system still stands today, and though the country battles issue of quality, it has improved health care for a wide segment of its population.
We must grow greater influence
It’s clear based on current and future challenges that developing countries need greater influence in global health governance platforms, where currently the decision-making power rests with developed countries and development partners from the global north.
So while BRICS countries bear the brunt of the global disease burden – South Africa, for example, has a disease burden more than double that of the global average, according to WHO – we have very little room to contribute to finding working solutions.
Greater political will is needed to establish the required influence. This is closely followed by the need for investment in technical experts with the ability to engage specialists from high-income countries.
As a practical means to solving some of the common health challenges impacting BRICS countries, the South African delegation at this year’s Forum put forward the idea of a Virtual Innovation and Knowledge Sharing Platform. This would essentially leverage BRICS expertise and simplify the process of accessing information by overcoming traditional barriers of distance and language.
Crowd processing would essentially be used to gather innovative ideas and attract funding to popular ideas.
Indeed the final list of 20 recommendations, which the BRICS Think Tanks Council put forward to BRICS leaders at the end of the Forum, included the establishment of a Vaccination Research Platform to respond to communicable and non-communicable disease challenges.
Of course, we don’t expect this technology to solve our problems overnight, but at least through collaboration, we can start moving in the right direction.
The South African BRICS Think Tank was established as a platform for researchers and academics to exchange ideas and generate evidence-based policy recommendations. It aims to shape the strategic vision of South Africa and the wider African region around global financial, economic and governance issues, and to conduct policy analysis to inform the long-term strategy of the BRICS. A significant part of the SABTT’s mandate is to provide research-based technical and institutional support to the South African government through BRICS-related policies and development programmes. It also conducts broad-based analysis on the relationships between South Africa and its BRICS counterparts, taking into consideration the interests of South Africa, the continent and the rest of the BRICS countries.