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Protecting the Health of the Poor

Protecting the Health of the Poor

Abraar Karan | Geeta Sodhi


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Book Details


Nowhere is the injustice of the global distribution of income and wealth more palpable than in health. While the world’s affluent spend fortunes on the most trifling treatments, poor people’s lives are ruined and often cut short prematurely by challenges that could easily be overcome at low cost: childbirth, diarrhoea, malnutrition, malaria, HIV/AIDS, measles, pneumonia. Millions are avoidably dying from such causes each year and billions of lives avoidably blighted by these diseases of poverty.

Drawing on in-depth empirical research spanning Asia, Latin America, and Africa, this path-breaking collection offers fresh perspectives from critically engaged scholars. Protecting the Health of the Poor presents a call and a vision for unified efforts across geographies, levels and sectors to make the right to health truly universal.

Abraar Karan is an MD candidate in the Global Health Pathway at the David Geffen School of Medicine at UCLA, where he serves as the student body president. His writings have been featured in a number of well-known publication venues, including Medscape, The Lancet, Academic Medicine, PLoS Global Health, Global Post, Kevin MD, and the Global Health Hub.

Geeta Sodhi, DNB (Paeds), is a qualified paediatrician who veered into public health and the development sector more than two decades ago as a social entrepreneur. Her research has been published in various edited volumes, and she has been an invited speaker at several international conferences and academic institutions.

‘Provides essential guidance for all development practitioners and reminds us to beware of easy fixes.’
Saman Yazdani Khan, Centre for Health and Population Studies, Pakistan

'This timely volume explores poverty and health in the context of the free market. The application of human rights to safeguard the health of poor people is illustrated with clarity and conviction.'
Lucia D’Ambruoso, University of Aberdeen

‘This book is a comprehensive assessment of the health consequences of poverty: it is courageous in its honesty and appropriately demanding of its reader. We must act.’
Stephen Leeder, University of Sydney (Emeritus)

‘Presents compelling evidence of diverse health inequities, traversing both political economy and political ecology, that continue to haunt global conscience.’
Rajib Dasgupta, Jawaharlal Nehru University

'A thought-provoking and provocative collection of essays that amount to an urgently needed call for action in promoting global health. Contains important contributions from scholars and development practitioners in many countries.'
Nicole Hassoun, Binghamton University

Table of Contents

Section Title Page Action Price
Front Cover Front Cover
About CROP i
Series Titles ii
Title Page iii
Copyright iv
Dedication v
Contents vii
Figures and Tables ix
Acknowledgements xii
Selected Abbreviations and Acronyms xiii
Foreword xv
Introduction 1
Responsibilities for the Right to Health 5
About the Book 10
References 13
Part One. Legal Movements 15
1 | Requesting a Compulsory Licence for Kaletra, an HIV/AIDS Antiretroviral Drug, in Colombia 17
Introduction 17
Analysis of the Colombian Health System 18
Patents and the Violation of the Right to Health 19
Kaletra: A Study of the Costs of the Patented Drug 20
Compulsory Licences 23
Analysis 31
Conclusions 36
References 38
2 | Impact of the World Trade Organization's Agreements on Agriculture and on Trade-Related Aspects of Intellectual Property Rights on the Health of Citizens in the Developing World: A Poverty-Production-Based Critique 40
Introduction 40
From the GATT to the WTO 41
The WTO and Poverty Production Under the Agreement on Agriculture (AoA) 41
Theory of Comparative Advantage 42
Export Subsidies and Trade Barriers 44
Poverty and Health 45
The WTO and Poverty Production Under TRIPS 47
Post-TRIPS 50
Relationship Between Rights and Trade: How the WTO Got it Wrong 51
Right to Health 53
The WTO and the Environment 56
The WTO and the United Nations 57
The WTO and International Law: The Contradictions 58
Conclusion and Recommendations 59
Notes 60
References 61
Part Two. Political Movement 65
3 | Managing an A(H1N1) Pandemic: Public Health or Healthy Business? 67
Introduction 67
Stockpiling Oseltamivir: The Case of A(H5N1) 68
New Pandemic, Old Response: Looking at A(H1N1) 72
Pushing Vaccines for H1N1: Faulty Calculations 73
Conclusions 75
Notes 76
References 77
4 | Catastrophic Health Expenditure, Health Insurance Coverage, and Poor People in India: New Evidence on Healthcare Costs Leading to Impoverishment 80
Data 81
Definitions 82
Findings 83
Discussion and Conclusions 98
References 99
5 | Crisis of the Global Innovation Model for Medicines: A Civil Society Organizations' Perspective 102
Introduction 102
Poverty, Health, and Access to Medicines 103
Global System of Innovation 106
Crisis of the Innovation Model 109
Technology Transfer and Local Innovation 118
Civil Society’s Perspective on Alternatives 119
References 121
Part Three. Interventional Approaches 125
6 | Advancing Tobacco Use Prevention and Cessation Among Socio-economically Disadvantaged Young Persons in India 127
Introduction 127
Background 128
Materials and Methods 133
Results 138
Discussion 143
Conclusion 146
References 148
7 | Addressing the Vulnerability of Urban Poor Women to Negative Maternal and Newborn Health Outcomes 152
Introduction 152
Background 155
Situational Analysis of Malegaon 158
Maternal and Newborn Health Initiative in Malegaon 159
Objectives of Swaasthya’s MNH Initiative in Malegaon 160
Key Elements of the MNH Initiative 160
Results 163
Sustainability and Replicability 169
Conclusion 170
References 171
Part Four. Multifaceted Movements 173
8 | International Poverty Law and Human Rights from Below: Latin American Affirmation of the Right to Health of Indigenous Peoples, Migrants, and the Displaced 175
Introduction 175
Right to Health in the Context of Hegemonic and Counter-Hegemonic Human Rights Notions and Practices 177
Overall Landscape 190
Conclusions 195
Note 197
References 197
9 | Sociopolitics of HIV in Uganda: Proposing a Socio-Behavioural Movement in Response to Donor Politics and the Economic Crisis 200
Introduction 201
Uganda’s Early Successes: Behaviour Change Before the Availability of Antiretroviral Therapy 205
Uganda in the Age of Antiretrovirals: Drawing Parallels with the Past 221
Moving Forward: The Future of HIV/AIDS in Uganda 235
Anecdotal Evidence: Homegrown Strategy 238
Final Thoughts: Case for a Socio-Behavioural Movement 240
References 243
10 | Health Impact Fund: Aligning Incentives 249
Tracking 253
Efficiency 254
A Way Forward 256
Secure Funding 258
Health Impact Fund in Relation to Other Global Health Initiatives 262
Lowest Feasible Price 266
Tightening Health Impact Fund Registration Conditions 268
Piloting the Health Impact Fund 269
Joining Forces for Justice in Global Health 271
Notes 272
References 275
About the Editors and Contributors 277
Index 282