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	<title> &#187; Selected writings</title>
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		<title>A Sustainable Globalisation?</title>
		<link>http://www.rogertatoud.com/2009/08/06/a-sustainable-globalisation/</link>
		<comments>http://www.rogertatoud.com/2009/08/06/a-sustainable-globalisation/#comments</comments>
		<pubDate>Thu, 06 Aug 2009 21:24:37 +0000</pubDate>
		<dc:creator>Roger</dc:creator>
				<category><![CDATA[Selected writings]]></category>
		<category><![CDATA[Development]]></category>
		<category><![CDATA[Economics]]></category>
		<category><![CDATA[Globalisation]]></category>
		<category><![CDATA[Society]]></category>

		<guid isPermaLink="false">http://www.rogertatoud.com/?p=142</guid>
		<description><![CDATA[Globalisation has been the buzzword of the roaring nineties and with the fall of the Berlin’s wall, the end of the cold war and the victory of capitalism over socialism it has opened a new era in human history. Rightly or not, globalisation has become synonymous with market economy, capitalism and development. Much discussions, books [...]]]></description>
			<content:encoded><![CDATA[<p style="text-align: left;"><a href="http://www.peripheries.org/wp-content/uploads/2009/08/washington-vs-Geneava.jpg"><img class="alignleft" style="margin-left: 5px; margin-right: 5px;" title="washington vs Geneva Consensus" src="http://www.peripheries.org/wp-content/uploads/2009/08/washington-vs-Geneava.jpg" alt="washington vs Geneva Consensus" width="220" height="150" /></a>Globalisation has been the buzzword of the roaring nineties and with the fall of the Berlin’s wall, the end of the cold war and the victory of capitalism over socialism it has opened a new era in human history. Rightly or not, globalisation has become synonymous with market economy, capitalism and development. Much discussions, books and movies have placed it at the centre of the debate about the future of development with a “New Deal” or a “New Barbarism” as two possible scenarios. As the <a title="Washington Consensus" href="http://www.cid.harvard.edu/cidtrade/issues/washington.html" target="_blank">Washington Consensus</a> is being challenged by the <a title="Geneva Consensus" href="http://www.social-protection.org/gimi/alliance/ShowMainPage.do" target="_blank">Geneva Consensus</a>, the possibility of a sustainable globalisation, conducive to social justice, human security and environmental protection, being an unrealisable goal is a question of great contemporary interest. To address this question we will examine how globalisation affects social justice, human security and the environment. We will then introduce different views and responses to the globalisation process, which when integrated altogether will provide a framework to answer the question of realizing a sustainable globalisation.</p>
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<p style="text-align: left;"><a href="http://www.peripheries.org/wp-content/uploads/2009/08/482492544_655d7be7ed.jpg"><img title="The other side of globalisation" src="http://www.peripheries.org/wp-content/uploads/2009/08/482492544_655d7be7ed.jpg" alt="The other side of globalisation" width="220" height="291" /></a></p>
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<td><span style="font-size: x-small;"><em>Globalisation is often associated with the McDonaldisation of the developing world, an association that ignores that globalisation also means that The South is now well present in The North. Photo (C) peripheries.</em></span></td>
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<p style="text-align: left;">The definition, relevance and even existence of globalisation (see Bayliss, 2008, pp. 10-11 for a summary or the sceptical view of globalisation) are the subjects of impassioned discussions. For the purpose of this essay we will consider a contemporary globalisation as defined by Manfred Steger as “the expansion and intensification of social relations and consciousness across world-time and world-space” (Steger, 2009, p. 15). This globalisation is sustained and driven by a set of processes involving economic, technological, political and cultural shifts and is characterised by the stretching and intensification of human activities and the increased speed at which these activities are conducted with the consequences that distant events in one place may have a massive impact elsewhere (Harriss, 2000, pp. 347-348).</p>
<p style="text-align: left;">Globalisation is palpably at work in many sectors of human activity and is typically multidimensional (Harriss, 2000, pp. 353-359; Bayliss, 2008, p. 21; Steger, 2009). We will consider four chief dimensions of globalisation.</p>
<p style="text-align: left;">The first is economic: with the triumph of capitalism over socialism and the self-regulated market as a development compass, globalisation inaugurates the emergence of a global economy and the internationalisation of trade and finance characterised by industrialisation, transnational exchanges, and delocalisation of production but market integration.</p>
<p style="text-align: left;">However, economic choices result in part from political decision; this is the second dimension of globalisation often characterised by the demise of the nation-state and the birth of global politics and policies and global governance.</p>
<p style="text-align: left;">Politics is inseparable from the cultural and social context in which it happens and which constitute the third dimension of globalisation characterised both by a homogenisation of cultures through migrations, communication and exchange networks but also the emergence of strong regional an ethnic identities with various outcomes.</p>
<p style="text-align: left;">Crucially, human activities do not happen in a vacuum but within the confines of the planet Earth and therefore another dimension of globalisation is environmental. There, the globalisation processes, which both depends and impacts on the way natural resources are managed and exploited, has significant repercussions on sustainable development and by extension sustainable globalisation.</p>
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<td><a href="http://www.peripheries.org/wp-content/uploads/2009/08/IMG_0627.JPG"><img title="An Asian wedding in Angkor Wat" src="http://www.peripheries.org/wp-content/uploads/2009/08/IMG_0627-768x1024.jpg" alt="An Asian wedding in Angkor Wat" width="220" height="292" /></a></td>
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<td><span style="font-size: x-small;"><em>An Asian bride is getting wed in Angkhor Wat, Cambodia. Rich and poor side by side, globalisation creates a new North/South divide. Photo (C) peripheries.</em></span></td>
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<p style="text-align: left;">With this in mind, different views of globalisation echoing different views of development (developed in Thomas, 2000) have led to different accounts of globalisation and its sustainability (McGrew, 2000; Bayliss, 2008, pp. 6-8). Whereas the Neo-liberals see globalisation mainly from an economic standpoint as a new epoch marked by the triumph of capitalism, a single market economy where capital flows freely and a global competition benefiting all, the Radicals see the continuation of Western imperialism, the perpetuation of a divide between “core and periphery” in place of “North/South divide” and capital replacing military power. To the Neo-liberal belief in a closer integration of markets, a borderless economy that spreads affluence through a trickledown effect and the fading away of the distinction between North and South, the Radicals oppose the impossibility to carry on with a growing divide between rich and poor, growing social exclusion and alienation, and the abandon of developing economies; global dependence is opposed to global interdependence. Likewise, the Neo-liberals hold that economic changes leads to a progressive democratisation of political life, a new division of labour and a positive homogenisation of cultures along the “American Way of Life” welcomed by social theorist like Francis Fukuyama, who equates the Americanisation of the world with the expansion of democracy (Steger, 2009, p. 75).</p>
<p style="text-align: left;">However, the Radicals have a point when objecting that this cosmopolitan outlook, driven by a technological revolution marked by the development of communication means that reduce distances between places and people (from air travel to the Internet), remains out of reach for most of the developing world. Far from unifying the world, the subordination of social relations to economic relations identified by Karl Polanyi as a key element of the Great Transformation (quoted in Harriss, 2000, p. 327), has led to social exclusion and the development of nationalism and politics of identity often triggering ethnic conflicts. As Manuel Castells puts it “Along with the technological revolution. The transformation of capitalism, and the demise of statism, we have experienced in the last quarter of the century the widespread surge of powerful expressions of collective identity that challenges globalization and cosmopolitanism on behalf of cultural singularity and people’s control over their lives and environment” (quoted in Allen &amp; Eade, 2000, p. 503).</p>
<p style="text-align: left;">The role and power of the state in a globalised world are perceived differently. Whereas Neo-liberals foresee the demise of the state and the emergence of market-lead global policies, the Radicals foresee the demise of the welfare state and its safety nets under the attack of all-powerful Trans-National Corporations (TNC). From livelihoods to conflict, it is ultimately the environment that suffers of benefits from globalisation. Here too views diverge between Neo-liberals and Radicals. Whilst the former see the environment as a commodity that can be valued and managed along classical economic principles, the latter denounce the environmental damages caused by the over exploitation and mismanagement of natural resources, the pollution and the social and cultural disruption caused by industrialisation and the market economy (Woodhouse, 2000, p. 159).</p>
<p style="text-align: left;">Whilst Neo-liberals and Radicals have clearly opposite views on the possibility to achieve a sustainable globalisation, a third “Transformationalist” analysis rejects both accounts and offers a different narrative and outcome for globalisation (McGrew, 2000, pp. 348-352). The Transformationalists see globalisation as a historically unique event (McGrew, 2000, p. 351). They recognise the problem identified by both Neo-liberals and Radicals but portray globalisation as a complex and dynamic phenomenon leading to a different role for the state and to the birth of a transnational civic consciousness.</p>
<p style="text-align: left;">The growth in interconnection is leading developing countries to compete with Western economies, to a redistribution of power and a shift in the configuration of global relations at all levels. Power inequality and access to resources still exist but they no longer mirror the North/South divide. National development is now connected to the world order and domestic and international matters can no longer be dealt with in isolation. In short, it is the end of the old Westphalian order (Bayliss, 2008, p. 23) and the birth of integrated economic and social policies. Hence, international cooperation is becoming necessary to achieve a sustainable management of the environment. Cooperation and global governance are the keywords that will make sustainable globalisation a realisable goal.</p>
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<p style="text-align: left;"><a href="http://www.peripheries.org/wp-content/uploads/2009/08/1406943631_a267559140_m.jpg"><img style="margin-left: 5px; margin-right: 5px;" title="Northern Rock" src="http://www.peripheries.org/wp-content/uploads/2009/08/1406943631_a267559140_m.jpg" alt="Northern Rock" width="220" height="165" /></a></p>
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<td><span style="font-size: x-small;"><em>The crash of the Northern Rock bank in September 2007 kicked off the Credit Crunch Era and the demise of a corrupted virtuous circle. Photo (C) peripheries.</em></span></td>
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<p style="text-align: left;">These three views of globalisation, its benefits and shortcomings have led to four responses (McGrew, 2000, p. 360; Bayliss, 2008, pp. 6-7). The first is to promote further the market economy with the belief that modernisation and industrialisation is leading to economic growth, democratisation and a better life, the so-called “virtuous cycle” of liberal democratic democratisation and “good governance” (Potter, 2000, pp. 374-381).</p>
<p style="text-align: left;">The second is to regulate the globalisation process to provide developing states with fairer trade conditions. Incidentally, developing states have shown that they can “use the system” to ensure fairer representation and fairer rights (See for example the <a title="openDemocracy" href="http://www.opendemocracy.net/globalization-hiv/thailand_health_3744.jsp" target="_blank">use of the TRIPS agreement by Thailand</a>).</p>
<p style="text-align: left;">The third is to built on the 1960’s ideas of “Tiersmondism” with the aim of developing sustainable regional models of globalisation that will enhance the power of local organisations within the global economy (McGrew, 2000, p. 361) as did <a title="BBC" href="http://news.bbc.co.uk/1/hi/technology/5053330.stm" target="_blank">Malaysia with its multimedia super corridor</a>. The last is to resist globalisation. Ironically building on the development of a trans-national civil society made possible by technological developments, and the idea of Justice Globalism (Steger, 2009), social movements are promoting a range of alternative models of development based on a “globalisation from below” (McGrew, 2000, p. 362). More radical organisations such as Al-Qaida have opted for a more drastic approach based on the use of global terror.</p>
<p style="text-align: left;">“The process of globalisation has been a long one and there is no reason to suppose that it is over yet” writes Michael Nicholson (2002). Its sustainability, in the broad sense of being conducive to social justice, human security and environmental protection, hinges on how we perceive and respond to it. What globalisation has achieved so far is an area where not only collecting accurate data is difficult but where facts and figures can be interpreted one way or another to support one side of the argument. If the income ratio between the richest and the poorest countries has arisen from 44 to 1 in 1973 to 74 to 1 twenty-five years later (Steger, 2009), at the same time, millions have been taken out of poverty (Zakaria, 2009).</p>
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<td><a href="http://www.chinadialogue.net/article/show/single/en/295-French-fries-and-fat-kids-Asia-s-next-epidemic"><img style="margin-left: 5px; margin-right: 5px;" title="obesity in china" src="http://www.peripheries.org/wp-content/uploads/2009/08/obesity-in-china.jpg" alt="obesity in china" width="220" height="165" /></a></td>
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<td><span style="font-size: x-small;"><em><a title="China Dialogue" href="http://www.chinadialogue.net/article/show/single/en/295-French-fries-and-fat-kids-Asia-s-next-epidemic" target="_blank">Obesity in Asia</a>, a disease of the developped world is turning into an epidemic worldwide.</em></span></td>
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<p style="text-align: left;">China, a recipient of food aid until 2005, is now <a title="WFP" href="http://www.wfp.org/node/534" target="_blank">a major donor</a>. The number of international wars has decreased and thought their nature has changed (Bayliss, 2008, pp. 212-224) since 1992 the number of refugees has declined whilst the number of internally displaced people has stabilised (IDMC, 2009, p. 15). The environment and in particular the effect of globalisation on climate change remains a major issue. However, world governments and in particular the US, the world’s largest polluter, have realised that this was <a title="BBC" href="http://news.bbc.co.uk/1/hi/sci/tech/8142935.stm" target="_blank">a global problem in need of a global solution</a>. China, which continuous growth is driving an increase in the number of cars has demonstrated its commitment to greener option as showed by Al Gore in “An Inconvenient Truth” (Guggenheim, 2006).</p>
<p style="text-align: left;">This is where it is useful to recall Polanyi’s observation of society’s reaction against the ravage of the satanic mill: “Society protected itself against the perils inherent in a self regulating market system” (quoted in Harriss, 2000 p. 328), and to trust that mankind would again react to protect itself. Assessing globalisation is a battlefield where Hirschman’s defence of industrialisation and Kitching’s “conventional wisdom” (Chataway &amp; Allen, 2000) collide with Korten’s “global threefold human crisis of deepening poverty, social disintegration and environmental destruction” (Korten, 2001, p. 28). A third way, close to the Transformationalist approach explains globalisation’s failures as the result of tensions between global problems and national politics that cannot produce global solutions. “We have globalized the economies of nations. Trade, travel and tourism are bringing people together. Technology has created worldwide supply chains, companies and customers. But our politics remains resolutely national” (Zakaria, 2009).</p>
<p style="text-align: left;">All along, it is important to remember that globalisation is not only about structures but is also about agencies. TNC certainly operate behind globalisation, but at the forefront there are men and women with needs and aspirations, strengths and weaknesses, morals and ethics. Too often human agency as a driving force behind globalisation is taken out of the global equation. Nobody is immune to globalisation and its effects and it is important to remember that “Globalisation is the product of our collective action, and it is in our collective interest to generate the will and capacity to fashion it into a creative force. [...] The impact of the ideas and actions of individuals and countries can and do have unimaginable consequences for the rest of the world. [...] It is therefore vital that we strive to live equitably. [...] Humanity must evolve a new set of ethics, a new approach to sharing rather than profiting” as Lyonpo Jigme Thinley,<a title="openDemocracy" href="http://www.opendemocracy.net/globalization-vision_reflections/article_280.jsp" target="_blank"> former Bhutan’s foreign minister</a> wrote.</p>
<p style="text-align: left;">It is our personal ethics that will decide if a sustainable globalisation is a realisable goal.</p>
<p style="text-align: left;"><strong><em>Bibliography</em></strong></p>
<ul>
<li><span style="font-size: x-small;">Allen, T., &amp; Eade, J. (2000). The new politics of identity. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">Bayliss, J., Smith, S., &amp; Owens, P. (2008). The globalization of world politics (4th ed.). Oxford University Press, Oxford.</span></li>
<li><span style="font-size: x-small;">Chataway, J., &amp; Allen, T. (2000). Industrialization and development: prospects and dilemnas. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">Guggenheim, D. (Director). (2006). An Inconvenient Truth [Motion Picture].</span></li>
<li><span style="font-size: x-small;">Harriss, J. (2000). The second &#8220;great transformation&#8221;? Capitalism at the end of the twentieth century. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">IDMC. (2009). Internal Displacement, Global Overview of Trends and Developments in 2008. Norwegian Refugee Council, Internal Displacement Monitoring Centre.</span></li>
<li><span style="font-size: x-small;">Korten, D. C. (2001). When Corporations Rule the World (2nd Revised edition). Kumarian Press, Sterling.</span></li>
<li><span style="font-size: x-small;">McGrew, A. (2000). Sustainable globalization? The global politics of development and exclusion in the new world order. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">Nicholson, M. (2002). International Relations, A Concise Introduction (2nd Edition ed.). Palgrave Macmillan, New York</span></li>
<li><span style="font-size: x-small;">Potter, D. (2000). Democratization, &#8220;good governance&#8221; and development. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">Steger, M. B. (2009). Globalisation, A Very Short Introduction. Oxford University Press, Oxford.</span></li>
<li><span style="font-size: x-small;">Thomas, A. (2000). Meanings and views of development. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">Woodhouse, P. (2000). Environmental degradation and sustainability. In T. Allen, &amp; A. Thomas (Eds.), Poverty and development into the 21st century. Oxford University Press, Oxford, in association with the Open University, Milton Keynes.</span></li>
<li><span style="font-size: x-small;">Zakaria, F. (2009, June 22). The Capitalist Manifesto. Newsweek , p. 36.</span></li>
</ul>
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		<title>Challenges facing the UK Research Base</title>
		<link>http://www.rogertatoud.com/2007/09/13/32/</link>
		<comments>http://www.rogertatoud.com/2007/09/13/32/#comments</comments>
		<pubDate>Wed, 12 Sep 2007 23:00:01 +0000</pubDate>
		<dc:creator>Roger</dc:creator>
				<category><![CDATA[Selected writings]]></category>
		<category><![CDATA[Education]]></category>
		<category><![CDATA[Science]]></category>

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		<description><![CDATA[The academic year 2007 started with a “Time Bomb” uncovered by the Higher Education Policy Institute (HEPI): student in England are having it the easy way with an average of 26 hours a week spent studying compared to 30 in Ireland, 35 in France and 41 in Portugal. Variations are wide depending on the subject [...]]]></description>
			<content:encoded><![CDATA[<p>The academic year 2007 started with a “Time Bomb” uncovered by the Higher Education Policy Institute (<a title="HEPI" href="http://www.hepi.ac.uk" target="_blank">HEPI</a>): student in England are having it the easy way with an average of 26 hours a week spent studying compared to 30 in Ireland, 35 in France and 41 in Portugal. Variations are wide depending on the subject but with less than 15 hours of tuition a week, fears and concerns are raised that Higher Education is going down the drain and will have serious academic consequences for the future of Science in the UK.</p>
<p>Some object that quantity does not equate quality; however, content is not the only challenge the UK science base is facing. Science faces a continuum of challenges from school to university, from university to the public world. It is a challenge to teach and train people in science but also to publicise and exploit, commercially or not, the results of scientific research. In this article, I will introduce 5 major challenges that should inform education and science policies.</p>
<p>The first challenge: changing the image of science in the public and the scientific community.</p>
<p>Science does not have a good public image, particularly in the media. When it is not “mad” scientists developing Frankenfood or carelessly releasing food and mouth virus into the English countryside, we are inflicted with TV-boffins trivialising science.</p>
<p>It results that the public lack confidence in science (MMR) or engineering (nanotechnologies), does not understand what science is about or what scientists do and can’t judge if science is good or bad. Often in this situation, bad prevails. We know the problem stems from <a title="Royal Society" href="http://www.royalsoc.ac.uk/page.asp?id=3180" target="_blank">scientists being bad communicators</a> but also that the public has received little science education. It is right to complain of the lack of science teachers or of the declining number of students taking science A-level, but let it be clear, for many young people a career in science does not sound a good career move. Studies are long, difficult, career prospects are uncertain and wages are not very good.</p>
<p>But science image-problem goes beyond the public and is manifest within the scientific community, where it originates as revealed by a report from the Council for Science and Technology <a title="CST" href="http://www2.cst.gov.uk/cst/reports/files/science-government/cst_pathways.pdf" target="_blank">in a recent report</a>. Forsaken PhD students, badly managed Post-docs and scientists fed up that science is not at the heart of what they are doing, contribute to the feeling that the pain is not worth the game.</p>
<p>The situation could be improved by tackling the second major challenged faced by science, that of improving science administration and management.</p>
<p>Scientists are professional people trained in science, but they are often unaware of basic administration and management skills that they will need in their career. This is a problem because grants need to be administered, projects need to be managed, and crucially people need to be managed and mentored. Too often Ph.D. students are left on their own, post doctoral fellows do not get the professional support they need, and researchers spend more time doing paperwork and politics than research. The result is a waste of time and resources.</p>
<p>Resources and in particular funding could be a challenge in itself, but because it is a pervasive issue, I’ll only underline the commercialisation of science and the funding priorities. It is nowadays common for senior scientists to be involved in a biotech company. Public/Private partnerships are becoming a necessity because research is costly and also because there is a political will to develop these collaborations. Such ventures influence the direction scientific research is taking as well as how it is administered and managed. It is important to ensure that the private sector does not dictate what science should be about as it is also important for research councils not to constrain research to what they are willing to fund.</p>
<p>If administration and management are new essential skills needed by scientists, they also need more scientific skills. Science has benefited for fast engineering development leading to the next challenge which, to borrow from Thomas Homer Dixon who wrote extensively about it, is the Ingenuity Gap challenge.</p>
<p>Dixon describes a world where complexity increases very quickly but where our ability to manage and comprehend it does not follow as quickly, hence an “ingenuity gap”. During the last 30 years, science had made tremendous technical progresses allowing us to do research at a very different scale. There are two major problems with the speed and breadth of these developments.</p>
<p>First the data collected can be so vast or so new (such as generated by genomic or metabonomic study) that scientists don’t always know how to handle them. Often people do not have the skills needed, in particular statistical skills, to analyse the data and new mathematical model need to be developed before sense can be make out of numbers. More often, the problem is that of 21st century science analysed with a 20th century mindset and of the nature and immensity of data confronting our inability to fathom it.</p>
<p>Second, these methodologies and equipment require specialist technicians to handle them, but technicians are not common in science; university does not produce them. Post doctoral fellow can be reluctant to accept a position where they will have limited input in the scientific work and little prospect for first author publication that they would need to progress in their career.</p>
<p>But the problem of analytical skills goes far beyond analysing complex data. There is a general problem of numeracy and literacy amongst the population that also affect science students and that seriously challenge their future ability to do research.</p>
<p>Unfortunately, this increased complexity is not happening in isolation but in a wider context leading to the next challenge, that of the globalisation of science.</p>
<p>5% of the world research is done in the UK. Students come from all over the world to study here, the UK counts four universities in the top 25 world universities.</p>
<p>But this should not hide the fact that less than 30% of the post graduates comes from the UK, that China is producing 2 millions graduates a year, that South Korea’s R&amp;D public budget will match that of the UK this year and that the situation worldwide is changing. The report from the HEPI indicates that some foreign students are not satisfied with the value they get for their money and that they now prefer to go to the US where there are more facilities and more scholarships.</p>
<p>Foreign students do not only contribute financially to UK science by paying heavy university fees, but they also sustain UK science. The truth is not that the UK cannot deliver good science but that other countries are able to do so and not only the US.</p>
<p>The challenge of globalisation also impacts on the scientist ability to conduct their work. The recent outburst from Lord Winston who was denied the possibility to carry on with a research work on humanised pig and decided to move this research to the US is an example of how red tape and policy can be an obstacle to research in the UK. Withholding judgement, this highlights a need to review processes and policies.</p>
<p>Falling standard, inadequate training, worldwide competition, and a bad press, is UK public science doomed? That would be painting too much a dark picture of a still thriving sector. The last challenge may give a new direction and provide innovative and relevant answers.</p>
<h3>Mainstreaming science and empowering scientists</h3>
<p>Although students and scientists organisations and Trade Unions have made <a href="http://www.officeronline.co.uk/about/274470.aspx" target="_blank">impressive achievements</a>, the policy-making process seems often in the hand of distant policy makers and the scientific establishment. It is fundamental to engage more students and scientists into the governance and political process and to value their day-to-day experience of science when drawing new policies. It is also important for these organisations to be representative of their base. And move the process “closer to the bench”.</p>
<p>Moreover, because so many aspects of our life today are connected to scientific or engineering issues, from health to personal freedom, mainstreaming science is a necessity. Science can not anymore be considered the exclusive domain of the white-coat-clad scientist who knows better. The challenge is to bring scientists and their science out into the public domain and into the political process and to make scientists the agents of science policy.</p>
<p>There is a long journey ahead to make science more relevant for public policies, less nebulous in the public eye and more considerate for science students and academics. But scientists are overall passionate people and it is possible to channel some of this passion into the social and political process.</p>
<p><em>© Roger TATOUD.</em></p>
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		<title>Gendering the Fight against Aids</title>
		<link>http://www.rogertatoud.com/2006/08/21/gendering-the-fight-against-aids/</link>
		<comments>http://www.rogertatoud.com/2006/08/21/gendering-the-fight-against-aids/#comments</comments>
		<pubDate>Mon, 21 Aug 2006 11:00:12 +0000</pubDate>
		<dc:creator>Roger</dc:creator>
				<category><![CDATA[Selected writings]]></category>
		<category><![CDATA[Asia]]></category>
		<category><![CDATA[HIV]]></category>
		<category><![CDATA[Public Health]]></category>
		<category><![CDATA[Society]]></category>

		<guid isPermaLink="false">http://www.rogertatoud.com/?p=48</guid>
		<description><![CDATA[Two strong messages have emerged from the 16th International Aids Conference in Toronto, Canada. The first is that with drug treatment now being rolled out in developing countries, prevention should return to centre stage in future policies and strategies. The second is that women&#8217;s lives and status need to be improved and that women need [...]]]></description>
			<content:encoded><![CDATA[<p>Two strong messages have emerged from the <a href="http://www.aids2006.org/" target="_blank">16th International Aids Conference</a> in Toronto, Canada. The first is that with drug treatment now being rolled out in developing countries, prevention should return to <a href="http://www.bloomberg.com/apps/news?pid=20601082&amp;sid=aq14H6fHw_QI&amp;refer=canada" target="_blank">centre stage</a> in future policies and strategies. The second is that women&#8217;s lives and status need to be improved and that women need to be given power to prevent HIV infection.</p>
<p>Both messages were embodied in Bill Gates&#8217;s <a href="http://www.gatesfoundation.org/MediaCenter/Speeches/BillgSpeeches/BGSpeech2006AIDS-060813.htm" target="_blank">keynote speech</a>:</p>
<p>&#8220;We need to put the power to prevent HIV in the hands of women. This is true whether the woman is a faithful married mother of small children or a sex worker trying to scrape out a living in a slum. No matter where she lives or what she does, a woman should never need her partner&#8217;s permission to save her own life.&#8221;</p>
<p>An <a href="http://www.eldis.org/gender/dossiers/index.htm" target="_blank">Eldis report</a> notes that &#8220;a decade ago women seemed to be on the periphery of the epidemic, today they are at the epicentre&#8221;. Of the 38.6 million people living with HIV at the end of 2005, nearly half of them, 17.3 million, were women (Unaids, <a href="http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp" target="_blank">2006 Report on the Global Aids Epidemic</a>). And of the 16,000 new infections that occur every day, up to sixty percent are now amongst women (<a href="http://www.ilo.org/" target="_blank">ILO</a>).</p>
<p>Empowering women was a central policy goal of both the International Conference on Population and Development (ICPD) in Cairo in 1994 and the Fourth World Conference on Women (FWCW) in Beijing in 1995. Women&#8217;s empowerment was emphasised in agreements at the World Summit for Children in 1990, the World Conference on Human Rights in 1993, the World Summit for Social Development in 1995, the World Food Summit in 1996, Habitat II in 1996, and the fifth-year review of ICPD implementation (ICPD+5) in 1999.</p>
<p>That, ten years later, women&#8217;s empowerment is back on the agenda in the fight against HIV/Aids suggests that it has somehow failed to fulfil its objectives. One explanation for the relative achievements of empowerment strategies might be the failure to recognise that empowering women without disempowering men is like giving a moneybox to the poor in the hope that they will get rich.</p>
<div>
<h3>The invisible gender?</h3>
<p>Let&#8217;s not underestimate the importance and success of policies to empower women from the last ten years. In a recent report, <a href="http://www.actionaid.org/index.asp?page_id=1242" target="_blank">ActionAid</a> emphasised how empowering young women through education has contributed to lowering the risk of HIV infection and increased safer sex practice in Africa.</p>
<p>Nowadays, prevention strategies target adolescent girls, to give them access to education and provide them with life skills. But as Mohammad Khairul Alam of the Rainbow Nari O Shishu Kallyan Foundation in Bangladesh <a href="http://www.gnpplus.net/bb2/viewtopic.php?t=499&amp;start=0&amp;postdays=0&amp;postorder=asc&amp;highlight=&amp;sid=0d2e897e57f78e05088885560e63c28c" target="_blank">observes</a>, &#8220;health education programmes which aim to empower women and girls to use condoms often fail adequately to tackle the actual problems because of imbalanced power relations. The desired changes in the behaviour of adolescent girls and boys cannot happen without programmes addressing such issues like how a girl can say no, but also why boys, teachers and other adults should respect the human rights of girls.&#8221;</p>
<p>Somehow, empowering women requires &#8220;disempowering&#8221; men. How to do this for the best is open to debate, in light of past experiences and <a href="http://www.unfpa.org/news/news.cfm?ID=835&amp;Language=1" target="_blank">ongoing efforts</a> discussed at the conference.</p>
<p>There are many initiatives and training manuals for empowering women, in particular around <a href="http://www.unfpa.org/intercenter/cycle/index.htm" target="_blank">reproductive rights</a>, from <a href="http://www.developmentgateway.org/pop/rc/ItemDetail.do%7E1069945?itemId=1069945&amp;itemId=1069945" target="_blank">UNFPA</a>, Unesco, Unifem, FAO, PHDRE &#8230; But few, if any, actually involve <a href="http://www.eldis.org/gender/dossiers/canmenchange.htm" target="_blank">men</a> in their approach. This overlooks the reality that in a relationship with a power imbalance, marital or not, it is the man who dictates when to have sex and how.</p>
<p>More appropriate are strategies and policies that bring men and women together, giving both sexes knowledge about HIV/Aids, life skills, leadership skills (since power does not equate to leadership), and showing men that they can confidently share power with women, while showing women that they can assume this power boldly.</p>
<p>In this regard, <a href="http://www.bridge.ids.ac.uk/" target="_blank">gender mainstreaming</a>, an approach that puts gender issues at the centre of organisational processes and programmes, might prove successful. Gender mainstreaming undertakes to include gender-related issues during strategy planning and policymaking. Women are not seen or treated as a special group but as one of the various groups concerned with an issue. Strategies are designed for the benefit of all and involve women in the formation process.</p>
<p>There are some advantages to this approach. One is that it does not portray women as powerless, as &#8220;women&#8217;s empowerment&#8221; can do. Another is that it avoids opposing one group to another (women to men) and thus reduces the dangers of confrontational dialogue and <a href="http://ccrweb.ccr.uct.ac.za/?id=320" target="_blank">gender-discriminated workshops</a> and training.</p>
<p>Mainstreaming is a relatively new concept, <a href="http://www.scotland.gov.uk/mainstreaming/?pageid=403" target="_blank">not restricted</a> to gender-related issues. For instance, the benefits of HIV/Aids mainstreaming were recently <a href="http://www.eldis.org/cf/search/disp/DocDisplay.cfm?Doc=DOC22516&amp;Resource=f1hiv" target="_blank">evaluated</a> in a report by Unaids, UNDP and the World Bank. Overall, it has had mixed results. In Thailand, the benefits of mainstreaming HIV/Aids in the National Development Plan were evident in terms of improved participation, commitment, coordination, and planning between various ministries and civil society, locally and nationally. The experience and skills acquired through mainstreaming produced faster, more effective responses to the challenges in hand. Where mainstreaming has failed, the report faults not the approach itself, but a lack of understanding, commitment, prioritisation, funding and skills among participants.</p>
<p>Gender mainstreaming is a globally accepted strategy for promoting gender equality in several areas, and <a href="http://www.satregional.org/attachments/Publications/Training%20and%20Practise%20Manuals%20E/TrainingManual2_black.white.pdf" target="_blank">training manuals</a> and <a href="http://www.policyproject.com/pubs/countryreports/Kenya_NACC_Gender.pdf" target="_blank">strategic plans</a> have already been developed to mainstream gender in HIV/Aids initiatives.</p>
<p>To &#8220;think&#8221; about women and their role in society is already to empower them. It is the first step that leads to power-sharing between men and women, and as such should be at the heart of the responsible and hopefully successful strategies much needed in the fight against HIV and Aids. Undoubtedly gender mainstreaming requires political will and commitment, often in the hands of men. But lest we forget, in France married women were given the right to dispose of their own wage ninety-nine years ago, on 13 July 1907, with the support of men like Tommy Fallot and Léon Richer who saw in women&#8217;s control of their personal income a protective measure against debauchery and prostitution. Their paternalist logic may be at odds with today&#8217;s empowerment, but it nevertheless raises hope for modern strategies involving men and women working together to fight HIV/Aids.</p>
<p><em>© Roger Tatoud.</em></p>
<p><em>Published online by <a title="openDemocracy" href="http://www.opendemocracy.net/globalization-hiv/gendering_3838.jsp" target="_blank">openDemocracy</a><br />
</em></div>
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		<title>French Fries and Fat Kids &#8211; Asia’s next Epidemic</title>
		<link>http://www.rogertatoud.com/2006/08/18/french-fries-and-fat-kids-asia%e2%80%99s-next-epidemic/</link>
		<comments>http://www.rogertatoud.com/2006/08/18/french-fries-and-fat-kids-asia%e2%80%99s-next-epidemic/#comments</comments>
		<pubDate>Fri, 18 Aug 2006 11:00:53 +0000</pubDate>
		<dc:creator>Roger</dc:creator>
				<category><![CDATA[Selected writings]]></category>
		<category><![CDATA[Asia]]></category>
		<category><![CDATA[Public Health]]></category>
		<category><![CDATA[Society]]></category>

		<guid isPermaLink="false">http://www.rogertatoud.com/?p=57</guid>
		<description><![CDATA[Popular belief has it that obesity only affects wealthier societies where food is plentiful: the curse of the developed world epitomized by hulking Americans that struggle to order their king-size Big Mac, French Fries and Coke without breaking sweat.
Obesity is no longer exclusive to the developed world
The reality is a very different. Obesity and its [...]]]></description>
			<content:encoded><![CDATA[<p>Popular belief has it that obesity only affects wealthier societies where food is plentiful: the curse of the developed world epitomized by hulking Americans that struggle to order their king-size Big Mac, French Fries and Coke without breaking sweat.</p>
<h3>Obesity is no longer exclusive to the developed world</h3>
<p>The reality is a very different. Obesity and its associated diseases &#8211; diabetes, hypertension and kidney diseases – respect neither wealth nor class and strike instead into the heart of every society where there is easy access to convenience food, low physical activity and ubiquitous advertisements for sugar-fat-salt-rich food.</p>
<p>Heart disease, stroke, cancer and other chronic diseases associated with poor diet and low exercise have now made serious inroads into the lives of people in poor and middle-income nations. In total, these accounted for 80% (28 million) of the cases of chronic illness in 2005, according to the World Health Organisation (WHO), which fears that a further 388 million people will die from such illnesses over the next ten years.</p>
<p align="center"><img src="http://www.chinadialogue.net/UserFiles/Image/obesityarticletwo.jpg" alt="" width="380" height="315" /></p>
<p align="center">Photo by <a href="http://www.flickr.com/photos/malias/89804420/" target="_blank">Malias</a></p>
<p>Across South East Asia, cases of chronic disease are also high, accounting for 54% of all deaths during 2005. The situation in Thailand is particularly serious, says the WHO, which estimates that the number of obese 5-to-12 year olds increased from 12.2% to 15.6% in just two years. Obesity is generally associated with older age groups, but has yet to permeate into poorer areas where the price of convenience food associated with the epidemic is prohibitive.</p>
<p>China, too, has an emerging epidemic with one or two pockets of high incidence. Overall, obesity levels range from under 5% to almost 20% in some areas, according to regional surveys conducted during 2003. Most concerning, however, is high prevalence among the young. In Wuhan Province 8.9% of 10-12 year-olds were classified as obese by the study. Some areas, such as Beijing, also suggest that there is a gender perspective to the epidemic. In the capital more than 10% of 10-12 year old boys were obese – more than three times the rate for girls in the same study.</p>
<h3>Responsibilities are divided</h3>
<p>The existence of a genetic predisposition to obesity would provide a straight-forward explanation for the world’s growing stock of rotund individuals, but the precise causes of obesity are multiple.</p>
<p>Changing diets have clearly contributed to the development of the pandemic, driven by the move towards food processing that relies heavily on high injections of sugar and salt. Recent research by <a title="Thai Health Promotion Foundation" href="http://www.thaihealth.or.th/" target="_blank">The Thai Health Promotion Foundation</a>, for example, found that more than 90% of its sample of 700 pre-packed foods to contain excessive levels of sugar, fat and salt – a cocktail that can lead to diabetes and hypertension as well as obesity.</p>
<p>Choice, of course, enables informed individuals to avoid (or moderate their consumption of) foods that are known to have damaging health effects, but bad labeling, the study suggests, does not help in the decision-making process. Just one third of the sample in Thailand, for example, managed to provide adequate nutritional information on their packaging or list ingredients. Where available, say researchers, labels also tended to use small fonts and present information in a way that is difficult to understand. At least part of the blame, therefore, lies with the food industry itself.</p>
<p align="center"><img src="http://www.chinadialogue.net/UserFiles/Image/obesityarticle.jpg" alt="" width="280" height="292" /></p>
<p align="center">Photo by <a href="http://www.flickr.com/photos/malingering/164197141/" target="_blank">Malingering</a></p>
<h3>Children are most at risk</h3>
<p>For now, young Thais have refrained from overindulgence in burgers and chips on account of taste. But tastes are changing and so is the food industry. Pizza Hut (aka <a title="The Pizza Company Website" href="http://www.pizza.co.th/1112/" target="_blank">Pizza Company</a> in Thailand) has already rewritten its menu to include a Tum Yum Kung (spicy prawn soup) variety. Western convenience food, which contains 3 or 4 times more fat, sugar and salt than healthier local Thai snacks, is now thought to pose one of the greatest dangers to a country of “snackers.”</p>
<p>Catering to oriental taste in order to boost market share is only one dimension of the corporate weaponry. Intensive marketing activity now mostly targets children and changing cultural values now mean that a visit to see Ronald McDonald has become a symbol of growing affluence and status. The price of a Big Mac in Bangkok (the equivalent of USD 1.5 or Baht 60) may cover the food costs of one meal for a family of four, but younger Thais are prepared to splash out on junk-food if it means impressing friends – especially girlfriends. Similar trends are noted throughout many of China’s larger central and eastern metropolises. Shopping malls in Cambodia also house fashionable western eateries that only the privileged can afford.</p>
<p>Obesity ought not to be a problem affecting children, but cases as young as 3 are not exceptional. And for those that then become obese adults the risks (particularly in developing countries) have alarming potential – an increasing susceptibility to illness coupled with reliance on fragile health care systems that may not be able to offer or afford treatment. In China, there is only a very basic social safety net and hospitals are run like profit-making concerns: Only those that can afford treatment receive treatment</p>
<p>Child obesity is expected <a title="Article on obesity worldwide" href="http://www.msnbc.msn.com/id/11694799/" target="_blank">to soar worldwide</a> according to the <a title="IJPO" href="http://journalsonline.tandf.co.uk/link.asp?id=119754" target="_blank">International journal of Pediatric obesity</a>, and could start to erode health gains in many countries. Both morbidity and cases of premature death are expected to rise over the next decade costing the economies of China, India and Russian billion of dollars according to the <a href="http://www.who.int/chp/chronic_disease_report/en/">WHO</a>. China alone will lose $558 billion over the next 10 years of its national income due to heart disease, stroke and diabetes. And other important Asian economies &#8211; Thailand, Malaysia, Indonesia and others – are fast reaching western levels of development and consumption.</p>
<p align="center"><img src="http://www.chinadialogue.net/UserFiles/Image/obesityseven.jpg" alt="" /></p>
<p align="center">Photo by <a href="http://www.flickr.com/photos/robadob/88894048/" target="_blank">Robad0b</a></p>
<div>
<h3>An incomplete response</h3>
</div>
<p>Political will and increased public awareness will decide whether obesity is here to stay or go, according to Prof. Philip James, the chair of the London-based International Obesity Task Force (IOTF).</p>
<p>“It is noticeable,” he says, “that the public and Ministers readily accept the problem of obesity in adults…..then often and very conveniently blame the individual for their predicament rather than questioning whether their obesity reflects the impact of deliberate policy and industrial developments over the last few decades.”</p>
<p>While the political elite ponder their next move a coalition of five international non-governmental organisations (NGOs) – known as the <a title="Global Prevention Alliance Website" href="http://www.preventionalliance.net/index.htm" target="_blank">Global Prevention Alliance</a> – has already pledged new action worldwide to combat obesity-driven chronic diseases. Obesity, the alliance says, ranks alongside HIV/AIDS in terms of importance and impact.</p>
<p>“Cutting death rates alone will not be enough,” according to Prof. James, adding that “No health system or economy can afford the cost of spiraling cases of chronic disease. The only way to address this is to recognize the need to revolutionise our approach to delivering healthier diets and reducing consumption of the foods high in fats, sugar and salt.”</p>
<p>Obesity is a new challenge for countries like China, which suffered a major famine in 1961, suffered routine food shortages until the mid-70s and received food aid from the <a href="http://www.wfp.org/policies/Annual_Reports/index.asp?section=6&amp;sub_section=3">World Food Programme</a> until 2005. But a solution is not out of reach. As many as 80% of the cases of premature heart disease, stroke and type-2 diabetes could be prevented by a healthy diet according to the <a title="Chronic Disease  Report SEARO" href="http://www.who.int/chp/chronic_disease_report/media/searo.pdf" target="_blank">WHO</a>. Missing only is the political will to legislate, educate and take on the powerful Food Industry.</p>
<p><em>© Roger Tatoud.</em></p>
<p><em>Published online by <a title="Chinadialogue" href="http://www.chinadialogue.net/article/show/single/en/295-French-fries-and-fat-kids-Asia-s-next-epidemic" target="_blank">Chinadialogue</a><br />
</em></p>
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		<title>Wealth versus Health &#8211; the Thai Frontier</title>
		<link>http://www.rogertatoud.com/2006/07/17/wealth-versus-health-the-thai-frontier/</link>
		<comments>http://www.rogertatoud.com/2006/07/17/wealth-versus-health-the-thai-frontier/#comments</comments>
		<pubDate>Mon, 17 Jul 2006 11:00:00 +0000</pubDate>
		<dc:creator>Roger</dc:creator>
				<category><![CDATA[Selected writings]]></category>
		<category><![CDATA[Business]]></category>
		<category><![CDATA[HIV]]></category>
		<category><![CDATA[Public Health]]></category>

		<guid isPermaLink="false">http://www.rogertatoud.com/?p=51</guid>
		<description><![CDATA[In the battle against HIV and AIDS, Thailand has been exemplary: since 2001, the AIDS death rate there has fallen by 79 percent, thanks to the supply of low-priced locally produced generic drugs and the 30-Baht universal health care scheme. But this success story is about to be challenged by the United States-Thai Free Trade [...]]]></description>
			<content:encoded><![CDATA[<p>In the battle against HIV and AIDS, Thailand has been exemplary: since 2001, the AIDS death rate there has fallen by 79 percent, thanks to the supply of low-priced locally produced generic drugs and the 30-Baht universal health care scheme. But this success story is about to be challenged by the United States-Thai Free Trade Agreement (FTA) currently under negotiation, which includes restrictive intellectual property rights, and will put at risk the survival of hundreds of thousands of Thai people living with HIV, and beyond Thailand, the survival of millions who will be affected by the Thai precedent.</p>
<p><img class="size-full wp-image-94 alignleft" style="margin-left: 5px; margin-right: 5px;" title="Keep The Promise" src="http://www.rogertatoud.com/wp-content/uploads/2006/07/Keep-The-Promise.jpg" alt="Keep The Promise" width="250" height="274" />The well being and lives of 600,000 Thais living with HIV (of whom 200,000 are women and 12,000 children) depend on readily available and affordable antiretroviral therapies. Currently, only 80,000 people have access to life-prolonging treatments, with a government target of 150,000 by 2008. If signed and implemented, the FTA would cover issues including trade liberalisation, services and investment, and intellectual property provisions, with dire, long-term consequences for the affordability and availability of drugs, especially in the case of HIV antiretroviral therapies.</p>
<p>Thailand and the US have now engaged in six rounds of negotiations. The last round, held in January, ended in limbo because of rising political opposition, unacceptable <a href="http://www.nationmultimedia.com/2006/01/18/headlines/index.php?news=headlines_19682846.html" target="_blank">demands from the US</a> and a Thai <a href="http://www.nationmultimedia.com/2006/01/12/headlines/index.php?news=headlines_19636703.html" target="_blank">delegation not prepared</a> to meet its US counterpart of highly skilled experts and negotiators. Following the dissolution of parliament by Thaksin Shinawatra in February, Thailand&#8217;s caretaker government is set to continue <a href="http://www.manager.co.th/IHT/ViewNews.aspx?NewsID=9490000089167" target="_blank">informal talks</a>, amid questions over its legitimacy to do so.</p>
<div>
<div>
<p>This article is part of the openDemocracy debates &#8220;<a href="http://www.opendemocracy.net/globalization-hiv/issue.jsp">HIV / Aids: what policy for life?</a>&#8221; and &#8220;<a href="http://www.opendemocracy.net/globalization-trade_economy_justice/issue.jsp">Trade, Economics, Justice?</a>&#8220;</div>
<h3>World trade and public health</h3>
<p>The World Trade Organisation&#8217;s patent rules, known as Trade-Related Aspect of Intellectual Property Rights (<a href="http://www.wto.org/english/tratop_e/trips_e/trips_e.htm" target="_blank">Trips</a>), recognise the right of countries to protect public health. They were introduced &#8220;in an attempt to narrow the gaps in the way [intellectual property] rights are protected around the world, and to bring them under common international rules&#8221;. The 2001 <a href="http://www.wto.org/English/thewto_e/minist_e/min01_e/mindecl_e.htm" target="_blank">Doha declaration</a> allowed flexibility in the application of Trips to ensure that medicines are available and affordable, and that generic drugs can be produced and drugs imported at a lower cost than brand versions.</p>
<p>The US Trade Act of 2002 instructs its negotiators to respect the Doha declaration in all trade negotiations. Yet US negotiators consistently ignore their obligations and violate their mandate by negotiating Trips-plus provisions in FTAs. These provisions extend the life span of patents on drugs from twenty to twenty-five years; require known substances to be re-patented for any new use whilst restricting the use of data previously acquired to patent these drugs; limit the use of compulsory patenting by government as a tool to ensure access to low cost medicine; and aim to turn the drug regulatory authorities into patent enforcers for pharmaceutical companies. Extending the life span of patents (through <a href="http://www.egagenerics.com/gen-evergrn.htm" target="_blank">evergreening</a> and &#8220;frivolous patenting&#8221;) will delay the production of generic products, as will measures that require the repetition of clinical trials prior to patenting new applications of old drugs. Restrictions on the licensing of drugs reaching the end of their patent period will lead to delays in their marketing.</p>
<p>The production of generics is essential in the struggle with the pharmaceutical industry to lower the cost of treatment. Brazil, which adopted a hard-line attitude in fighting the HIV epidemic, was successful in bringing the price of first line treatment from US $10,439 to US $152 between 2000 and 2004. However, AIDS is a chronic disease and the challenge will become more prominent with second, third and fourth generation antiretroviral therapies (ART), which are more expensive and protected by recent patents. Since it will be necessary to move from one line of treatment to another with the development of drug resistance, the cost of treatment may rise from a current $470 per patient per year to $7000. Fourth generation ART may bring the cost up to $30,000 per patient per year in the absence of competition, generics or other provisions ensuring drug availability for all within government budget. (Brand-name versions of some first-line AIDS drugs in Thailand are between 5.6 and 25.8 times higher than the prices of generic versions.) Such costs put these medicines out of reach for a country like Thailand.</p>
<p>Medecins Sans Frontieres (MSF) <a href="http://www.accessmed-msf.org/prod/publications.asp?scntid=4820041126222&amp;contenttype=PARA&amp;" target="_blank">warns</a> countries negotiating trade agreements with the United States against provisions that will dramatically reduce their ability to provide low-cost quality medicines for their citizens. Such restrictions will have long-term effects and will not be limited to HIV/AIDS. Oxfam <a href="http://www.oxfam.org.uk/what_we_do/issues/health/bn_fta_hivaids.htm" target="_blank">observes</a> that &#8220;the case of HIV/AIDS in Thailand illustrates how unnecessarily strict intellectual property protection could block access to medicines. But the problem is not limited to this disease. Thai people need other medicines to treat diseases such as pneumonia, gonorrhoea, and cancer. The rising incidences of resistant infections and of chronic disease also require new, effective, and affordable medicines. Many of these medicines are, and will be, under patent and therefore too expensive for those who need them.&#8221;</p>
<h3>Methods and motives</h3>
<p>Beyond the life-threatening limitations introduced by the Trips-plus provisions, the methods and the motivations behind their introduction are questionable too. In December 2005, during Thailand&#8217;s <a href="http://www.undp.or.th/publications/documents/UNDPTRIPS.pdf" target="_blank">National Technical Consultation</a> on FTAs and intellectual property, sponsored by the United Nations Development Programme, Carlos Correa of the University of Buenos Aires observed that the United States&#8217; strategy is to leave the issue of intellectual property to the very last stage of the negotiations, after other compromises have been reached. Only then are the Trips-plus provisions put on the table, when it is too late to re-negotiate the whole package. He also pointed out that some of the Trips-plus provisions go beyond US patent legislation and that the industry is using the FTAs to further tighten US legislation. Nevertheless, similar agreements have been signed between the US and other countries such as Vietnam, Lao PDR and Singapore.</p>
<p>During the negotiation of previous free trade agreements, no attempt was made to hide the close ties between US trade representatives and the pharmaceutical industry. A glance at the <a href="http://www.us-asean.org/us-thai-fta/" target="_blank">composition</a> of the US-Thailand Free Trade Agreement Business Coalition, which is &#8220;strongly committed to promoting the negotiation, passage, and implementation of a meaningful and comprehensive bilateral FTA between the United States and Thailand&#8221;, is worth many words.</p>
<p>The US shows a trend towards increasing the number of Trips-plus provisions in trade agreements. The US-Vietnam FTA signed in 2000 included only a data exclusivity provision, while the 2004 US-Bahrain FTA included in addition to this provision an extended patent period for each new indication (even when registered abroad), an extended patent term, and a &#8220;linkage&#8221; provision which prohibits the Drug Regulatory Authority from registering a generic version of a medicine that is still protected by a patent. Hence, for each new FTA signed, the United States is adding further restrictions that contravene the spirit of the Doha declaration and threaten further people&#8217;s lives. MSF concludes that, &#8220;the pharmaceutical industry in wealthy countries has refused to accept the primacy of health over commercial interests &#8230; Under pressure from industry, wealthy countries, and the United States in particular, have been using bilateral and regional trade agreements to negotiate provisions which go beyond the WTO&#8217;s TRIPS Agreement (&#8220;TRIPS-plus&#8221;), which undermine the Doha Declaration and which restrict, if not eliminate, the flexibilities and safeguards it reaffirmed.&#8221;</p>
<p>In 2005, when asked if the US would agree to a deal that does not include its proposed patent provisions, US spokesperson <a href="http://www.twnside.org.sg/title2/gtrends87.htm" target="_blank">Neena Moorjani</a> replied that &#8220;we have not concluded any previous FTAs that did not include these provisions. US FTAs maintain the same standards no matter which country we are negotiating with&#8221;. Standards built step-by-step on previous free trade agreements, each creating a dangerous precedent for the next.</p>
<h3>Saying no</h3>
<p>After the collapse of the last round of negotiations, American businesses <a href="http://www.bilaterals.org/article.php3?id_article=4480" target="_blank">offered</a> to &#8220;help&#8221; in lobbying the US Congress to allow talks on the Thai-US free-trade agreement to move forward, with overt intimidation that &#8220;the prolonged delay to the negotiations will discourage world-class companies from opting [to invest in] Thailand&#8221;. Thailand still has several options when the next round of negotiation opens. The Thai representatives should not let themselves be bullied by the US negotiators and should push their agenda forward, as did Colombia, Brazil and Malaysia. Most importantly Thai negotiators and the government should make the matter public. One of the major obstacles in addressing this issue has been the negotiating process&#8217;s lack of transparency and therefore the absence of public debate. The participants in the National Technical Consultation made ten recommendations to Thai negotiators, including building on existing studies assessing the impact of Trips-plus provisions and drawing on the technical expertise of relevant international organisations.</p>
<p>In this regard, Malaysia&#8217;s experience is of particular interest: by issuing compulsory licenses for the import of HIV medicine, the Ministry of Health successfully reduced the cost of the monthly treatment from US $261 to US $41. Likewise, <a href="http://us.oneworld.net/article/view/108186" target="_blank">changes</a> in India&#8217;s Patents Act allowed Indian manufacturer Cipla to <a href="http://news.bbc.co.uk/2/hi/south_asia/3220619.stm" target="_blank">supply</a> African developing countries with inexpensive import of generic drugs that cannot be produced locally. But the production of generics is not without challenges: the recent attempt by Gilead Sciences to <a href="http://www.accessmed-msf.org/prod/publications.asp?scntid=1052006112802&amp;contenttype=PARA&amp;" target="_blank">patent</a> the key AIDS drug tenofovir, a previously known compound, shows that the pharmaceutical industry is not giving up.</p>
<p>Remarkably, the role and awareness of these FTAs in US civil society is crucially lacking, judging by the poor coverage of these issues in mainstream printed media in the US. If US citizens were informed of the practice of the FTA negotiators and of the consequences of these agreements, that go far beyond Thailand and have an impact back home, Thai negotiators may have more leverage in the forthcoming negotiations and be better equipped to resist an agreement that will seriously impact people&#8217;s access to medicine, prevent the scaling up of HIV/AIDS programmes, undoubtedly increase disease-related death rates and create a huge burden for the national health budget.</p>
<p>Ultimately, the Thais still have the option to give a polite &#8220;No&#8221; to the US Free Trade Agreement, as Thailand has been TRIPS compliant for a long time and investment will still come to this part of the world where the future of business belongs, FTA or no FTA. This FTA will have a significant impact on all future FTAs and it is worth watching closely the next round of negotiations to ensure that access to life-saving medicine remains a fundamental right for everybody all over the world.</p>
<p><em>© Roger Tatoud.</em></p>
<p><em>Published online by <a title="openDemocracy" href="http://www.opendemocracy.net/globalization-hiv/thailand_health_3744.jsp" target="_blank">openDemocracy</a></em></div>
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