Brics countries must step up on healthcare

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"It would hardly be news to anyone living in the developing world that we’re not faring particularly well in our quest to end epidemics such as Aids, tuberculosis (TB) and malaria by 2030," said Dr Aquina Thulare, Department of Health, at the 10th Brics Academic Forum.

According to the World Health Organisation, TB is the ninth leading cause of death worldwide and Brics countries together account for 46% of all incident cases.

"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?" she said.

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," Thulare said.

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 healthcare for a wide segment of its population.

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," Thulare said.

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.