www.eg4health.org

1. Money & Health Taavi Tillmann, taavi@eg4health.org Arnoupe Jhass, arnoupe@eg4helath.org www.eg4health.org

2. People living in s*** conditions • Eating rubbish Problems (bad things, somewhat under our control) www.eg4health.org

4. People living in s*** conditions • Eating rubbish • Drinking & washing in **** Problems (bad things, somewhat under our control) www.eg4health.org

6. People living in s*** conditions • Eating rubbish • Drinking & washing in **** • People suffering daily physical hardship (poverty) Problems (bad things, somewhat under our control) www.eg4health.org

7. Nr. of people on < 2 $ /day: • 1981: 2542 million • 1990: 2765 million • 1998: 2801 million • ----------------------------- •  + 260 million • more people in poverty Problems (bad things, somewhat under our control) www.eg4health.org

9. People living in s*** conditions • Eating rubbish • Drinking & washing in **** • People suffering daily physical hardship (poverty) • People not getting drugs that could have saved their life • 2 000 000 people died of AIDS in 2007 (WHO) • Western world getting unhappier • Huge increases in alcohol, chronic illness, depression, economic inactivity, divorce, drug use, obesity, smoking... Problems (bad things, somewhat under our control) www.eg4health.org

10. Chronic illness: estimated • 30-40% of Western populations have a chronic illness (Knottnerus 1992). • 20-30% of Western populations have a disabling chronic illness. • Divorce: 46% of all USA marriages had one or both spouses remarry (2008). • Economic inactivity: in Glasgow, 30% of working-age population do not work. Problems 3 - Western world getting unhappier www.eg4health.org

12. Hanlon P., et al. “Let Glasgow Flourish”. Glasgow Centre for Population Health. 2006

13. People living in s*** conditions • Eating rubbish • Drinking & washing in **** • People suffering daily physical hardship (poverty) • People not getting drugs that could have saved their life • 2 000 000 people died of AIDS in 2007 (WHO) • Western world getting unhappier • Huge increases in alcohol, chronic illness, depression, economic inactivity, divorce, drug use, obesity, smoking... OK- 3 Problems www.eg4health.org

15. World Bank: to reduce poverty • International Monetary Fund (IMF): to prevent global economic collapse • Failed outcomes Greedy economic governance

16. Nr. of people on < 2 $ /day: • 1981: 2542 million • 1990: 2765 million • 1998: 2801 million • ----------------------------- •  + 260 million • more people in poverty Greedy economic governance Meanwhile, world income increased 2.5% every year  Increased inequality www.eg4health.org

17. World Bank: to reduce poverty • International Monetary Fund (IMF): to prevent global economic collapse • Failed outcomes • ↑ • Inappropriate methods ideology not evidence; hypocrisy; tunnel vision • ↑ • Subverted aims (i.e. corruption) Mr. Rubin: Goldman Sachs  IMF  Citibank. • ↑ • Lack of transparency • closed doors; Greedy economic governance – what are they doing Citibank makes 30% of its profit from IMF loan to Brazil. Overall net cashflow from poor countries is negative. Poor-poor feed the rich-rich. • , accountability • faceless; & democracy WWII structure

18. Solution www.eg4health.org

19. by dictating to poor countries how to they should run their country • Fundamental free market ideology • (Thatcherism, Reganism, M. Friedman, neoliberals, neoconseravives, corporatism) • Rapid trade liberalization • Rapid financial liberalization • reduced private sector spending • “Light” state • Excess privatization • Reducing government spending How do economic institutions entrench poverty? www.eg4health.org

20. Entrenched poverty means people have to eat rubbish and drink **** • Wider national and international health inequalities increases psychosocial stress: • poor health behaviours (smoking, alcohol) • unhealthy society (violence, individualism) • inflammatory diseases (incl. heart problems, depression and autoimmune illness), • 3. People have fewer doctors, nurses & beds, equipment & medicines to look after them. Economic institutions have callous disregard for health, illness and death www.eg4health.org

21. Economic institutions have callous disregard for health, illness and death Outcome: more people are die (Stuckler 2008): • tuberculosis mortality ↑17% • causality shown • after exiting IMF programme, deaths dropped back to previous levels • borrowing from IMF was 2x more deadly than other sources • TB killed 1 600 000 people in 2005  Poverty is the most fundamental source of poor global health.

22. Trade always trumps Health: • Breastmilk • 3% of Haiti mothers breastfeed • 1 500 000 babies could be saved every year (WHO 2004) • Vs $10 B market...$7000 per death. • Tobaccokills 5 400 000 every year (WHO 2009). • HIV  AIDS: completely preventable 2 000 000 deaths Trade Vs health intersections • 9 000 000 easily preventabledeaths /yr from these 3 sources. • One –two-three-four. • 500 people in half an hour. www.eg4health.org

23. Evidence-based, Transparent& accountable • Who made that call? • How did the decision impact their end goals? • How did the decision impact other goals (health, environment)? • Should we use this action (or decision maker) in the future? • Democratic & accountable (nationally): each representative has to report to his constituency: • what they did • how they voted • Democratic (internationally): voting rights should represent: • current economic power • OR one per country • OR per capita... Solution 1 - Make global economic institutions more: www.eg4health.org

24. Promote health effects of trade agreements research: • Educating the medical community about its importance and fostering interest. • Sharing research between medical institutions and between non-medical institutions (e.g. climate change groups, bretton woods, tax justice, fairtrade, anti-poverty groups) & fostering common aims. • Helping the WHO secure funding for such research. • The research, coupled with public support, will enable the WHO to be more assertive and speak out trade decisions that will impact social determinants of health and influence decision making. Solution to problem 2 – Trade and Health intersections www.eg4health.org

25. Make global economic institutions more evidence-based, transparent, accountable and democratic (nationally and internationally). • Grow the pie also in the lower spectrum & ameliorate the most fundamental cause of pool global health • Develop & disseminate knowledge about health effects of trade agreements. Empower the WHO to influence talks. •  health reprioritized over trade. • This overlaps with aims of climate-friendly groups. Summary of our solutions www.eg4health.org

26. Trade always trumps Health • TRIPS illustrates powerless WHO Vs powerful WTO • IMF forced cutbacks to Thailand healthcare •  huge AIDS increase and economic disruption • But concessions can be won: Problem 2 – trade Vs health intersections www.eg4health.org

27. 2001: 39 pharma companies Vs S.A. govt. • 300,000 people from over 130 countries signed a petition. Created in international outcry, backed by EU parliament. • Pharma dropped case, and GSK even shared licenses. •  ‘tiered’ pricing, based on per capita income. • At first, vested interests seemed too powerful to overturn... • ...but, campaigning and public opinion CAN make a difference. Campaigning can make a difference www.eg4health.org

28. Understand: • Email us for accessible materials • eg4health.org • Sign our open letters and petitions: • G20 leaders at last G20 meeting • New campaign: pressure for UN to look why Millenium Development Goals are failing & push economic governance reform • join our Facebook page&cause: • Invite others you know. (Everyone invites 3). • Talk, write articles, blogs, develop new knowledge: • 2 articles in the Lancet, more coming up • Get it on the syllabus (SSCs, then core) What you can do www.eg4health.org