Promoting Equity through Health System Strengthening in BRICS countries

The Struggle for Health

Amit SenguptaPeople’s Health Movement

Civil BRICS Forum

Moscow, 29 June -1 July, 2015

The evidence of the HEALTH CRISIS is all around us……

What good does it do to treat people's illnesses ...

then send them back to the conditions that made them sick?

Brazil Russia India China South Africa

Life Expectancy 73 70 65 73 53

Maternal Mortality Rate

56 34 200 37 300

U5MR 14.4 10.3 56.3 14 44.6

OoP on Health 57.8% 35% 59% 35% 7%

Public Expenditure on Health

3.3% (2005)

4.1% (2011)

3.2% (2005)

3.7% (2011)

0.9% (2005)

1.2% (2011)

1.8% (2005)

2.9% (2011)

3.4% (2005)

4.1% (2011)

Private Expenditure on Health

4.9% 1.9% 2.8% 2.3% 5.1%

Gini Index 54.7 40.1 33.4 47 63.1

Selected Indicators: BRICS Countries

HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva”

• BRICS countries, given different contexts, exhibit wide variations in indicators and priorities

• However, a common thread, is the focus on re-imagining and building health systems

• The global discourse on Universal Health Coverage (UHC) is important to relate to

• Unfortunately in many situations UHC is reduced to access to narrow packages, mediated by insurance companies and provided often by an array of private providers

• Important to return to the vision of Alma Ata, of building public systems that are publicly funded and publicly provisioned

BRICS: Priority to building Public Systems for Healthcare

HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva”

Access to Medicines

•Access to medicines is crucial while securing access to comprehensive healthcare services

•While medical products are available as tools to combat an array of diseases, their availability is compromised by a variety of factors

HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva”

Medicines expenditure as percent of total health expenditure

HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva”

Barriers for Access to Medicines

•Poor access to public services forces a large population to access medicines privately

•Lack of dispersed facilities for domestic manufacture of medicines drives up medicine costs and compromises access•Intellectual Property Rights (IPRs) are a significant barrier to access to new medicines

BRICS countries: Uniquely situated to facilitate access to medicines

• Build on existing capacity for local manufacture in India and China to scale up manufacturing in all BRICs countries

• Promote innovation and research through co-operation between research institutions – innovation that is priority driven, and whose products are not prohibitively priced

• Collectively resist attempts by the bloc of developed countries to impose higher standards of Intellectual Property protection

HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva”

Thank You!