This page intentionally left blank International Political Economy Series General Editor: Timothy M. Shaw, Professor and Director, Institute of International Relations, The University of the West Indies, Trinidad & Tobago Titles include: Hans Abrahamsson UNDERSTANDING WORLD ORDER AND STRUCTURAL CHANGE Poverty, Conflict and the Global Arena Morten Bøås, Marianne H. Marchand and Timothy Shaw (editors) THE POLITICAL ECONOMY OF REGIONS AND REGIONALISM Sandra Braman (editor) THE EMERGENT GLOBAL INFORMATION POLICY REGIME James Busumtwi-Sam and Laurent Dobuzinskis (editors) TURBULENCE AND NEW DIRECTION IN GLOBAL POLITICAL ECONOMY Elizabeth De Boer-Ashworth THE GLOBAL POLITICAL ECONOMY AND POST-1989 CHANGE The Place of the Central European Transition Bill Dunn GLOBAL RESTRUCTURING AND THE POWER OF LABOUR Myron J. Frankman WORLD DEMOCRATIC FEDERALISM Peace and Justice Indivisible Helen A. Garten US FINANCIAL REGULATION AND THE LEVEL PLAYING FIELD Barry K. Gills (editor) GLOBALIZATION AND THE POLITICS OF RESISTANCE Richard Grant and John Rennie Short (editors) GLOBALIZATION AND THE MARGINS Graham Harrison (editor) GLOBAL ENCOUNTERS International Political Economy, Development and Globalization Patrick Hayden and Chamsy el-Ojeili (editors) CONFRONTING GLOBALIZATION Humanity, Justice and the Renewal of Politics Axel Hülsemeyer (editor) GLOBALIZATION IN THE TWENTY–FIRST CENTURY Convergence or Divergence? Helge Hveem and Kristen Nordhaug (editors) PUBLIC POLICY IN THE AGE OF GLOBALIZATION Responses to Environmental and Economic Crises Takashi Inoguchi GLOBAL CHANGE A Japanese Perspective Jomo K.S. and Shyamala Nagaraj (editors) GLOBALIZATION VERSUS DEVELOPMENT Dominic Kelly and Wyn Grant (editors) THE POLITICS OF INTERNATIONAL TRADE IN THE 21st CENTURY Actors, Issues and Regional Dynamics Sandra J. MacLean, Sherri A. Brown and Pieter Fourie (editors) HEALTH FOR SOME The Political Economy of Global Health Governance Craig N. Murphy (editor) EGALITARIAN POLITICS IN THE AGE OF GLOBALIZATION George Myconos THE GLOBALIZATION OF ORGANIZED LABOUR 1945–2004 John Nauright and Kimberly S. Schimmel (editors) THE POLITICAL ECONOMY OF SPORT Morten Ougaard THE GLOBALIZATION OF POLITICS Power, Social Forces and Governance Jørgen Dige Pedersen GLOBALIZATION, DEVELOPMENT AND THE STATE The Performance of India and Brazil Since 1990 Markus Perkmann and Ngai-Ling Sum GLOBALIZATION, REGIONALIZATION AND CROSS–BORDER REGIONS Marc Schelhase GLOBALIZATION, REGIONALIZATION AND BUSINESS Conflict, Convergence and Influence Herman M. Schwartz and Leonard Seabrooke (editors) THE POLITICS OF HOUSING BOOMS AND BUSTS Leonard Seabrooke US POWER IN INTERNATIONAL FINANCE The Victory of Dividends Timothy J. Sinclair and Kenneth P. Thomas (editors) STRUCTURE AND AGENCY IN INTERNATIONAL CAPITAL MOBILITY Fredrik Söderbaum and Timothy M. Shaw (editors) THEORIES OF NEW REGIONALISM Susanne Soederberg, Georg Menz and Philip G. Cerny (editors) INTERNALIZING GLOBALIZATION The Rise of Neoliberalism and the Decline of National Varieties of Capitalism Ritu Vij (editor) GLOBALIZATION AND WELFARE A Critical Reader Matthew Watson THE POLITICAL ECONOMY OF INTERNATIONAL CAPITAL MOBILITY International Political Economy Series Series Standing Order ISBN 978–0–333–71708–0 hardcover Series Standing Order ISBN 978–0–333–71110–1 paperback You can receive future titles in this series as they are published by placing a standing order. Please contact your bookseller or, in case of difficulty, write to us at the address below with your name and address, the title of the series and one of the ISBNs quoted above. Customer Services Department, Macmillan Distribution Ltd, Houndmills, Basingstoke, Hampshire RG21 6XS, England Health for Some The Political Economy of Global Health Governance Edited by Sandra J. MacLean Simon Fraser University, Canada Sherri A. Brown Simon Fraser University, Canada and Pieter Fourie Macquarie University, Australia Introduction, selection and editorial matter © Sandra J. MacLean, Sherri A. Brown and Pieter Fourie 2009 Individual chapters © contributors 2009 Foreword © Alan Whiteside 2009 Softcover reprint of the hardcover 1st edition 2009 978-0-230-22424-7 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No portion of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, Saffron House, 6-10 Kirby Street, London EC1N 8TS. Any person who does any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The authors have asserted their rights to be identified as the authors of this work in accordance with the Copyright, Designs and Patents Act 1988. First published 2009 by PALGRAVE MACMILLAN Palgrave Macmillan in the UK is an imprint of Macmillan Publishers Limited, registered in England, company number 785998, of Houndmills, Basingstoke, Hampshire RG21 6XS. Palgrave Macmillan in the US is a division of St Martin’s Press LLC, 175 Fifth Avenue, New York, NY 10010. Palgrave Macmillan is the global academic imprint of the above companies and has companies and representatives throughout the world. Palgrave® and Macmillan® are registered trademarks in the United States, the United Kingdom, Europe and other countries. ISBN 978-1-349-30920-7 ISBN 978-0-230-24439-9 (eBook) DOI 10.1057/9780230244399 This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. Logging, pulping and manufacturing processes are expected to conform to the environmental regulations of the country of origin. A catalogue record for this book is available from the British Library. A catalog record for this book is available from the Library of Congress. 10 9 8 7 6 5 4 3 2 1 18 17 16 15 14 13 12 11 10 09 Contents List of Tables vii List of Figures viii Foreword by Alan Whiteside ix List of Abbreviations xi Notes on Contributors xv Part I Introduction 1 Introduction: The Social Determinants of Global Health: Confronting Inequities 3 Sandra J. MacLean and Sherri A. Brown Part II Globalization, the State, and Global Health 2 The G8, Globalization, and the Need for a Global Health Ethic 21 Ted Schrecker 3 The Accumulative Nature of the US Health Complex 39 Rodney Loeppky 4 Palliative Interventions: Canadian Foreign Policy, Security and Global Health Governance 53 Colleen O’Manique 5 The Relationship between the AIDS Pandemic and State Fragility 67 Pieter Fourie Part III From International to Global Health Governance 6 Transnational Norm-Building in Global Health: The Important Role of Non-State Actors in Post-Westphalian Politics 87 Wolfgang Hein and Lars Kohlmorgen 7 Global Public Health and Innovation in Governance: The Emergence of Public–Private Partnerships 105 Carmen Huckel Schneider 8 Philanthropic Foundations and Global Health Partnership Formation: The Rockefeller Foundation and IAVI 118 Michael Moran v vi Contents 9 Southern Actors in Global Public–Private Partnerships: The Case of the Global Fund 130 Sonja Bartsch 10 ‘Making the Money Work’: Challenges towards Coordination of HIV/AIDS Programmes in Africa 145 Siri Bjerkreim Hellevik Part IV The Governance of Global Health Research and Product Access 11 The Political Economy of Global Health Research 165 Sandra J. MacLean and David R. MacLean 12 Dealing with Public Health and Intellectual Property for Pharmaceuticals at the World Trade Organization 183 Valbona Muzaka 13 Patents, Policies and Pricing: Access to Medicines for Vulnerable Populations in a Global Economy 196 Shree Mulay, Eowynne Feeney and Daya R. Varma 14 The Partnership Prescription: Access to HIV/AIDS-related Medicines and Public–Private Partnerships 210 Sherri A. Brown Part V Conclusion 15 Conclusion: Towards Equitable Global Health Governance 227 Sherri A. Brown and Sandra J. MacLean References 237 Index 273 Tables 5.1 HIV/AIDS prevalence levels in Southern Africa 68 5.2 Projected life expectancy (in years) in Swaziland 76 6.1 Access to medicines: norm-building process and main norm carriers 102 7.1 Monitoring the growth of PPPs for health 107 14.1 Accelerating Access Initiative country participants 216 14.2 Pharmaceutical companies’ total revenues and net incomes from 2004 and 2005 218 vii Figures 2.1 Socio-economic gradients in under-5 mortality, by household wealth quintiles, selected countries 23 2.2 Debt service and development assistance, by region, 2000–2005 27 2.3 Additional cost to the G7 nations in 2007 of spending 0.7 per cent of GNI on development assistance, in Big Macs per capita 36 5.1 Male mortality in South Africa 75 5.2 Female mortality in South Africa 75 5.3 The ‘Security Demographic’ 76 6.1 Transformation of international relations into a system of global politics 92 viii Foreword This book is published at a crucial moment in global economic develop- ment. The 2008 calendar year saw an economic crisis develop, the like of which had not been seen for decades. There are those who argue Marx is vindicated; this is the ‘collapse of capitalism’. Others suggest that now is the time for Keynesian economic policies to be revisited. The economic turmoil is taking place in a globalized world. Unless there are some dramatic new developments, either an economic turnaround or a new political order, then the Millennium Development Goals are unlikely to be met. In this book globalization