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The right to water, and after?

Posted by Jean-Michel Severino on 20 October 2010

The United Nations has just made an important political and symbolic breakthrough by integrating the right to water into individual human rights. A critical universal demand has finally been recognized and with this, a milestone has been reached with the consecration of one of the Millenium Development Goals.

Everyone however is aware that the most significant efforts still lie ahead. The real goal our planet must establish is universal access to quality water. Achieving this will help improve overall health (waterborne diseases remain the leading cause of death in poor countries), thereby helping with demographic control, the reduction of social tensions and even open conflicts. This is visible in many parts of the world affected by water stress and competition for access to water between communities. Economic growth also depends on universal access. Investing in water means investing in Keynesian mechanisms for growth, it means freeing productivity, providing access to schooling, particularly for girls…

The road to this goal contains a gigantic investment deficit. Fixing it requires providing specific answers to the question of funding. Both the report prepared under the direction of Michel Camdessus and the recent OECD report presented at World Water Forum in Istanbul have demonstrated that for such a subject, we must base ourselves on three axes: adequate tariffs for management and investment agencies, solidarity transfers among users, and finally grants because it seems unlikely that water can fully fund water. We have not done so in Western Europe, and it will not happen in the rest of the world. The only reason for this is the externalities to access to water, as economists say, for financial reasons, legitimize and even demand that the entire economy participate in such an investment via tax contributions.

In the globalized world in which we live, subsidies must be approached as a globally managed entity that comprises North-South transfers, inspired not by charity but rather by the awareness that we share a common space in which we influence one another. Take the case of Africa. Maintaining a growth rate above 6% per year, which would progressively provide for universal access to water would require over 100 billion Euros per year in investments. We are currently only roughly half way there. These investments are closely linked to energy, because water requires large quantities of energy and dams have multiple uses. Given the meagre taxes levied in the least developed of African countries coupled with their low debt capacity, it is impossible to achieve such levels of investment in the next ten years without significant financial contributions from abroad, much of it in grants. These investments require a marked improvement in the design and implementation of local water policies, including socially just and financially realistic tariff policies. A common effort must therefore be undertaken.

The next World Water Forum, to be held in Marseille in March 2012, should focus on allowing this effort to intensify until it reaches the required level to make the right to water a reality. This will be a unique opportunity to take action that France can promote. This should be an opportunity to free the financial bottleneck and link this topic to innovative financing. France is the driving force in the work group that steers the progression of this fundamental issue. As host of the Marseille forum, France has the opportunity to simultaneously accomplish two goals: to make sense of the summit’s political process, and thus of the entire meeting, as well as to offer a concrete subject to a discussion that until now has been abstract.

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Sustainable Forest Stewardship: The model approach of the Forest Trust

Posted by Tristan Lecomte on 20 October 2010

According to the WWR, 40 % of timber imported into France is illegal. The lack of information on the stakes of eco-certification explains this behavior. There is a powerful incentive to effectively fight against uncontrolled deforestation throughout the World. The Forest Trust (TFT) is a respected non-governmental organization working in the field and a valued partner of the Fondation Chirac in its program to “Fight Deforestation and Desertification”.

The originality of the TFT is to tackle the problem of deforestation using a global approach to the domain. What is the use of raising consumer awareness about buying sustainably managed timber if the channels are not established and properly controlled beforehand? How can the logging industry be encouraged to undertake better practices without technical assistance and without incentives from subsequent markets?

Thus, the TFT works from one end to the other of the timber chain in order to ensure proper management. By bettering conditions for planting, logging, and the sales of timber we switch from a situation in which deforestation worsens global warming and increasingly pauperizes populations (they benefit very marginally from profits of the illegal sale of timber) to a virtuous situation in which forests are responsibly managed, in which their capacity to stock CO2 is accrued, and in which the value of the entire sector increases for the benefit of all.

Les étudiants de la promotion Moabi sur un chantier d’exploitation forestièreThis is the driving spirit behind the Centre for Social Excellence for the sustainable stewardship of forests in Cameroon, financed by the Fondation Chirac. This center is associated with a logging concession of 365 000 hectares that obtained an FSC certificate guaranteeing the sustainable management of its activities, a first in Africa. Their practices take into account the rights and lifestyles of local communities who are directly implicated, most notably by way of a community radio. The goal of the center is to expand the project to 7 million hectares by involving and training over a dozen local logging companies in sustainable forest stewardship.

The TFT is following the same approach in a number of countries. One of these is Laos where we had a chance to better grasp the added value of TFT on the field. The TFT is training communities and logging companies to optimize the planting and cutting of trees as well as in the sustainable management of timber. They also reinforce the ties and traceability with environmentally concerned buyers in our countries.

The forest is not an obstacle to development in developing countries

Together, the Fondation Chirac and the TFT strengthen these ties all the way to architects in France, the primary purchasing advisors for timber used in construction, by offering innovative and exemplary training. The Fondation also supports this newest initiative, in keeping with its partner’s example of a holistic approach to the sector.

The TFT’s approach to the sector has many advantages, one of which is to show that respecting the environment through better forest stewardship one is also creates added value for economic entities and improved social impact for the poorest populations. The forest is not an obstacle to development in developing countries. On the contrary it is one of their most precious assets. We must render it even more attractive in order to better ensure the sustainable development of these countries.

Tristan Lecomte discovers the project at Luang PrabangBusinesses and consumers in wealthy countries are more and more concerned with the social and environmental conditions of the products they buy. This is a powerful incentive for operators at the beginning of the chain. The TFT and the Fondation Chirac have therefore naturally joined forces around these themes that demonstrate the interdependence of economic, social, and environmental issues. Their partnership intends to shed light on the challenges and encourage the development of virtuous practices throughout the timber industry. Perhaps one day, their efforts will extend to every consumer product.

This would be an excellent reminder that all of our purchases at home condition the factors of social and environmental peace in the most vulnerable countries from whence these products are issued. This is a starting point to rethink our relationship to consumerism and its impact on Humanity and the Environment.

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Justice, an obstacle to peace?

Posted by Georges Tsaï on 13 October 2010

Peace and Justice, two incompatible concepts?

Next January, if everything goes according to the 2005 Comprehensive Peace Agreement (CPA) between the Government of Sudan and the Sudan People’s Liberation Movement (SPLM), Southern Sudan will hold an independence referendum.

Interested observers (there are not that many for, after all, the conflict between North and South Sudan resulted in only two million deaths between 1983 and 2005) are holding their breath. Will President Omar el Bashir respect the terms of the Agreement, or will he find an excuse to cancel or at least delay the referendum? Keep in mind that significant oil reserves are located in South Sudan. Many fear that such an event could result in renewed hostilities after five years of respite.

While the issue is important in and of itself, it is also coupled with an ethical dilemma that has become highly acute in recent years. Is it possible to negotiate or make peace with someone who is accused of committing crimes against humanity or genocide? Is it morally just to deal with someone who has been indicted by the International Criminal Court for war crimes and crimes against humanity? The ICC decided in the end to drop the accusations of genocide.

For some (the realists?), peace is made as best we can and an imperfect peace from a moral point of view, but which offers expected results (no more death and suffering due to conflicts) is much better than demanding for a brand of justice that could heighten conflict.

For others (the idealists?), making peace without justice (by granting impunity to the guilty) is not only betraying the memory of victims but also running the risk of not appeasing one of the conflicting factions and entering into an endless spiral of violence, thus destroying the hopes of the realists.

Is this an irreconcilable dilemma?

Is each case singular?

Reality, as is often the case in human experience, is certainly much more complex than the dichotomy posited in the precedent paragraph. As Pierre Hazan so justly observed in an excellent book published recently (La paix contre la justice?, André Versaille – GRIP, 2010), history offers examples that support both sides (we need simply think of what has happened in South Africa, Latin America, and former Yugoslavia). These examples lead us to believe that it is important to be wary of dogmatic positions between peacemakers (or mediators) and proponents of a strict application of international laws. Only a precise analysis of each situation can dictate a course of action.

Of course, this analysis is complex. It must take into account both the perceived consequences and values embodied in international law based on human rights. Let’s return to Sudan in 2009, less than two years before the upcoming, crucial referendum for peace in the region. Was Luis Moreno-Ocampo, Prosecutor of the ICC, justified in his indictment of Omar el-Bashir for war crimes and crimes against humanity? I for one would be more inclined to give the Comprehensive Peace Agreement a chance to work its way through the process provided. There is always time enough to revise my analysis if Omar al-Bashir ever sought to cancel or torpedo (an incongruous image for a resolutely terrestrial conflict) the referendum.

What do you think?

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An End to Falsified Medicines

Posted by Dr. Aboubakrine Sarr on 13 October 2010

Medicines are an important factor in the management of the health of populations. The prescription and rational use of medicines ensure for patients a therapeutic outcome based primarily on the quality, effectiveness, and safety of the drugs themselves. In sum, results hinge on proper practices in terms of manufacturing, distribution, and dispensing. The effectiveness of medication depends on its traceability.

Nowadays, it is a truism to recognize the importance of counterfeit drugs commonly called falsified medicines. They represent roughly 10% of the world market; adding up to nearly 45 billion US dollars within a global pharmaceutical production that totals approximately 570 to 575 billion US Dollars. Predictions for 2020 foresee world production reaching a value of 1,200 to 1,300 billion US dollars. The tragic health, social, and economic consequences will certainly be considerable if we are not careful.

According to WHO, if counterfeit drugs in certain developed countries represent about 1% of their market, figures reach 30% in African markets (reaching as high as 50% of all available medicines in some countries).

Worse yet, in Africa, counterfeit medicines are likely to focus on products most in demand for the treatment of endemic diseases (malaria), chronic diseases (tuberculosis, diabetes, hypertension ….), and devastatingly lethal diseases (AIDS). For example, two thirds of all antimalarial drugs sold on the continent are falsified, for a disease that kills on average over one million people each year, 80% of them in Sub-Saharan Africa alone.

We must take into account that health policies, as are medicines, have always been a source of political competition worldwide, regardless of pharmaceutical or medical aspects. This principle is often used by industrialized countries to maintain their rank within the alliance of great nations. Nowadays, organizations (NGOs, IGOs,…) and institutions of defense and financing of human health such as the WHO, the Global Fund, the Fondation Chirac, the Bill & Melinda Gates Foundation, are mobilizing to improve access to safe medicines wherever they are lacking and in the exclusive interest of public health.

Moreover, the evolution and development of the pharmaceutical industry in emerging countries like China, India, Brazil, Russia, Turkey, South Africa, Nigeria, Indonesia, and Thailand have also contributed significantly to overcoming the challenges of global production, geographical accessibility, and affordability of essential medicines. However, it would be a shame to allow counterfeit medicines to increase exponentially at the hands of mafia networks, which often take advantage of the vulnerability of countries or emergency regulations and decisions at the international level (compulsory licensing, the Doha declaration, parallel imports … .. ) to accomplish their dirty work.

To fight falsified medicines at all levels (networks, channels, trafficking, local markets…), we need to mobilize global resources, with the support of national and international political will.

Such political will must first be nourished by strong and coordinated commitments. Then it must be rendered concrete through consistently consensual legal provisions, and finally be complemented by sustainable actions that are supported by all.

Dr. Aboubakrine CARS

Chairman of Private Pharmacists’ Union of Senegal

Secretary General of the Inter-African Association of Pharmacists (Ispharma)

SG of the Permanent Secretariat of the Pharmaceutical Forum International (FPI)

Priorities in the fight against falsified medicines:

On the African continent, throughout regional and subregional institutions, such as the African Union, the West African Economic and Monetary Union (UEMOA), the Economic and Monetary Community of Central Africa (CEMAC), The Customs and Economic Union of Central Africa (UDEAC), the cornerstones and priorities of the fight are threefold:

➢ At the Legislative and Regulatory level:

1 / the development of coordinated laws and regulations to streamline litigation (through the use of different emergency procedures), to assess damage in relation to the harm caused to the licensee or patent holder, and to make provisions for more deterrent and coercive fines and prison sentences.

2 / the development of new offenses in the Customs Code penalizing the importation, exportation, trading, and transit of counterfeit goods and giving Customs full jurisdiction over suspected counterfeit products and the capacity to appeal directly to the Public Prosecutor.

3 / drawing up and/or updating within the Health Code of legal, regulatory, and disciplinary measures that are context-specific, coordinated, and valid in all member countries of the sub-regional or regional institution.

➢ At the communicative, informational and educational level:

1 / the development and creation of tools adapted to informing and raising awareness of the different target audiences (government, national and/or community institutions, opinion leaders, public health officials, and even counterfeiters)

2 / organizing seminars and workshops and/or strengthening the capacity of institutional enforcement authorities (customs, police…) in terms of detection, quality control, and traceability of medicines.

➢ At the health and socio-economic level:

1 / encouraging local production of essential medicines that are geographically and financially accessible.

2 / harmonizing international financial and technical support for the implementation of horizontal projects and programs according to the principles of the 2005 Paris Declaration.

3 / the adoption in the different regional and sub-regional areas of principles harmonized according to GMPs, GPDs and Pharmacovigilance (currently part of the WAEMU since July 2010 with the development of the GMP Guide).

4 / The creation of national committees in all the countries of the different regional and sub-regional areas. This would include pharmacists, but also the various State departments and services involved in tracking and enforcing laws against counterfeiters and sellers of falsified medicines.

The African pharmacist has a major role to play in this great undertaking, through his continuing education and that of his agents; through information and awareness campaigns for his patients/clients on the complexity of drug stability, as well as the dangers of consuming counterfeit medicines including those purchased in illicit channels and on the Internet; and finally through the advice he offers his patients.

We have benefited, as others, from technical and financial support to strengthen our capabilities particularly in the field of drug quality control at the Central Humanitaire Medico-Pharmaceutique of Clermont-Ferrand. Today, our priority is on this area of control along with pharmacovigilance in order to ensure the quality of the pharmaceutical care offered to our population.

This is the moment to encourage and congratulate institutions such as the Fondation Chirac and the Council of Europe, which, with the Cotonou Declaration and MEDICRIME have finished bravely establishing the basis for this global desire to fight the perpetrators of the genocide of fake medicines.

“Fear has changed sides.”

Together, with ethics, equity, solidarity, and justice as their sole weapons, the determination of just men will soon overcome the greed of the merchants of death.

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