Author Archives: benequec

Global Health Law and Access To New Medicine: Ebola, Money Distribution, and The World Bank

What is Global Health Law? Global health law is a field that encompasses the legal norms, processes, and institutions needed to create the conditions for people throughout the world to attain the highest possible level of physical and mental health[1].

Global Health Law is carried out by countries and several major international agencies including the World Bank. As an investment bank, the World Bank provides technical and financial assistance to developing countries with the aims of reducing poverty and increasing development[2]. In addition to poverty and development, the World Bank has played a pivotal role in combating global health pandemics for the last 50 years.

In August 2014 the Ebola pandemic took center stage on a global platform as contraction of the Ebola virus began to escalate at an exponential rate. On August 8th, 2014 the World Health Organization (WHO) declared Ebola as a Public Health Emergency of International Concern (PHEIC). With the gravity of the impact that Ebola has had West Africa, West African governments became vocal about their need for help. The increase in viral outbreak required the leadership of international health organizations to implement solutions – including new medicine and increased access to medical care.

With the World Bank’s investments into emergency medical care, it has dramatically increased West Africa’s access to medication and medical treatment regarding Ebola. As of early November, the World Bank has mobilized nearly a billion dollars for use in the hardest hit areas in Western Africa, the largest contribution by a single-organization to combatting Ebola. The distribution of money, mostly managed by UNICEF, has provided medical solutions to thousands of people in Western Africa.[3]

There is currently no FDA-approved cure for Ebola. Several pharmaceutical companies have created trial medication to combat the disease, but the medication is not produced in large quantities nor is it guaranteed to work. While the World Bank has been able to mobilize money to provide antibiotics to treat symptoms and side effects of Ebola it has not contributed funding to finding a cure for the disease. As a result, Western countries are acting independently to find a cure through trial medicine. While West Africa has been hardest hit by Ebola, trial medication is currently only being used on Ebola patients in the US and Europe. A disproportionate number of Ebola cases have occurred within West Africa – The US and Europe have a combined total of 7 confirmed Ebola cases, while West Africa has had over 15,000 cases[4].

With the leadership role that the World Bank has taken on, it would be beneficial if the World Bank directed that some of the money acquired be used in conjunction with the WHO and Center For Disease Control (CDC) towards a cure for Ebola. Rather than just providing money towards antibiotics, putting the World Bank’s money behind finding a cure, could positively impact those that need it the most – and not just the Western world.

[1] Gostin, Taylor. “Global Health Law: A Definition and Grand Challenges.” Public Health Ethics (2008): 53-63

[2] World Bank . What We Do. 2014. <http://www.worldbank.org/en/about/what-we-do&gt;.

[3] World Bank Group Ebola Response Fact Sheet. November 2014. <http://www.worldbank.org/en/topic/health/brief/world-bank-group-ebola-fact-sheet&gt;

[4] BBC. Ebola: Experimental drugs and vaccines. November 2014. <http://www.bbc.com/news/health-28663217&gt;.

Beauty & The Beast: Why greater tobacco regulation is necessary, but unlikely, in South Africa.

The tobacco industry has made a lasting impression on Africa, birthed by a need for expansion and fostered by a lack of regulation . With South Africa being home to Africa’s top big name tobacco companies, the people of South Africa have been especially hit hard from a health perspective. How has tobacco use remained high over the last 20 years in South Africa when tobacco consumption is dramatically falling everywhere else around the world? Let’s dig a little deeper.

How did Tobacco find its way to Africa?

The US began exporting tobacco to Europe in early 17th century, using slave labor. The cost of cigarettes greatly decreased in 1880, as cigarette manufacturing mechanized and tobacco production increased. By the 1950’s cigarettes accounted for 80% of tobacco use in the US and 50% of American men smoked[1]. As tobacco regulations increased in the US in the form of Surgeon General Warnings and taxes, American consumption of tobacco began to decrease. In the 1990s as American consumption began to decrease Tobacco companies increased expansion and marketing to international countries. Due to South Africa’s need for economic growth and lack of tobacco regulation, tobacco companies began to thrive in South Africa.

The Health & Economic impact of Tobacco on South Africa.

By 1995, South Africa’s largest tobacco company Rothman International, held 87% of the tobacco market share in the country. Rothman International was one of the country’s largest employers offering fair and equal wages to all employees1. In a country split for years by apartheid, many South Africans flocked to Tobacco companies for better wages and a better way of life for them and their family. By 1996 smoking consumption was up to 36% for 18-24 year olds, and by 1999 23% of adolescents reported as being current smokers with a substantial percentage reporting that they had been smoking since before the age of 10[2]. During the early 1990s there was very little regulation regarding the tobacco industry’s advertising and marketing in South Africa. Major tobacco company ads could be found everywhere from a local magazine to the sponsorship of a local elementary school.

The future of Tobacco in South Africa

From the mid 1990s to early 2000’s the South African government has introduced legislation that has aimed to reduce the consumption of tobacco and limit the marketing ability of large tobacco powerhouses. Several bans were put in place that restricted tobacco companies from activities such as sponsoring sports teams, and limited their ability to advertise in commercial areas. While there has been a decrease in tobacco consumption, South Africa still has one of the highest rates of tobacco use within Africa as a result of widespread consumption, lack of health education, and lax tobacco regulations. Additional tobacco controls such as taxes, administered through tax policy, would help create a financial disincentive that would have a long lasting impact on the tobacco industry and people of South Africa.

[1] Bitton, Asaf, Julie Talbot and Lucy Clarke. “Tobacco Control in South Africa.” CASES IN GLOBAL HEALTH DELIVERY (2011

[2] Panday, Dehran Swart and Saadhna. “The Surveillance and Monitoring of Tobacco Control in South Africa.” (2003).