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B R I C S
It was also agreed to institutionalize BRICS cooperation with the establishment
of a technical working group to consider issues of technological cooperation.
In 2012 in New-Deli the leaders underscored that “most of BRICS countries face
a number of similar public health challenges, including universal access to health
services, access to health technologies, including medicines, increasing costs and
the growing burden of both communicable and non-communicable diseases.”
14
As
a result, they supported the idea of the regular meetings of the Health Ministers.
During the year of Indian BRICS Presidency two ministerial meetings were
held — on the sidelines of the 65th session of the WHA as well as separate meeting
of Health Ministers (January 10-11th, 2013 in New Delhi). The Ministers assumed
twenty two obligations concerning control of communicable and non-communica-
ble diseases, mental disorders, tobacco, tuberculosis, malaria and HIV; increase
of health surveillance effectiveness; development of medical bio-technology and
achievements of the Millennium Development Goals in the public health service
15
In spite of the high BRICS public health dialogue institutionalization and its po
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tential importance, this issue did not become the part of the agenda on the BRICS
summit in Durban in March 2013 with leaders mentioning the necessity to continue
the Health Ministers’ meetings
16
. At the same time both dialogue options — WHA
and separate ministerial meetings were held In the joint communiqué the parties
articulated 5 priority areas for the technical group including health surveillance and
combat against non-communicable disease. They also discussed “the WHO report
on Monitoring Achievements of the Millennium Development Goals and acknowl
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edged that despite progress made, much needs to be done if these Goals are to
be achieved by 2015 and beyond.”
17
The BRICS representatives determined to
“jointly promote access to affordable, safe, efficacious and quality medical prod
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ucts, through the use of TRIPS flexibilities.”
18
BRICS Framework for Collaboration
on Strategic Projects in Health was negotiated.
19
In general, the institutionalization of public health collaboration in BRICS is con
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sidered as high dynamic process, while delivery remains quite low.
HEALTH WORKING GROUP DRAFT RECOMMENDATIONS
Recognizing that right to life is an inalienable right of every human being, pro
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tected by law
20
.
14
The 4h BRICS Summit: Delhi Declaration. New Delhi, March 29, 2012
15
BRICS Health Ministers' Communiqué Delhi, January 11, 2013
16
BRICS and Africa: Partnership for Development, Integration and Industrialization: eThekwini Dec
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laration. Durban, South Africa, March 27, 2013
17
Joint Communiqué of the BRICS Member States on Health on the Sidelines of the 66th WHA
Geneva, May 20, 2013
18
Joint Communiqué of the BRICS Member States on Health on the Sidelines of the 66th WHA
Geneva, May 20, 2013
19
Third Health Ministers Meeting: Cape Town Communiqué. November 7, 2013, Cape Town, South Africa
20
Article 6 (1) of the International Covenant on Civil and Political Rights. Adopted by General As
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sembly resolution 2200A (XXI) of the General Assembly on December 16, 1966
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B R I C S
Emphasizing that continuous threat to public health, infectious and chronic non-
communicable diseases, conservation of poverty, increase of migration flows and
environmental changes require an integrated approach, mobilizing financial and
human resources both within countries and internationally.
Attaching special role in improving the availability and quality of services in the
field of prevention and treatment of socially significant infectious and chronic non-
communicable diseases to NGOs (non-profit) organizations, and the community
of people affected by these diseases, including coalitions and alliances at various
levels: international, regional, national and local.
Noting that public health collaboration with non-governmental (non-profit) orga
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nizations has considerable advantages like access to private groups of the popula
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tion at risk of HIV infection and tuberculosis, the versatility of the proposed methods
and approaches in the work with vulnerable groups prepared to motivate employ-
ees, including a number of community representatives, independent evaluation of
medical and social programs, and monitoring human rights violations and protect
the interests of the target groups.
Representatives of civil society of the BRICS countries working in health pro-
grams have combined to make suggestions to minimize the negative impact on
public health of a variety of factors and conditions.
Globalization and urbanization
Globalization and urbanization lead to improvement in living standards due to in
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creased accessibility to technology, healthcare and essential medicines, education
and occupations, prolongs the life of people and changes the terrain of economic
prosperity. However, large-scale unplanned urbanization, particularly in overcrowded
conditions, and non-compliance with the elementary rules of hygiene, progressive ag-
ing of the population, active migration contribute to the spread of many infectious and
chronic non-communicable diseases, the emergence of new threats and challenges.
1.
We call on BRICS leaders to consolidate efforts in the fight against poverty
and the effects of the economic crisis, prevent the negative impact of global-
ization and urbanization on health, ensuring access for all segments of the
population to clean water. The frequency and severity of natural and man-
made disasters is a global problem. These disasters have lasting impact and
have far-reaching implications for public health, healthcare and economy.
Clean water and sanitary conditions
Lack of access to clean water and poor sanitary conditions in the majority of
the population in the BRICS countries continue to cause high rates of intestinal
infections, typhoid fever, hepatitis A, and high mortality from these diseases. The
economic crisis can significantly worsen the situation.
2.
We suggest that it is high time for BRICS to improve the coordination mecha-
nisms work to provide urgent international assistance to the health sector in
the natural and man-made disasters.
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B R I C S
Maternal and infant mortality
Maternal and infant mortality remains a major problem in most vulnerable and
poorest communities on the planet. Therefore, BRICS states should make every effort
to implement the rights of the child to the enjoyment of the highest attainable stan-
dard of health
21
and to take appropriate measures to eliminate discrimination against
women, on the basis of equality of men and women, their access to health care
22
.
3.
Particular attention should be paid to health coverage the most defective, of
poor and marginalized populations, employing professionally trained specialists.
4.
Work should be strengthened in the field of education and social mobilization to
achieve the objectives of the Special Session of the UN General Assembly in
2010 to ensure full immunization of children under one year at 90 percent na
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tional coverage and to combat vitamin A deficiency in children, including women
and children, living in remote areas, the urban poor and children in war zones.
Infectious diseases
Infectious diseases, including malaria, infectious hepatitis, intestinal infections,
etc. continue to be a challenge for the health systems of the BRICS countries, in-
creasing risk of pandemics.
5.
Further development of systems for monitoring, prevention and specific
treatment of infectious diseases is required.
6.
To prevent pandemics BRICS should ensure availability of therapeutic mea-
sures and essential drugs, improving communication strategies and cam-
paigns to raise public awareness, the development of close cooperation be-
tween veterinary and public health, the support of research and development
of new treatments.
7.
TB, HIV and malaria remain a serious threat. BRICS should strengthen co
-
operation to exchange best practices, research and development in the field
of prevention, diagnosis and treatment of tuberculosis, as well as their ac-
cess to the WHO Prequalification Program (Provisional) of new drugs and
diagnostic methods.
Tuberculosis
8.
BRICS should step up joint efforts to prevent TB spreading to implement the
proposed priority actions by WHO: enhanced action to identify new cases
of tuberculosis by expanding services in all health care systems with a wide
participation of NGOs, social workers and volunteers to conduct controlled
treatment and care of TB patients, especially in the penitentiary institutions.
21
Article 24 (1) of the Convention on the Rights of the Child The adoption of resolution 44/25 of the
UN General Assembly on November 20, 1989
22
Article 12 (1) Convention on the Elimination of All Forms of Discrimination against Women Ad
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opted by General Assembly resolution 34/180 of 18 December 1979
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B R I C S
9.
Five countries should expand the coverage of the needy patients with HIV infec
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tion and tuberculosis chemoprophylaxis ensure maximum coverage of TB pa-
tients with antiretroviral therapy in HIV. Promote a health care system that mini
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mizes the possibility of intersection of flows of epidemiologically dangerous pa
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tients (TB patients — MbT, especially those with multidrug-resistant, and people
with severely immunocompromised), especially in the penitentiary institutions.
10.
Governments should consider increasing funding for the elimination of the
resource gaps in the rapid innovation in the field of diagnostics, treatment
and prevention of tuberculosis, as well as of anti-epidemic measures.
HIV/AIDS
Despite the fact that over 30 years since the beginning of the HIV / AIDS epi
-
demic there was significant progress in the prevention and treatment of HIV infec
-
tion, a number of constraints remain in place, including lack of political will, unstable
and limited funding, unpreparedness of public health system, as well as lack of pro-
grams for vulnerable populations such as sex workers, drug users, homosexuals
and transgender people, prisoners in detention, illegal migrants. A large spread of
hepatitis C among HIV-infected persons and problems with its diagnosis and treat
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ment are of great concern to BRICS.
11.
National legislation of BRICS should be put in conformity with the commit-
ments of the UN in the framework of international human rights instruments
to meet the challenges of HIV / AIDS
23
, in particular:
•
Adopt and implement legislation aimed at eliminating systemic discrim-
ination against people living with HIV and representatives of the most
vulnerable groups, as well as guaranteeing access to information, social
and health services and other conditions of the right to health, the right to
respect private and family life, the right to work and other rights as well as
to enhance effective, science-based programs to prevent HIV infection.
•
Adopt and implement laws that aim to protect sexual and reproductive
rights of women and girls, as well as young people in general, including
the right to information and the right to freely and responsibly make deci-
sions in the field of sexual and reproductive health services without any
coercion, discrimination and violence.
•
Conduct a study of the impact of existing legislation to ban various activi-
ties related to the risk of HIV infection, in order to create ideas about ways
of exposure to high-risk groups, and facilitate the adoption of a differenti-
ated legal approach, leading to a reduction in the incidence of HIV and at
the same time to solve other social problem.
12.
BRICS governments are advised to consider adoption and implementation
of laws that guarantee freedom of movement, regardless of health status,
including presence or absence of HIV infection.
23
International Guidelines on HIV / AIDS and Human Rights. Office of the High Commissioner for
Human Rights and the Joint United Nations Programme on HIV / AIDS, 2006
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B R I C S
13.
BRICS should ensure availability of medicines, including for the treatment of
hepatitis C, as a means of safeguarding human rights, including the right to
protection of human dignity. Direct efforts to eliminate all forms of discrimina
-
tion in access to medicines is a must.
Migration
Migration is ever-increasing phenomenon, covering virtually all of the country. Ac-
cording to the International Organization for Migration (IOM) in the world, there are
1 billion migrants. People are forced to leave their homes because of conflict, persecu
-
tion, disasters, poverty. The consequences of international migration is the vulnerability
of people. Migration issues are relevant to all of the BRICS countries. In the absence
of a traditional support system, migrants often do not have access to health services,
shelter, education and social services. Women and children are involved in the migra-
tion process, a person under 18 years of age, illegal migrants, persons with physical
and mental disabilities, people in older age groups are particularly vulnerable. The vul-
nerability is exacerbated by illegal migrants to their stigmatization.
24
Access to health
care for migrants may be insufficient because of the legal, social and cultural barriers.
14.
Thus it is vital that BRICS promote sustainable cooperation between States
and humanitarian agencies, regional and local organizations to maximize posi
-
tive effects of migration, reducing the risks and negative humanitarian conse-
quences of international migration, implementation of procedures to ensure re-
spect for the rights of migrants and their access to obtain health care services.
15.
There’s a need to develop cross-border cooperation of medical services to
ensure continuity of treatment of migrants, especially in the treatment of tu-
berculosis and HIV infection.
16.
BRICS acting as host countries should elaborate migrant program access to
diagnosis and treatment of diseases of the budget sources.
Aging population
Aging population of the BRICS countries is accompanied by growth of chronic
non-communicable diseases (NCD), addiction, increased the vulnerability of the
elderly and increase the burden on health systems and social protection of the
population and guardians. Chronic non-communicable diseases such as cancer,
diabetes, heart disease and blood vessels, lungs, joints, nervous system, including
Parkinson’s disease and dementia, and the gastrointestinal tract require lifelong
monitoring and treatment.
17.
Prevention and slower progression should be aimed at through elimination of
risk factors such as smoking, exposure to carcinogenic and polyutantami, un-
healthy diet, physical inactivity and excessive alcohol consumption, develop-
24
Illegal migration problems will be regarded separately in the Peace and Security Section