theglobaljournal.net: Latest articles of Alphee September

Saving Lives Through Infection Control

2013-06-10T11:59:10Z

Outbreaks of viral and bacterial infections may seem banal in light of the progress made in medical science. Yet hundreds of millions of patients worldwide are affected by healthcare-associated infections every year, and thousands ultimately die. From 25-28 June, over 1,000 world experts in the prevention and control of these infections will gather in Geneva for the 2nd International Conference on Prevention & Infection Control (ICPIC).

The first ICPIC conference was convened in 2011 as a platform to foster exchange and debate about the prevention and control of healthcare-associated infections and anti-microbial resistance around the world, attracting 1,200 experts from 84 countries. The second edition will includes keynote lectures, interactive sessions, meet-the-expert workshops and pro-con debates on a number of pressing issues, including SARS, the new coronavirus and H7N9, cultural differences in infection control and patient safety, anti-microbial stewardship, health economics, antibiotics in food and animals and antibiotic resistance.

One of the highlights of the conference will be the new Innovation Academy chaired by Didier Pitter and John Conly. From more than 30 abstracts, 15 finalists have been selected by the International Jury of the Academy to present their research. Each participant will provide a succinct oral summary of their work during the course of the forum, and the Jury will choose the five finalists to remain in the running for three 'Innovation Awards of Excellence' to be presented on 28 June.

Over the next two weeks, The Global Journal will present a special digital feature showcasing the inspiring stories behind the vital work being done to reduce the global burdern of healthcare-associated infections. Check back each day for updated content.

Click here for the detailed ICPIC program as well as further information.

Made In China

2013-05-21T16:24:13Z

China’s Silent Army: The Pioneers, Traders, Fixers And Workers Who Are Remaking The World In Beijing’s Image, Juan Pablo Caedenal & Heriberto Araújo, Allen Lane, £25.00.

More than a sporting event, the opening ceremony of the Beijing Olympic Games in 2008 marked the beginning of a new era for China on a global scale. In the wake of this coming out party, journalists Juan Pablo Cardenal and Heriberto Araújo set off on a journey to investigate China’s economic activity in the developing world. They tracked China’s presence in untapped markets – from the extraction of raw materials in Russia’s taiga and Burma’s jade mines, to gigantic construction projects in some of Africa’s most turbulent states.

While the rest of the world suffered the economic consequences of the financial collapse, Beijing’s intervention in the financial system allowed China to sidestep the recession. The Asian giant is buying debt, giving out loans, investing and acquiring assets globally. But economic success has a cost – Chinese banks are financed by the deposits of millions of Chinese savers receiving negative returns, combined with strict controls on capital outflow. China’s steady expansion is indeed led by a “silent army” of millions of anonymous citizens “with a limitless capacity for self-sacrifice”.

Through countless stories of ordinary Chinese emigrants working in the developing world for minimal salaries, without job security, contracts or medical insurance, in China’s Silent Army the authors provide readers with a first-hand, detailed and vivid account of China’s global reach.

Hypochondriac Societies

2013-03-25T17:46:17Z

Drugs for Life: How Pharmaceutical Companies Define Our Health, Joseph Dumit, Duke University Press, $23.95.

The average American is prescribed and purchases between nine and 13 prescription-only drugs per year. Overall healthcare expenditures were over $2 trillion in 2011 and are projected to reach one-fifth of the country’s GDP by 2020. Drugs For Life reveals the glaring contradiction that exists between economic policies prescribing cuts in healthcare and more effective medication, versus a continual growth in costs.

Joseph Dumit explains how marketers began to redefine the very concept of health in the 1960s, replacing the idea of inherently healthy bodies with the concepts of risk and prevention. In this new paradigm, to be normal is to be insecure. Throughout the book, Dumit unravels the corporate strategies employed by pharmaceutical companies to appropriate research and clinical trials, manipulate facts and norms and expand their market. Despite his challenge to the hijacking of public health by the private sector, the sheer size of the pharmaceutical industry means governments are compelled to let the industry conduct studies at a lower cost. Companies have taken control of research, scientific literature and advertising – bypassing regulators and healthcare professionals.

If the purpose of healthcare is no longer to reduce the need for future treatments but instead to increase that need, then the meaning of health and its relationship to business must be reconsidered.

- AS

The Sino-Tibetan Issue: Searching for a Middle Way

2013-02-26T17:34:58Z

In the run up to the 22nd session of the United Nations Human Rights Council, Kalon Dicki Chhoyang addressed the issue of Sino-Tibetan relations at the 5th Geneva Summit for Human Rights and Democracy on 19 February. This annual event gathers hundreds of dissidents, human rights victims and activists to bring urgent human rights situations to the attention of the international community.

Dicki Chhoyang was born in India in 1966 and grew up in Montreal, Canada. She began working for the Tibetan community at a young age through various development projects. Between 1994 and 2003, she studied in Beijing and lived in Tibet where she learned the local Tibetan dialect and conducted field research on Tibetan-medium higher education. She then worked for a private American philanthropic foundation that funded community development projects in Tibetans areas of the Qinghai and Gansu of China. In 2011, Chhoyang was appointed head of the Department of Information and International Relations for the Central Tibetan Administration based in Dharamsala, India.

Since 2009, over a hundred Tibetans have self-immolated in protests against Chinese rule. The self-immolations began with monks and now include teenagers, women, middle-aged parents and nomads. Tibet has been under Chinese rule since 1951, why this outbreak now?

I think there is a sense of urgency about the gravity of the situation. Eighty-six of the self-immolators have passed away since 2009. This is a clear signal from Tibetans against the repressive policies of the Chinese government in Tibet. We are losing our language, our way of life and the environment is being destroyed. It is not a new phenomenon, but the form of protest we are seeing now is a consequence of the fact that Tibetans inside Tibet have no other conventional space for protest. They tried demonstration and petition, but when you live in a police state you are silenced within a matter of minutes and never heard. Also, a lot of the self-immolators were born and raised after the Chinese occupation and have their own view as to how they want to react to China's occupation of Tibet.

Policies imposed on Tibetans are characterized by cultural assimilation, with Tibetan monasteries run by the Chinese Communist Party and the language of instruction being changed from Tibetan to Chinese. Environmental policies include a lot of mining operations and dam building without consultation with local communities and the benefits going to the Chinese government. A direct consequence of this is the forced settlement of Tibetan nomads who are being settled into simple brick houses and forced to sell their livestock and to abandon a way of life they have known for generations without planning as to how they will cope with livelihood issues once they run out of the few thousand Renminbi they have been giving when settled by the government. Thirdly, there is the economic marginalization of Tibetans with an influx of Chinese migrant workers and increasing unemployment of young Tibetans in urban areas. These are some of the causes behind the self-immolations.

Do you see a significant difference between the administration of western and central Tibet (Tibet Autonomous Region) and that of eastern areas, which are mostly incorporated into the neighbouring Chinese provinces of Sichuan and Qinghai?

Even in the so-called Tibet Autonomous Region, Tibetans do not have much more autonomy than in the east because the decisions are made in Beijing and executed locally. Each province in China is governed according to a parallel system. There is an administrative system with governor and vice-governor, and a party-system with party secretary and deputy-secretary of the communist party. The power belongs to the party structure. So even if a governor in western Tibet is Tibetan, the power lies with the party secretary who will always be a Chinese person.

Considering China's refusal to engage in open dialogue on the situation in Tibet, do you think the international community's perception of the political reality in this region is accurate?

What is important for the international community to know is that China keeps saying everything is fine in Tibet and people who are self-immolating are being incited by the Dalai clique and the diaspora. Well, if everything is fine in Tibet then why aren't they letting anybody in? The United Nations (UN), the media and foreign envoys are being denied entry. The Chinese have developed infrastructure in both urban and rural Tibetan areas. Sure, they developed the infrastructure in cities, but to whose benefit? If after all these improvements, Tibetans still feel compelled to protest against Chinese policies, it means something in these policies is misguided. What people see when they go to Tibet is a facade. The monasteries have no control over the curriculum for monks and nuns, historians cannot research any topic they want, and now they cannot even teach in Tibetan. But China wants to maintain appearances.

It is internationally unprecedented to have self-immolations on that scale as a form of political protest, and it certainly is unprecedented in Tibetan history. We have seen it in Vietnam, Tunisia, China but nowhere on the scale we are witnessing in Tibet. Right from when the immolations began, the Central Tibetan Administration* appealed to Tibetans inside Tibet not to resort to drastic measures, including self-immolation. Despite our appeals, the self-immolations have persisted. So as an administration, we feel a duty to speak up on their behalf and explain to the international community the reasons behind the self-immolations. We also have been making great efforts to appeal to the Chinese government not to respond to protests with greater repression but to listen to Tibetans. None of these people, including the administration that I represent, is challenging China's political and territorial integrity. We are not asking for independence. We are willing to remain a part of China provided we are given genuine autonomy on matters such as education, culture and religion.

Is the UN taking appropriate action with regard to the situation in Tibet?

We have seen some reactions. In November last year, UN High Commissioner for Human Rights, Navi Pillay, issued a very strong statement regarding the situation inside Tibet and foreign affairs ministries have also issued statements of concern. But it is clear that more needs to be done. I think Tibet is a very strong test of people's principles when it comes to supporting non-violence and encouraging peaceful conflict resolution, because Tibetans are faced with formidable force in China. We talk a lot about principles of non-violence and peace. These principles have to be upheld not when it is convenient, but particularly when it is inconvenient. In the context of the UN, we are asking to have China held accountable as a member of the UN and the Human Rights Council - to uphold the commitments it has made. There are 12 outstanding human rights related requests by special rapporteurs to visit China. In 2004, China agreed to have the special rapporteur on freedom of religion visit Tibet and the visit has yet to take place.

China's strategy is to turn a deaf ear to whatever the international community says about Tibet, claiming Tibet is China's internal matter. But pressure has to be sustained because I do believe China pays attention to public opinion and it can make a difference.

How do you think the situation will evolve in Tibet?

We see the interest for Tibetans to be part of China, and of course China wants Tibet to remain in China. Tibet is very strategically located and has huge amounts of natural resources. It is the origin of ten of Asia's major rivers and has various types of minerals. The last round of talks took place in 2010 and there has not been any contact since then. For us, substance is primary and we want to engage in dialogue. So if China wants envoys of the Dalai Lama, we will send them. Whenever they want to meet, we are ready to resume dialogue without pre-conditions.

As we speak, there are some misconceptions that the Chinese government is trying to perpetuate when it comes to the issue of Tibet. One is that we are seeking independence. Of course, there are two schools of thought within the Tibetan community, one is for independence and the other is for autonomy. I represent the legitimate, democratically elected leadership of the Tibetan community and our position is autonomy – just like the Dalai Lama's. But we let the people who believe in independence speak because they have the right to express their views. Secondly, it is often believed in Europe that Tibet is still a theocracy, which is not the case. The Dalai Lama devolved his political authority to the elected leadership in 2011.

During the last round of talks, at the request of the Chinese government, we submitted a document presenting our vision of autonomy. So we put it in writing in a document called Memorandum on Genuine Autonomy – also known as the Middle Way Policy – where we seek a middle-ground between complete independence and the status quo. Currently, the decision making power is centralized in Beijing, but if we look at places such as Hong Kong we see it is possible to have one country with two systems. So we believe that if there is a political will, common ground can be found.

*The Central Tibetan Administration (CTA), commonly referred to as the Tibetan Government in Exile, is based in Dharamshala, India and was established by the 14th Dalai Lama in 1959 shortly after his exile from Tibet. While its internal structure is government-like, it has stated that it is “not designed to take power in Tibet” but aims to restore freedom for Tibetans inside Tibet. The CTA's policy does not seek independence for Tibet, but proposes that Tibetan regions remain an integral part of China provided they are granted genuine autonomy.

Photo © Geneva Summit for Human Rights and Democracy

At the Crossroads of Public Health, Intellectual Property and Trade

2013-02-05T11:18:47Z

For the first time, the three global institutions dealing with health, intellectual property and trade have pooled their expertise on a study of policies needed to advance medical technologies and ensure they reach the people who need them most.

The book, Promoting Access to Medical Technologies and Innovation: Intersections Between Public Health, Intellectual Property and Trade was launched at the World Trade Organization (WTO) in Geneva on 5 February, by the heads of the three bodies. Former Swiss President, Ruth Dreifuss, who is also a former Chairperson of the World Health Organization's (WHO) Commission on Intellectual Property, Innovation and Public Health, chaired the event.

The goal of the study is ambitious, aiming to support governments – particularly in developing countries – that want to increase access to effective treatments while containing costs. A guide for policy-makers, academics and researchers, the book brings together a vast amount of analytical and factual material on medicines, technologies and innovation, in one concise volume.

“Promoting both medical innovation and access to the fruits of that innovation is indispensable for progress towards improved and more equitable health outcomes,” said Dreifuss. World Health Organization Director-General Dr Margaret Chan said the report “sets out a comprehensive and coherent inventory of legal instruments and policy options that can be drawn on to craft measures that meet national public health objectives.”

The purpose of a joint publication is to enhance the global understanding of health, including its trade and intellectual property dimensions, while providing policy-makers with sustainable solutions for effective health policies. The book looks at ways to tailor systems that encourage innovation, yielding new treatments for the diseases of the poor and ensuring sustainable and equitable access to these innovations. It also sets out the international policy framework, as well as the factors shaping that policy.

Much attention is paid to health challenges such as HIV/AIDS, malaria, tuberculosis and non-communicable diseases. The evolution of research and development as well as alternative ways of promoting innovation for neglected diseases are also explored. The study demonstrates how the way in which intellectual property rights such as patents and trademarks are obtained and managed determines access to medical technologies and innovation. Equally, trade rules (pricing policies, taxes and import duties on medicines, procurement, regulation, technology transfer, compulsory and voluntary licences) can either promote or hinder innovation and access to medicines.

While the study does not prescribe any way to deal with a country's particular health problems, it is a cutting-edge tool for decision-makers to face the evolving worldwide burden of disease. By explaining trade and intellectual property rules and their link to health in a global context to a non-specialist audience, the book unlocks complex global health problems. Ultimately, it delivers solutions to meet objectives such as the right to health and the United Nations’ Millennium Development Goals.

Photo on Frontpage © Health Poverty Action

Photo © Allied Healthcare Group

A Global Alliance for a Toxics-Free World

2013-01-24T18:35:07Z

As negotiations on a new Mercury Convention wrap up in Geneva, Richard Fuller presents the Global Alliance on Health and Pollution (GAHP), a new collaborative body tasked with coordinating resources and activities to solve toxic pollution problems in low- and middle-income countries.

The Global Alliance on Health and Pollution participated in the INC5 negotiations as an observer. Could you tell us more about GAHP and its role in addressing toxic pollution?

The Global Alliance on Health and Pollution is a newly formed organization that was created in July last year. Its membership comprises most of the large development agencies – the World Bank, Inter-American Development Bank (BID), Asian Development Bank – UN agencies such as UNEP, UNIDO and WHO (as an observer), and donor agencies such as the European Commission. The purpose of our organization is to help the developing world deal with toxic hotspots and help them to solve environmental health problems. This is a larger problem than most people are aware of. Some of the research coming out now finds that the amount of health damage caused by chemicals in toxic hotspots is as significant as that of malaria or tuberculosis.

GAHP is a collaborative organization that has Blacksmith Institute as secretariat, and the World Bank and European Commission currently taking the lead in funding resources. One of the activities of the Alliance is to expand the inventory of contaminated sites that Blacksmith had started. In about fifty countries, we have been doing site assessments in places that are potentially toxic and dangerous. In all these countries there are trained investigators - usually staff from the environmental health department of national universities – who go and visit sites and follow through on a protocol that was developed in conjunction with John Hopkins university and Mt Sinai University. It is a rapid-assessment version of the Superfund USA evaluation protocol, and aims to take enough samples of contaminants to determine if there are toxins at levels that exceed either local standards or US EPA standards, and then determine if they are in a pathway of exposure into a local population. This is the '3 P method': pollutant, pathway, population. If there are toxins at a level that is significant – usually it reaches a minimum of five times the EPA standard – and there is an affected population, then a set of data is collected that can provide the starting point for that country to be able to prioritize clean-up operations. Obviously, places where the most number of children are killed or injured should be dealt with first. The Alliance has taken on this role of helping countries in a collaborative way, reviewing and identifying these toxic problems, and assisting in clean-up.

Which standards does GAHP use to assess levels of pollution and decide which toxic sites have priority?

We can use local standards as a reference to determine if the toxin is elevated or not, but if there are no local standards for a particular country, we usually use either EU or US EPA standards. In reality, it does not matter that much which standard you use. For example when looking at lead in soil, standards differ slightly from one country to another. But this can be somewhat irrelevant for our work because most of the sites we measure have contamination levels that are well in excess of these standards anyway.

At the beginning of the final round of negotiations on the new Mercury Convention here in Geneva, David Piper from UNEP's chemical branch said that so far UNEP has mostly been trying to regulate manufactured toxic chemical substances. This time, it is focusing its efforts on mercury, a complex natural element. Do you think this affects the negotiation process in any way?

For us, the fact that mercury is an element rather than a manufactured chemical is not so important. What we are concerned about is whether humans are being damaged by exposure to toxic pollutants. There are certainly natural mercury sources in different countries which affect people who live around them. But the majority of mercury exposures are from human activities, and the largest immediate source of exposure is probably artisanal gold-mining, because mercury there is so localized and concentrated. We see our responsibility to deal with toxic hotspots that were created by humans.

What kind of outcome do you expect from the current Mercury Convention negotiations?

It seems like there is going to be quite a good document coming out of the negotiations. Some of the drafts really have some strength and are calling for substantive action, so I am hopeful. There is not much that deals specifically with cleaning toxic hotspots and the language used is mostly voluntary. But that is fine, we cannot expect governments to commit to such processes and I do not think it is appropriate to include them in a treaty anyway. It is a country's prerogative to decide how to deal with toxic hotspots, according to its own means, so a treaty does not necessarily mean there will be direct requirements to deal with the issues GAHP deals with. This treaty brings attention to the problem and that is what matters for us.

What are the main goals of GAHP for the future?

There is a long way to go. Very few countries are actually doing something about their environmental health problems. In fact, there are only three or four in the developing world. In the West, these problems have been dealt with for decades. But there are neighborhoods and towns with very serious and acute toxic hotspots, some where life expectancy is less than forty. The Alliance will work in a collaborative way to bring resources to all these places through different avenues. We will help them to learn what they need to do and implement programmes that will save lives.

Mercury is one of the problems we face, but the largest and most significant toxicant today is lead. Primary smelters take lead (Pb) ore from the ground and make lead as a raw product or as a by-product from making copper for instance, and the lead then exposes populations living around these smelters. But several times worse than this is informal battery recycling smelting or melting, which is taking place in urban centres in every city throughout the tropics. People collect used car batteries, bust them open with an axe, pull out the lead plates and melt the material that is inside so they can recover the lead. But they throw out all the lead oxide onto the ground which then spreads through the community and poisons children. The lead collected in that way provides an income for many people, but millions of people are badly intoxicated as a result. In our database of acute toxic hotspots, lead is the worst toxin, then chromium, mercury, pesticides, radionuclides and so on. But heavy metals cause the most problems.

Global Mercury Agreement to Lift Health Threats from Lives of Millions World Wide

Final Negotiations on Mercury Convention Kick Off in Geneva

Global Mercury Agreement to Lift Health Threats from Lives of Millions World-Wide

2013-01-19T17:22:49Z

Photo: During the afternoon plenary with Naoko Ishii, GEF CEO and Chairperson; Achim Steiner, UNEP Executive Director; Tim Kasten, UNEP; INC Chair Fernando Lugris, Uruguay; Jacob Duer, INC Team Coordinator, UNEP; Masa Nagai, UNEP; and Nina Cromnier, Rapporteur, Sweden.

In the early hours of Saturday morning, delegates from nearly 140 nations clinched a deal on a global Mercury Convention aiming to regulate emissions and releases of a notorious heavy metal with significant health and environmental effects. Over 900 people including government delegates, civil society groups, profit and non-profit organisations took part in extensive negotiations on complex issues such as mercury-related health impacts.

Uruguayan Chair of negotiations Fernando Lugris emphasized the significance of this achievement in the post-Rio+20 world. The Minamata Convention on Mercury – named after a city in Japan where serious health damage occurred as a result of mercury pollution in the mid-20th Century – provides controls and reductions across a range of products, processes and industries where mercury is used, released or emitted. These range from batteries, lamps and cosmetics to the mining, cement and coal-fired power sectors. The new agreement also addresses the direct mining of mercury, export and import of the metal and safe storage of waste mercury.

The Convention is the outcome of a lengthy process that started in 2009 and will be open for signature at a diplomatic conference in Japan in October. UNEP representatives are confident that the 50 ratifications required for the Convention to come into force will be achieved within the next three to four years. Initial funding to fast track action until the new treaty comes into force has been pledged by Japan, Norway and Switzerland. Support for developing countries is also expected from the Global Environment Facility[1] once the convention is operational.

Achim Steiner, Executive Director of the UN Environment Programme (UNEP) which convened the negotiations in Geneva, said: “After complex and often all night sessions here in Geneva, nations have today laid the foundations for a global response to a pollutant whose notoriety has been recognized for well over a century.”

“Everyone in the world stands to benefit from the decisions taken this week in Geneva - in particular the workers and families of small-scale gold miners, the peoples of the Arctic and this generation of mothers and babies and the generations to come. I look forward to swift ratification of the Minamata Convention so that it comes into force as soon as possible,” he said.

Chair of negotiations Fernando Lugris emphasized that the Minamata Convention is not a soft law instrument but a legally binding agreement that will become part of international environmental law. Compliance will however depend on guidance and monitoring from the Conference of the Parties (COP) to be established once the Convention comes into force.

“This treaty will not bring immediate reductions of mercury emissions. It will need to be improved and strengthened, to make all fish safe to eat,” said David Lennett from the Natural Resources Defense Council representing the Zero Mercury Working Group a global coalition of environmental NGOs “Still, the treaty will phase out mercury in many products and we welcome it as a starting point.”

Ambassador Franz Perrez of the Federal Ministry for the Environment, Switzerland said: “Switzerland, which initiated with Norway the negotiations for a mercury convention, is very pleased about this impressive success. It will help us to protect human health and the environment all over the world and is a proof that multilateralism can work when political will exists.”

The scope of the new treaty which puts in controls and also reduction measures in respect to mercury is as follows.

Products

Governments have agreed on a range of mercury containing products whose production, export and import will be banned by 2020.

These include:

Batteries, except for ‘button cell’ batteries used in implantable medical devices
Switches and relays
Certain types of compact fluorescent lamps (CFLs)
Mercury in cold cathode fluorescent lamps and external electrode fluorescent lamps
Soaps and cosmetics

Certain kinds of non-electronic medical devices such as thermometers and blood pressure devices are also included for phase-out by 2020.

Governments approved exceptions for some large measuring devices where currently there are no mercury-free alternatives:

Vaccines where mercury is used as a preservative have been excluded from the treaty as have products used in religious or traditional activities

Delegates agreed to a phase-down of the use of dental fillings using mercury amalgam.

Artisanal and Small-Scale Gold Mining (ASGM)

The booming price of gold in recent years has triggered a significant growth in small-scale mining where mercury is used to separate gold from the ore-bearing rock.

Emissions and releases from such operations and from coal-fired power stations represent the biggest source of mercury pollution world-wide.

Workers and their families involved in small-scale gold mining are exposed to mercury pollution in several ways including through inhalation during the smelting.

Mercury is also being released into river systems from these small-scale operations where it can contaminate fish, the food chain and people downstream.

Governments agreed that the treaty will require countries to draw up strategies to reduce the amount of mercury used by small-scale miners.
Nations with artisanal and small-scale gold mining operations will draw up national plans within three years of the treaty entering into force to reduce and if possible eliminate the use of mercury in such operations
Public awareness campaigns and support for mercury-free alternatives will also be part of the plans

From Power Stations to Cement Factories

The new treaty will control mercury emissions and releases from various large industrial facilities ranging from coal-fired power stations and industrial boilers to certain kinds of smelters handling for example zinc and gold.

Waste incineration and cement clinker facilities are also on the list.

Nations agreed to install the Best Available Technologies on new power plants and facilities with plans to be drawn up to bring emissions down from existing ones.

The negotiations were initially looking to set thresholds on the size of plants or level of emissions to be controlled. But it was decided this week to defer this until the first Conference of the Parties (COP) after the conventions comes into force.

Notes

Background to the fifth session of the Intergovernmental Negotiating Committee to prepare a global legally binding instrument on mercury (INC5)

Global Mercury Assessment 2013

Time to Act

[1] http://www.thegef.org/gef/

Final Negotiations on Mercury Convention Kick Off in Geneva

2013-01-14T16:25:47Z

The fifth and final round of negotiations on the establishment of an international mercury convention opened today in Geneva. The final meeting of the International Negotiating Committee on Mercury (INC5) is taking place until Friday 18 January. It is expected to culminate in the adoption of a global, legally binding treaty regulating the use of mercury from production to waste management. Almost 900 registered delegates from over 130 countries and 115 NGO representatives gathered in Geneva to address the threat posed by mercury to human health and the environment.

Since 2003, together with Norway, Switzerland has requested the initiation of negotiations under the umbrella of the United Nations Environment Programme (UNEP) for the reduction of global mercury emissions. In 2009, the international community through the 25th session of the UNEP Governing Council agreed to address mercury at the global level. In 2010, the first International Negotiating Committee on Mercury (INC1) started the negotiation process.

A UNEP Global Mercury Partnership was formalized to take immediate action to reduce the risks to human health and the environment from the release of mercury and its compounds to the environment. As of December 2012, this Partnership comprises 116 official partners, including 25 governments, 5 intergovernmental organizations, 46 NGOs, and 40 other stakeholders (global associations representing industry sectors or global civil society consortia). It has provided expertise and information for decision-makers involved in the negotiation process and is expected to oversee the implementation of the future convention on mercury.

As Tim Kasten, Head of UNEP's Chemicals Branch, explained “mercury as an element will always be with us” and the goal is to minimize to the extent possible man-made emissions of this highly toxic and volatile metal to air and its releases to land and water. Although UNEP has been involved in the negotiation of other multilateral environmental agreements (MEAs) regulating toxic chemical products in the past, it is the first time it has to deal with a natural element such as mercury which has many complexities.

Mercury is not only a local issue but one that affects all nations as a global community. It travels through air, water, the food chain, and products such as cosmetics and vaccines. Every year, about 2,000 tonnes of mercury are emitted into the atmosphere throughout the world. Artisanal and small-scale gold mining (ASGM), the production of ferrous and non-ferrous metals, and deforestation are the main sources of these emissions.

Deputy Head of UNEP Chemical Branch David Piper explained that UNEP's latest report Global Mercury Assessment 2013 indicates that the global demand for mercury is decreasing but emissions continue to increase in developing countries where ASGM is practised. Chief Environmental Scientist to the Nigerian Ministry of Environment, Abiola Olanipekun, pointed out that a lack of awareness of the dangers of exposure to mercury contributes to the levels of pollution and intoxication in developing countries. However, as industrialisation proceeds, emissions will tend to decrease with the use of better technology and pollution-control mechanisms.

Leader of the Swiss delegation H.E. Franz Perrez emphasized that developed and developing countries need to compromise on this issue. He further underlined that from the Swiss perspective, “compromising does not mean searching for the lowest common denominator, but finding together the most effective common solution to address a global challenge”. Clear obligations and commitments with regard to reducing the supply, limiting trade and phasing out products containing mercury are necessary. Financial support, access to technology and strong implementing mechanisms will be key in securing compliance with the convention.

The INC5 will report back to the 27th session of the UNEP Governing Council in a month. Chair of the INC5 Fernando Lugris said the the international community has a text to work with and the negotiating committee has a “high level of ambition”. He is confident an agreement will be reached by Friday.

Who Killed the Hippocratic Oath?

2013-01-09T16:45:03Z

Thieves of Virtue: When Bioethics Stole Medecin, Tom Koch, The MIT Press, £20.95.

Born in the 1960s, bioethics was to bring “a specific kind of analytic, moral philosophy to questions of medical care and healthcare delivery.” In this well researched book, Tom Koch explains why contemporary bioethics fails to fulfill its role – to the detriment of patients, research subjects and citizens. Under the old Hippocratic Code, medical practitioners were care givers of the individual as well as society at large. The code was idealistic and simplistic: some acts were encouraged and others – such as abortion or euthanasia – prohibited. But the clinical, environmental and social elements of the Hippocratic vision also provided a guide as to how health could be promoted. It was left for societies to find the balance between economic constraint and human necessity.

In the late 19th century, however, the focus shifted from patient care and communal responsibility to individual autonomy and economic efficiency. Practitioners were elevated to authoritative positions as medical judges, including the power to decide whether to give, withhold, withdrawor continue care. The new goal of medicine through fundamental research became “the definition of the acceptable person within a population whose composition could be controlled to the advantage of the state and its economies.”

Borrowing from Confucius, Koch warns us against “thieves of virtue” –bioethicists who promote as universal a perception of medical ethics whose end is moral action. They teach, write, advise hospitals and review boards, and generally serve as “surrogates of the general public” when ethical issues arise in practice and research. While bioethicists present the scarcity of medical services as natural, Koch argues that scarcity is the predictable result of “economic choices and political decisions made with full knowledge of the dire consequences.” Scarcity disappears when the US Congress votes to fund dialysis as a national entitlement, or when local healthboards argue for urban sanitation and preventive measures against epidemics.

As political actors and social participants, bioethicists shape health policy. Their assumptions define life, health and normalcy; the care or non-care of persons depends on their perspective on the human condition. Through various case studies, Koch explains that bioethicists can – and do – regularly deny care for those with limiting cognitive, physical or sensory attributes, advocating the right to die as an individual choice rather than the right to live with dignity despite difference.

Koch’s critique is an appeal for a transformed medical ethics that is humanist, responsible, and defensible. A fundamental question to be revisited is whether we understand society as an economic enterprise in which patients are consumers, or a “social covenant in which all are able to participate…irrespective of their physical abilities.”

- AS

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A Swiss 'Google Tax'?

2012-12-03T17:24:52Z

As the landmark World Conference on International Communications (WCIT-12) begins in Dubai, the Swiss Social Democratic Party is devising bold propositions to defend democracy, media pluralism and freedom of expression for digital media and the press. Taking cues from France and Germany, Switzerland is targeting Google as a subject of public regulation. In an interview with the Swiss magazine Edito+Klartext, former President of the Social Democratic Party of Switzerland, Hans-Jürg Fehr, outlined these propositions.

Despite the fact that a concentration of media outlets diminishes the diversity of viewpoints, the Swiss Federal Council decided in June 2011 to let market forces regulate the media. Determined to defend smaller and new media outlets – both press and digital – the Chambers decided to mandate the Federal Council to devise a media policy within two years. New economic models are now sought in order to replace the ordinary direct and indirect subsidies granted to the media, which have failed to guarantee the viability of many actors.

As financing the media remains the focal point, a new model is currently being discussed by the Social Democratic Party. Unlike previous approaches, this model does not rely on taxpayers' money, but instead seeks solutions within the system.

Hans-Jürg Fehr explained the concept of a fund to provide financial support to online media based on two main forms of tax.

The first tax would target advertising revenue, amounting to 1-2 percent of the proceeds received by the media. It would be similar to a VAT and easily collected by cantons through telecommunications operators. Hans-Jürg Fehr emphasized that “implementing this system would only require a fund and a commission that would manage and distribute the money raised to media eligible for financial support.”

Another tax would target bandwidth usage and would apply to content senders. Such a tax would be paid by Google and other search engines as a contribution to media content generating bandwidth consumption. Swiss telecommunication operator Swisscom already confirmed that it is technically possible to identify the server from which data is sent. If this tax were to be implemented, state subsidies to the press would become superfluous and could be used as a subsidiary source of financing.

As Hans-Jürg Fehr pointed out, “what matters is that the current 'paying receiver' system would be replaced by a system where big monopolies such as Google would pay.”

These propositions potentially represent global solutions to some international communications challenges. They address systemic hardships faced by online media and would benefit all media – unlike subsidies granted to specific categories. Most importantly, it would ensure a more equitable cost distribution between content producers, Internet users and major industry players.

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