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Canada’s New Government Should Reject the TPP Agreement in its Current Form

As it currently stands, the TPP text pushes beyond the rules of the WTO TRIPS Agreement  with the effect of further limiting the room for manoeuvre that countries need in order to protect the public good, including by trying to achieve non-discriminatory, affordable access to medicines. Instead of accepting the TPP provisions in their current form, Canada should demonstrate international leadership and honour its repeated commitments to global health, including access to medicines

Richard Elliottt

By Richard Elliott

Executive Director Canadian HIV/AIDS Legal Network, Toronto

Canada’s New Government Should Reject the TPP Agreement in its Current Form

 

On 5 November 2015, the text of the Trans-Pacific Partnership (TPP) Agreement was finally made public. Running to more than 6000 pages, it raises a host of grave concerns about its impact on everything from environmental protection to labour and other human rights, from internet privacy to food safety… and much more, including access to affordable medicines.

Before the final text was released, alarm bells were already ringing: for example, Médecins Sans Frontières has called the TPP “the most harmful trade pact ever for access to medicines” – and not just for those in the negotiating countries, but for many more, since the TPP is being billed as a model for future trade agreements across the globe.

What’s the Threat?

As outlined by the Legal Network and several other NGOs in an open letter to the newly-elected Liberal government, various aspects of the TPP are cause for concern when it comes to access to medicines:

  • New intellectual property (IP) rules on patents, as well as rules on “data exclusivity” over information submitted to get marketing approval of drugs, would be even more restrictive than what already exist at the World Trade Organization (WTO). These would further impede and delay the competition from generic drugs that is key to pushing down prices and therefore making medicines available to many more people. In addition, new, harsher provisions on enforcement of private IP rights would be available to big pharma to try to undermine competition – including injunctions, higher damages for patent infringement, and various border measures that could interfere with transit of legitimate generic medicines based on mere suspicion of infringing intellectual property rights claimed by big pharma.
  • So-called “transparency” provisions would create more opportunities for drug companies to challenge governments’ decisions about reimbursing medicines under public health insurance programs, while also allowing more direct marketing to consumers by drug companies. In the Canadian context, this would create an additional hurdle to overcome in eventually creating a truly national, equitable pharmacare programme, which has been a long-standing and major gap in the country’s system of public health insurance.
  • Finally, the TPP would expand so-called “investor-state dispute settlement” rules to cover IP rights. This would allow drug companies to sue governments if they interfere with companies “expectations of profit” through public interest laws or regulations on things such as patents, the use of data submitted in getting marketing approval for drugs, and setting prices of pharmaceuticals, including the prices at which drugs are covered under public health insurance plans. Canada is already facing the world’s first such suit by the pharmaceutical company Eli Lilly, which is attempting to push into new territory the interpretation of similar provisions in the North America Free Trade Agreement (NAFTA) – in which the company seeks to force changes to well-settled principles of patent law in Canada after two courts ruled two of the company’s patents were invalid because the product in question did not live up to the scope of the patent claimed. This is an unprecedented proceeding in seeking to expand investor-state dispute settlement provisions to IP claims; now the text of the TPP would give an explicit green light to such mischief, in a wider array of countries, with yet more of a chilling effect on the ability or willingness of governments to regulate in the public interest.

Time for Action

But there’s still time to head off this disaster for public health and human rights.

The TPP has to be ratified and implemented by the 12 negotiating countries before it takes effect.This makes it all the more critical that governments hear from the public, whose rights, health and lives will be affected by the TPP’s provisions.

This includes the new government in Ottawa. While PM Trudeau and the Liberal Party have stated support for the TPP in principle during the election, the party also declared that “it must keep its word and defend Canadian interests during these negotiations.”

Those interests clearly include access to affordable medicines. Canadians already pay some of the highest drug prices in the world and spending on pharmaceutical products is one of the three largest elements of our overall health care spending, year after year. No wonder, then, that Canadians have repeatedly expressed their opposition to longer patents for drug companies.

“Canadian interests” also include a commitment to ending the tragic global gap in access to medicines, particularly burdensome for developing countries facing multiple major public health challenges – including, but not limited to, HIV. This commitment was reflected in the widespread support – including from 80% of Canadians polled – for fixing the flaws in Canada’s Access to Medicines Regime (CAMR). Such fixes were, and are, needed so that the regime could deliver on Parliament’s previous unanimous pledge (a decade ago!) to support developing countries in getting more affordable, generic medicines.

Sadly, a bill to fix CAMR was narrowly defeated by the previous government in the last Parliament – and while the new government has not yet specifically committed to supporting those reforms again in the new Parliament (as it did previously), it did declare during the election that “there is no question that we need to get more low-cost medicines and other essential medical supplies and equipment to people in developing countries.”

Canada’s new government should not only fix the existing flawed CAMR, but also reject the TPP in its current form. The agreement’s provisions stand in direct contradiction to the goals of improving access to medicines, for Canadians and for people in developing countries. Canada should:

  • commit to a full public consultation on the TPP, including an independent assessment of its impact on human rights (including access to medicines), among other concerns;
  • refuse to ratify the TPP as long as it contains any “TRIPS-plus” provisions that exceed the already-restrictive rules on intellectual property that have been adopted at the WTO; and
  • reject any deal that extends the discredited, damaging “investor-state dispute settlement” system to cover intellectual property or other laws and regulations affecting pharmaceuticals, as this would enable pharmaceutical companies to impede regulation of this sector in the public interest.

————————————————————————–

 

Related articles:

TPP: Up With Corporate Profits Outweighing Equity in Health!
http://www.peah.it/2015/11/tpp-up-with-corporate-profits-outweighing-equity-in-health/

Impact Of The TPP On The Pharma Industry http://www.ip-watch.org/2015/12/02/impact-of-the-tpp-on-the-pharma-industry/

TPP Strengthens Controversial IP Arbitration http://www.ip-watch.org/2015/11/30/tpp-strengthens-controversial-ip-arbitration/

US ITC notice for public comment, Jan 13, 2016 hearing, and Commission report on the TransPacific Partnership Agreement (TPP) http://www.keionline.org/node/2371

 

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South Africa’s NHI, a Spark of Hope for Health

South Africa's achievements towards a National Health Insurance (NHI) whole country system implementation need strengthening now that only 17 per cent of the population can access well sourced private health services, whereas most people have to rely on understaffed and overstretched public facilities. A refined NHI-related white paper, reportedly close to presentation to Cabinet for approval could be a milestone for all South Africans’ non-discriminatory access to health

Pietro_picture-150x150

by Pietro Dionisio

Degree in Political Science, International Relations

Cesare Alfieri School, University of Florence, Italy

South Africa’s NHI, a Spark of Hope for Health

 

The path towards a National Health Insurance (NHI) is fundamental to South Africa’s people. Indeed, South Africa’s history of reforming health care financing system dates back to the year 1928 when a “Commission on Old Age Pension and National Insurance” was established aiming at the constitution of an insurance scheme covering medical, maternity and funeral benefits for all low- income formal sector employees in urban areas.

Unfortunately, while the country is home to 53.4 million people with a 0,78 per cent annual growth rate in 2015, the achievement of Universal Health Coverage (UHC) remains a difficult task for three main reasons at least:

  1. At a time when the expenditures in either the private or public health sector are roughly the same (about R100 billion each, 9 per cent GDP overall), inequity is in the coverage since apartheid institutionalized social distortions are not easy to root out and the health system is divided too. Only a minority of the population (nearly 17 per cent) can access well sourced private health services, whereas who cannot (approximately 83 per cent) are forced to rely on understaffed and overstretched public facilities.
  2. Health scourges place a burdensome pressure on the health system since HIV/AIDS and tuberculosis are still leading causes of death now that maternal, neonatal and child mortality rates are high and Non Communicable Diseases (NCDs) are rising.
  3. South Africa is a middle-income country but after years of economic roller coaster (GDP contracted an annualized 1.3 per cent in the second quarter of 2015 over the previous quarter), doubts emerge as to the Government capacity to finance a health system reform requiring amazing infrastructural transformation and not only.

Since recent years the Government has been lavishing efforts aimed at the establishment of a national health insurance scheme. In this regard, a “Green Paper”, published in 2011, mapped out a two-phase strategy to move towards UHC over a 15-year period.

The first phase emphasized on how to make headway in improving the management and quality of (and access to) public, particularly primary care level, health services.

The second phase was intended to introduce a strategic purchasing mechanism by establishing a semi-autonomous National Health Insurance Fund (NHIF) whose sources would be pooled through general tax revenues and additional earmarked, pay-roll and pre-payment taxes.

In the Government’s vision, the introduction of a “National Health Insurance” (NHI) would help  improve access to quality health care services and provide financial risk protection against health-related catastrophic expenditures for the whole population.

What’s more, the “Green Paper” encourages the creation of a system whereby public and private providers would collaborate in supplying health services, health promotion and illness prevention.

Coherently, South Africa’s health Minister Aaron Motsoaledi steadfastly insisted on the implementation of NHI. In a related speech, delivered on 31 May 2011, he showed strong political will by stating that:

“The problem is that many believe that NHI is just the release of a document. For us in health, we know that it also involves an extensive preparation of the health care system while at the same time preparing a policy document and in this case, the reengineering of the Health Care System is very vital.”

Since then, NHI was introduced in 10 pilot districts which are still making headway in improving primary health care  through three kinds of working teams:

  1. School health teams including nurses at schools and mobile vans to check pupils’ eyes, ears and teeth;
  2. Ward-based outreach teams staffed by door-to-door nurses and community health workers aimed at safeguarding the health of pregnant women and children under five while educating people on healthy living;
  3. District medical specialist teams, made up of health experts tasked with supporting health workers, particularly clinic nurses.

These teams collaborate with each other to prevent hospitalization by finding out most vulnerable people to sickness and decentralizing the delivery of medicines for chronic illnesses from hospital pharmacies to more convenient places, including schools and private pharmacies.

Despite efforts, one of the problems South Africa still faces as regards implementation of the pilot projects above is drawing general practitioners-GPs (whose services will be essential for making public health facilities scale up performances) into actively working for public clinics. Fewer than 200 of the 8,000 GPs working in private practice have agreed to work in public clinics since the NHI pilot program was launched.

In the face of this, Dr. Motsoaledi recently declared that the Government would supply 180,000 hours to clinics in 10 pilot districts during the 2015/16 financial year so as to encourage private sector doctors to work in public clinics.

According to South Africa’s making law process, the 2011 “Green Paper” stands as a discussion document. Hence, while giving an idea of the general thinking that informs health policy, it was published for comment, suggestions or additional ideas. Hereinafter, a more refined document, a white paper, had to be drafted. This is what the South African people are waiting for.

As per Dr. Motsoaledi’s recent words, the long awaited white paper is finished now and will be presented to Cabinet for approval soon:

“We have completed with it, we have discussed with treasury , the next nearest space I get which cabinet says you are ready you can come in, I go there and present it chairperson and after presenting it to cabinet the very next day I will present it to the nation”.

The patience of South Africans will probably be rewarded shortly.

Concerns remain about the sustainability of the whole project, but Dr. Motsoaledi’s policy has to be considered positively. Definitely,  the efforts spent are producing results and the path taken might be the right one.

A little more persistence, a little more effort, and what seemed hopeless failure may turn to glorious success, in the words of Elbert Hubbard.

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TPP: Up with Corporate Profits Outweighing Equity in Health!

The TPP case just represents the tip of the iceberg for the underhanded tactics to ensure that countries accept IP clauses that go beyond the full extension they have a right to under the WTO’s TRIPS. This context entails that TPP involved governments should, as per MSF words, “….carefully consider before they sign on the dotted line whether this is the direction they want to take on access to affordable medicines and the promotion of biomedical innovation...”

MINOLTA DIGITAL CAMERA

by Daniele Dionisio*

Policies for Equitable Access to Health – PEAH

TPP: Up with Corporate Profits Outweighing Equity in Health!

 

On 5 October 2015, ministers from Pacific countries clinched hard-fought, five-year Trans-Pacific Partnership, or TPP, trade agreement negotiations as the largest pact of its kind outside the World Trade Organization (WTO). The 12 countries involved – Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, the United States (US), and Vietnam – are home, indeed, to almost 800 million people and represent nearly 40 percent of the global economy.

The talks were promoted by the US to enhancing free trade in the Pacific realm by addressing global trade issues (including piracy and counterfeiting) and raising standards by taking into account the implications for the multilateral trade system and the different economic levels and needs of participating countries.

Disappointingly, the negotiations were shrouded in unprecedented lack of transparency and unbalanced secrecy level, whereby, as reported [here] and [here], the public was frozen out, US Congress members were severely limited in their access to treaty-related documents at a time when pharmaceutical and content industries sat on the IP advisory committee as corporate representatives, while smaller innovators and generics companies did not.

As such, it is unexpected news that, under recent decision by the federal district court in Manhattan, the Office of the United States Trade Representative (USTR) has been ordered to provide justification for withholding from a Freedom of Information Act request the communications with its industry advisors as confidential commercial or financial information in the lead-up to TPP agreement completion.

On 5 November 2015, the full text of the agreement was released by TPP Parties. Now it will have to be public for several weeks or months before being considered by the domestic parliaments of participating economies for ratification, implementation and, finally, entry into force.

Yet, the road ahead remains an arduous one given allegations that the agreement serves the interest of the wealthiest, caters to the needs of big industry rather than the citizens of member nations, and protects monopolistic interests now that, on a world scale, corporate profits outweigh any commitment to the global human rights  and equitable access to health [here] [here] and [here].

As argued, … The Obama Administration’s most important objective in this [TPP] negotiation was to raise the prices for drugs, vaccines and medical devices, worldwide, and they have no doubt achieved that objective, albeit not to the degree that meets every single one of the pharmaceuticals and medical device company asks….

A case in point, the minimum period for exclusivity data protection on biologic drugs was an harsh contention area in the final TPP negotiation days owing to the profit  interests of a number of corporations (e.g., Pfizer Inc, Roche Group’s Genentech and Japan’s Takeda Pharmaceutical Co, among others) relevant to state-of-the-art vaccines, anti-toxins, blood or blood products for transfusion, gene therapies, and cellular therapies.

As contended …..the real truth to the matter is that biologics are in the TPP because they represent big money for pharmaceutical companies as new chemically synthesized drugs offer less of a chance for “blockbuster” drugs than biologics. The global biopharmaceuticals market was valued at US$161,851.6 billion in 2014 and is expected to expand at  rate of 9.4 per cent to reach US$278,232.9 billion by 2020. Other studies believe the global market biologics will reach $386.7-billion by the end of 2019. Further, biologics are expected to account for approximately 17 per cent of total global spending on medicines by 2016 and reach an overall market value of $200 billion to $210 billion in 2016, up from $157 billion in 2011. Biologics provided roughly 22 per cent of the Big Pharma companies’ sales in 2013, will likely rise to 32 per cent by 2023. While promising in their potential to treat diseases ranging from cancer to rheumatoid arthritis, such drugs are significantly costly, with the Brookings Institution finding that these can cost up to 22 times the price of chemical drugs.

Unfortunately, though developing “biosimilars” (as “follow-ons” to an original biologic) would dramatically knock prices down, the US 12- year exclusivity data protection law currently makes that biosimilars cannot be approved during the period if they rely on the data used for the original biologic.

Relevantly, though the standing power of their counterparts has forced the US negotiators to fall short of demand and accept TPP rules that allow for a minimum five-year standard to eight years of data protection, regrettably, as stated,.… this is still the longest term of data protection ever enshrined by treaty, and will unquestionably hurt developing countries.

No surprise, the Big Pharma lobby and its Congressional supporters were unhappy with the TPP terms above. Does unhappiness explain why the US  has opposed a LDC Group’s request for an indefinite exemption from trade rules on pharmaceuticals?

The TPP deal has been dubbed as being transformational not just for the Asia-Pacific region, but also for the global economy at a time when, with new membership requests seemingly in the offing, the TPP terms are feared to influence still underway trade deals such as, among others, the EU-US Transatlantic Trade and Investment Partnership (or TTIP), and the EU-Japan, EU-India FTA negotiations.

As for India case, the concerns definitely outweigh optimism now that an ongoing breakthrough of multinational drug corporations in the country couples with protectionist US and EU policies, with India’s obligations as a WTO member, and with pressures on India’s government towards adopting IPRs beyond the Trade-Related Aspects of Intellectual Property Rights Agreement (or TRIPS) and strengthened enforcement mechanisms as the keys to foreign investments and innovation.

Overall, these circumstances put India’s freedom in jeopardy  as an independent  provider of affordable medicines for domestic and resource-limited countries’ needs

Relevantly, the chapter 18 (Intellectual Property) in the agreement confirms that, in spite of some lip service, the US has been pursuing a TRIPS-plus, corporations friendly policy over TPP negotiators  even though, just in the aftermath of the clinched pact, the USTR office stated that the IP chapter “reaffirms Parties’ commitment to the WTO’s 2001 Declaration on the TRIPS Agreement and Public Health, and in particular confirms that Parties are not prevented from taking measures to protect public health, including in the case of epidemics such as HIV/AIDS” .

Admittedly, the chapter largely grounds on TRIPS-plus measures including patents for new uses (the so-called ever-greening), granting of patents on medicines even in the absence of improved therapeutic effects, data/regulatory monopolies on clinical trial data (data exclusivity), patent term extensions (supposedly to compensate patent holders for delays in getting regulatory  approval), as well as enhanced mandatory injunctions for patent infringement and strong border measures.

As such, IP protection enforcement provisions, which make up a broad section of IP chapter, not only re-present but even exacerbate the provisions from the shelved ACTA treaty.

As would be the case for counterfeit trademark goods that are meant to be, for IP chapter purposes, .. any goods, including packaging, bearing without authorization a trademark that is identical to the trademark validly registered in respect of such goods, or that cannot be distinguished in its essential aspects from such a trademark;….

As regards the sectors to packaging and labelling of medicines, the impending threat of the definition above binds up with its potential to affect the patent holders’ access to the market at a time when the legislation against counterfeit and substandard medicines too often does not address quality issues, but instead is aimed at protecting the commercial interests of brand-name manufacturers.

Under these circumstances, it would make it easier for a claim to be lodged by the right holder against an infringer or alleged infringer for nullifying or eroding benefits by applying packaging and labelling models that, despite fair trading and full alignment with TRIPS requirements, are deemed to be insufficiently distinguishable or fraudulent.

The IP chapter enforcement provisions also contend that…. each Party shall provide that, in civil judicial proceedings concerning the enforcement of an intellectual property right, its judicial authorities have the authority, on a justified request of the right holder, to order the infringer or, in the alternative, the alleged infringer, to provide to the right holder or to the judicial authorities, at least for the purpose of collecting evidence, relevant information…. regarding any person involved in any aspect of the infringement or alleged infringement and the means of production or the channels of distribution of the infringing or allegedly infringing goods or services, including the identification of third persons alleged to be involved in the production and distribution of the goods or services and of their channels of distribution.

As such, TPP targets third parties by exposing them to the risk of punitive action also in trademark and patent infringement allegations.  As regards non-discriminatory access to medicines, this could play as an unfair deterrent to anyone engaged in the production, sale and distribution of affordable, high quality generic medicines including treatment providers like MSF, suppliers of active pharmaceutical ingredients used for rolling out generic medicines, as well as distributors and retailers who stock generic medicines.

Moreover, as regards border measures and criminal procedures and penalties relevant to products under infringement allegations, IP chapter terms appear unreliably vague or extortionate when stating that:

-Each Party shall provide that its competent authorities may initiate border measures ex officio [i.e., without the need of a formal complaint from a third party or right holder] with respect to goods under customs control that are: (a) imported; (b) destined for export; or (c) in-transit and that are suspected of being counterfeit trademark goods…

– Each Party shall adopt or maintain a procedure by which its competent authorities may determine within a reasonable period of time after the initiation of the procedures…whether the suspect goods infringe an intellectual property right.

– If a Party requires identification of items subject to seizure….., that Party shall not require the items to be described in greater detail than necessary to identify them for the purpose of seizure….

Furthermore, the Damocles’ sword of an investor state system enforcement as regards access to medicines cannot be underestimated since USTR office terms clearly state that “the dispute settlement mechanism created in chapter 28 [of the agreement] applies across the TPP, with few specific exceptions”.

Consequently, being not explicitly excused from, the chapter 18 (Intellectual Property) is undoubtedly subject, as just argued, to the dispute settlement mechanism whereby private companies located in the territory of any TPP disputing Party are allowed to sue governments directly for policies the governments take.

In this regard, many forms of government regulations, including price cuts of medicines, could be argued not to conflict with the TRIPS agreement, yet to make pointless or erode the expectations of the patent owners.  Relevant risk sectors also include tariffs on medicines, as would be the case should a country that has agreed to reduce tariffs on an imported product later subsidize home manufacturing of the same medicine. A complaint against this country under an investor state system would be allowed to re-establish the conditions of competition in the original transaction.

These prospects appear ominously alarming  and compound fear that the afterglow from the TPP’s completion could lead other trade initiatives on a world scale to adopt “investor-state mechanism” friendly terms.

Last but not least, while TPP focuses on expanding IPRs and defends market-driven rather than needs-driven rules, it, as reported, …also fails to give attention to innovative approaches to stimulating R&D for new drugs, vaccines and medical devices that delink R&D costs from product prices. Such new approaches would ensure the development of needed new treatments at affordable prices.

Taken together, all insights here suggest that the TPP case just represents the tip of the iceberg for the underhanded tactics to ensure that countries accept IP clauses that go beyond the full extension they have a right to under the WTO’s TRIPS.

On these grounds, what expectations now that US pressure  will certainly force through its position to allow the TPP to be ratified by the national parliaments, hence undermining access to  care and lifesaving medicines for millions of people in resource-constrained settings?

This context entails that TPP involved governments should, as per MSF words, “….carefully consider before they sign on the dotted line whether this is the direction they want to take on access to affordable medicines and the promotion of biomedical innovation. The negative impact of the TPP on public health will be enormous, be felt for years to come and it will not be limited to the current 12 TPP countries, as it is a dangerous blueprint for future agreements.”

 

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*Daniele Dionisio is a member of the European Parliament Working Group on Innovation, Access to Medicines and Poverty-Related Diseases. He is an advisor for “Medicines for the Developing Countries” for the Italian Society for Infectious and Tropical Diseases (SIMIT), and former director of the Infectious Disease Division at the Pistoia City Hospital (Italy). Dionisio is Head of the research project PEAH – Policies for Equitable Access to Health. He may be reached at d.dionisio@tiscali.it http://www.peah.it/ https://twitter.com/DanieleDionisio

 

 

Acqua e Servizi Igienici: in Kenya un Miraggio per Molti

Il libero accesso a fonti di acqua potabile e ad idonei servizi igienici è un diritto universale. Sfortunatamente, la realtà che riscontriamo ci racconta una storia diversa. Milioni di persone muoiono ogni anno per le difficoltà che alcuni Governi riscontrano nel garantire tale diritto. Il Kenya è fra questi. Molto è stato fatto da questo Governo, ma maggiori sforzi devono essere profusi

Pietro_picture-150x150

by Pietro Dionisio

Degree in Political Science, International Relations

Cesare Alfieri School, University of Florence, Italy

Acqua e Servizi Igienici: in Kenya un Miraggio per Molti

 

Una questione internazionale

La disponibilità adeguata di acqua potabile e di servizi igienici rappresenta un elemento basico per potere garantire un livello di salute dignitoso ad una popolazione. La mancanza di tale fornitura di servizi è alla base delle ricorrenze infettive che affliggono milioni di persone nei Paesi poveri. A farne maggiormente le spese è la fascia infantile spesso colpita da forme gravi di diarrea dovuta a mancanza di igiene o di acqua potabile; le stime parlano di circa 1,5 milioni di minori che ogni anno muoiono per infezioni correlate.

Tale questione è sentita come di vitale importanza dalla comunità internazionale. Negli ultimi anni i governi, anche dei Paesi in via di sviluppo, hanno cercato di promuovere politiche atte alla risoluzione del problema. E le Nazioni Unite, prima con gli MDGs (Millennium Development Goals), e poi con gli SDGs (Sustainable Development Goals), hanno posto un forte accento sull’argomento dimostrando come il garantire un facile accesso ad acqua potabile e opportuni servizi igienici non sia un mero esercizio retorico ma una volontà pratica e concreta.

L’interesse su tale argomento è ovvio solo prendendo in considerazione gli effetti positivi che conseguirebbero ad un impegno coerente per colmare il gap. Se i governi afflitti da questa piaga investissero nel settore, avrebbero la possibilità di recuperare l’investimento ottenendo una popolazione più sana e quindi più produttiva. Inoltre, il capitale umano a disposizione ne risentirebbe positivamente poiché i minori avrebbero la possibilità di accedere allo studio e alla frequenza scolastica, mentre la conseguente riduzione dei livelli di povertà in una popolazione più sana comporterebbe la flessione della spesa sanitaria pubblica.

Ne risulterebbero volumi di risparmio che potrebbero essere spesi in consumi interni così da produrre un ulteriore beneficio economico.

Sfortunatamente, queste prospettive non sono alla portata di tutti. Oggi, sebbene a livello mondiale il target MDG relativo all’accesso a fonti di acqua potabile sia stato raggiunto, ancora alcune regioni faticano a garantire tale diritto.

Il caso Kenya

La regione Sub-Sahariana è una di queste. In essa, solo il 68% della popolazione ha accesso ad acqua potabile, e molti Stati stentano a garantire questo diritto.

Il Kenya non è da meno. Su una popolazione complessiva di circa 47 milioni di persone, il 38% non ha accesso ad acqua potabile e il 5,3% delle morti totali è riconducibile ad infezioni contratte tramite l’assunzione di acqua contaminata o  per mancanza di consoni servizi igienici. Per decenni, la scarsità di acqua è stato uno dei principali problemi del Paese. Frequenti siccità, un sistema idrico insufficiente, una deforestazione indiscriminata, la contaminazione dell’acqua a disposizione, il tutto unito ad un aumento della domanda dovuto all’incremento della popolazione, hanno fatto sì che il problema assumesse proporzioni considerevoli.

Negli ultimi quindici anni il governo Keniota ha cercato di superare il deficit ma ad oggi, sebbene qualche miglioramento sia stato ottenuto, ancora molto deve essere fatto.

Come accennato, gli sforzi promossi sono stati notevoli: ne sono esempi il “Water Act 2002” e la “Costituzione del Kenya del 2010” dove all’Art. 43.1 e all’Art. 56 si fa esplicito riferimento alla volontà di garantire a tutti l’accesso a quantità adeguate di acqua potabile e servizi igienici e sanitari.

Le politiche implementate hanno portato ad un miglioramento della situazione. I dati riferiti dal Governo Keniota affermano come dal 2008 al 2013 la proporzione di popolazione che ha accesso a fonti di acqua potabile sia cresciuta dal 59% al 62% e, sempre nel 2013, è il 55% della popolazione rurale che riesce ad approvvigionarsi a fonti di acqua sicura.

L’impegno del Governo è considerevole. Gli obiettivi che le varie strategie si propongono di raggiungere riguardano l’ottimizzazione della gestione dei lavori e dei piani di investimento, l’aumento dei fondi da destinare al settore, la promozione di interventi volti a garantire fonti idriche e igieniche per i gruppi più svantaggiati (soprattutto nelle zone rurali), e l’aumento di lavoratori formati per potere sviluppare il settore stesso e rendere le riforme sostenibili nel lungo periodo.

Oltre a questo, il Governo Keniota è impegnato nella costruzione di un serie di dighe così da incrementare l’approvvigionamento idrico mediante progetti quali, ad esempio, il “Background-Badasa Dam Project”, il “Maruba Dam Project”, il “Chemususu Dam Project” e il “Umaa Dam Project”.

Questi progetti fanno seguito al “Mwache Multipurpose Dam Project” del 2014 le cui finalità sono molteplici. L’obiettivo principale è la costruzione della diga, quale prerequisito per la realizzazione  di infrastrutture idonee a migliorare la fornitura di acqua e servizi igienici nelle contee di Mombasa e Kwale, e per l’ottimizzazione dell’intero sistema di irrigazione locale.

Una agenda da ampliare

Nonostante tutti gli sforzi profusi, non è ipotizzabile che un Governo possa considerarsi soddisfatto se il 38% della sua popolazione ancora non ha accesso ad acqua potabile e ad appropriati servizi igienici. Purtroppo la realtà del Paese ci racconta una storia dove gli investimenti nel settore non possono assolutamente ritenersi sufficienti e dove il gap tra offerta di fondi e la domanda fa sì che ci sia più di un dubbio circa il mantenimento dei servizi esistenti. Tali presupposti ci possono solo fare immaginare le problematiche che il Governo incontra  per l’implementazione di nuovi progetti!

Al fine di garantire un miglioramento del persistente deficit attuale alcune misure sarebbero richieste. Un maggiore coinvolgimento della comunità internazionale potrebbe garantire fondi più consistenti.  L’apporto congiunto di politiche più chiare e di una strategia più definita, renderebbe il miglioramento del settore un obiettivo realmente conseguibile.

In aggiunta, il sistema di valutazione e monitoraggio dovrebbe essere rafforzato al fine di realizzare efficaci politiche di intervento ad hoc.

Nel contempo dovrebbero essere poste in atto permanenti campagne informative per la popolazione al fine di infondere consapevolezza sui rischi connessi alla assunzione di acqua non potabile.

In conclusione, se i progressi conseguiti ad oggi dal governo Keniota, certamente considerevoli,  fanno ben sperare per il futuro, è chiaro che ulteriori energie devono essere profuse affinché il libero accesso ad acqua potabile e a servizi igienici, quale diritto inalienabile di ciascuno, sia davvero garantito!