The BRICS countries: a new force in global health?
Diverse in profile, but unified in purpose. Andrew Harmer tells Fiona Fleck why the BRICS countries' approach to health is different. Q: The term BRIC was coined by a Goldman Sachs analyst for four big emerging economies, Brazil, the Russian Federation, India and China, in 2001. Why has the group--with South Africa added in 2010--embraced the term? A: Goldman Sachs was not the only one to realize that these four economies were way ahead of the others, but they didn't meet as a group until 2006 and only held their first formal summit in 2009 in the Russian Federation to discuss the global economy and reform of global financial institutions, their primary concerns. Academics started looking at these countries as a group from early on, so in some ways there may be a sense of self-fulfilling prophecy in their formation. They now meet regularly and, although they have never actually signed a document saying are the BRICS, they seem quite happy with the term. Q: When did the BRICS countries start discussing health? A: Health appears for the first time as a discussion point in the Sanya Declaration at the 3rd BRICS Summit in 2011 in China, with regard to HIV/ AIDS. Since then the group has held annual meetings devoted to health, with the first meeting of the BRICS health ministers hosted by the Chinese in Beijing in July that year. In 2012, the BRICS health ministers also decided to meet every year on the side-lines of the World Health Assembly. Q: How did you become interested in researching this area? A: The BRICS countries were being discussed, but there was very little published on their role in health. It was an obvious area to explore. What interested me most was the extent to which they were acting as a unified bloc: looking at what they were doing, compared with the rhetoric, was fascinating. It's fascinating to see a new centre of power emerging in global health with a new set of priorities that contrast with the dominant western health development paradigm. This is seen in their efforts to promote multilateralism in health, in contrast to the United States, for example, that is keen to pursue bilateral relations. In 2012, the BRICS countries announced they would create a new development bank with a start-up capital of US$ 50 billion, eventually increasing to US$ 100 billion, and a BRICS Contingency Reserve Arrangement, which would be a US$ 100 billion fund to steady currency markets. These two projects are expected to be finalized at their next summit in Brazil in July this year. Q: On which health areas do these five countries work together most? A: They have committed themselves to promoting certain health issues above others. In some ways their priorities are different to the priorities of the Organisation of Economic Co-operation and Development (OECD) countries. At their first meeting of health ministers, they discussed four priorities: strengthening their domestic health systems, primarily by developing and ensuring access to health technologies, the double burden of infectious and noncommunicable diseases (NCDs), support for international organizations, such as WHO and UNAIDS as well as global health partnerships, and promoting technology transfer to developing countries. There is a lot of interest in intra-BRICS health cooperation. The health ministers referred to this last year at the 3rd health ministers' meeting in Cape Town. Soon, we may have a new development bank doing development differently to the World Bank. Other than that and supporting international organizations and health partnerships, there are few tangible examples of the BRICS countries working together on health. Q: How are the BRICS countries facing up to the problem of NCDs? A: With the exception of South Africa, NCDs are the biggest problem facing these countries and the incidence of NCDs is increasing, even as infectious diseases are being brought under control. …