1. Promoting Equity through Health System Strengthening in BRICS countries The Struggle for Health Amit Sengupta People’s Health Movement Civil BRICS Forum Moscow, 29 June -1 July, 2015

2. The evidence of the HEALTH CRISIS is all around us……

3. What good does it do to treat people's illnesses... then send them back to the conditions that made them sick?

6. BrazilRussiaIndiaChinaSouth Africa Life Expectancy7370657353 Maternal Mortality Rate 563420037300 U5MR14.410.356.31444.6 OoP on Health57.8%35%59%35%7% Public Expenditure on Health 3.3% (2005) 4.1% (2011) 3.2% (2005) 3.7% (2011) 0.9% (2005) 1.2% (2011) 1.8% (2005) 2.9% (2011) 3.4% (2005) 4.1% (2011) Private Expenditure on Health 4.9%1.9%2.8%2.3%5.1% Gini Index54.740.133.44763.1 Selected Indicators: BRICS Countries

7. HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva” BRICS countries, given different contexts, exhibit wide variations in indicators and priorities However, a common thread, is the focus on re-imagining and building health systems The global discourse on Universal Health Coverage (UHC) is important to relate to Unfortunately in many situations UHC is reduced to access to narrow packages, mediated by insurance companies and provided often by an array of private providers Important to return to the vision of Alma Ata, of building public systems that are publicly funded and publicly provisioned BRICS: Priority to building Public Systems for Healthcare

8. HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva” Access to Medicines Access to medicines is crucial while securing access to comprehensive healthcare services While medical products are available as tools to combat an array of diseases, their availability is compromised by a variety of factors

9. HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva” Medicines expenditure as percent of total health expenditure

10. HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva” Barriers for Access to Medicines Poor access to public services forces a large population to access medicines privately Lack of dispersed facilities for domestic manufacture of medicines drives up medicine costs and compromises access Intellectual Property Rights (IPRs) are a significant barrier to access to new medicines

11. BRICS countries: Uniquely situated to facilitate access to medicines Build on existing capacity for local manufacture in India and China to scale up manufacturing in all BRICs countries Promote innovation and research through co-operation between research institutions – innovation that is priority driven, and whose products are not prohibitively priced Collectively resist attempts by the bloc of developed countries to impose higher standards of Intellectual Property protection

12. HEALTH AND DEVELOPMENT IN PREPARATION FOR THE 60TH WORLD HEALTH ASSEMBLY “11th – 12th May 2007 - Geneva” Thank You!