The World Today

During the presidential election campaign, both Barack Obama and his Republican opponent John McCain expressed the view that the United States was and ought to remain the guarantor of international stability and the indispensable stabilising power. Against the backdrop of the present financial and economic crisis and rekindled discussion about the decline of US power, it is easy to overlook the fact that America is structurally superior to all other countries and will remain so for the foreseeable future.

Twenty years after the end of the Cold War, Russia seems intent on re-writing the rules on media freedom, democracy and security on which a new, more cooperative relationship with the west was to be built. Moscow’s crack down on freedom of expression may make conflict more likely.

The Balkans is so far missing from urgent reports of areas hard-hit by the international financial crisis. Once famous for pyramid selling – now familiar as Ponzi schemes – Albania is predicted some eight percent growth by the World Bank. But behind this apparent stability is a much darker side.

Health issues have a roller-coaster ride on the international agenda. Rising alarm about rampant viruses or bio-terrorism is just as rapidly overtaken by more topical pressing concerns like climate change or financial meltdown. What are the obstacles to health assuming its rightful place in global policy?

Around three million people living with AIDS in developing countries have access to treatment, a ten-fold increase in just a few years. A key factor in this dramatic achievement was the availability of low-cost drugs produced in India, the pharmacy of the developing world. Companies there could produce AIDS drugs generically because the country did not grant medicine patents until 2005. However, this is now changing. India has begun granting patents on medicines to meet its obligations under the 1994 World Trade Organization (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The prices of newer essential medicines are likely to rise, threatening the viability of many AIDS treatment programmes – and access to medicines more broadly. An international patent pool for essential medicines could help address this looming crisis.

Recent events in Gaza have shown beyond doubt that the world must do better in protecting the lives and health of civilians during violent conflicts. Despite the United Nations system, including the Security Council, the Geneva Conventions, the Universal Declaration of Human Rights, the World Health Organization’s ‘health is a bridge’ initiative, and adoption of the health as a foreign policy concept by various countries, including Britain, the international community could not prevent more than thirteen hundred Palestinians being killed. This despite intense diplomatic efforts and extensive media coverage. So what hope is there for conflicts that have raged for years and receive little if any political or media attention? Doctors and diplomats must cast a fresh approach.