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      Assessing the health impact of transnational corporations: its importance and a framework

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          Abstract

          Background

          The adverse health and equity impacts of transnational corporations’ (TNCs) practices have become central public health concerns as TNCs increasingly dominate global trade and investment and shape national economies. Despite this, methodologies have been lacking with which to study the health equity impacts of individual corporations and thus to inform actions to mitigate or reverse negative and increase positive impacts.

          Methods

          This paper reports on a framework designed to conduct corporate health impact assessment (CHIA), developed at a meeting held at the Rockefeller Foundation Bellagio Center in May 2015.

          Results

          On the basis of the deliberations at the meeting it was recommended that the CHIA should be based on ex post assessment and follow the standard HIA steps of screening, scoping, identification, assessment, decision-making and recommendations. A framework to conduct the CHIA was developed and designed to be applied to a TNC’s practices internationally, and within countries to enable comparison of practices and health impacts in different settings. The meeting participants proposed that impacts should be assessed according to the TNC’s global and national operating context; its organisational structure, political and business practices (including the type, distribution and marketing of its products); and workforce and working conditions, social factors, the environment, consumption patterns, and economic conditions within countries.

          Conclusion

          We anticipate that the results of the CHIA will be used by civil society for capacity building and advocacy purposes, by governments to inform regulatory decision-making, and by TNCs to lessen their negative health impacts on health and fulfil commitments made to corporate social responsibility.

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          Most cited references23

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          The political origins of health inequity: prospects for change

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            Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the commission on the social determinants of health

            M Marmot (2008)
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              Driving a decade of change: HIV/AIDS, patents and access to medicines for all

              Since 2000, access to antiretroviral drugs to treat HIV infection has dramatically increased to reach more than five million people in developing countries. Essential to this achievement was the dramatic reduction in antiretroviral prices, a result of global political mobilization that cleared the way for competitive production of generic versions of widely patented medicines. Global trade rules agreed upon in 1994 required many developing countries to begin offering patents on medicines for the first time. Government and civil society reaction to expected increases in drug prices precipitated a series of events challenging these rules, culminating in the 2001 World Trade Organization's Doha Declaration on the Agreement on Trade-Related Aspects of Intellectual Property Rights and Public Health. The Declaration affirmed that patent rules should be interpreted and implemented to protect public health and to promote access to medicines for all. Since Doha, more than 60 low- and middle-income countries have procured generic versions of patented medicines on a large scale. Despite these changes, however, a "treatment timebomb" awaits. First, increasing numbers of people need access to newer antiretrovirals, but treatment costs are rising since new ARVs are likely to be more widely patented in developing countries. Second, policy space to produce or import generic versions of patented medicines is shrinking in some developing countries. Third, funding for medicines is falling far short of needs. Expanded use of the existing flexibilities in patent law and new models to address the second wave of the access to medicines crisis are required. One promising new mechanism is the UNITAID-supported Medicines Patent Pool, which seeks to facilitate access to patents to enable competitive generic medicines production and the development of improved products. Such innovative approaches are possible today due to the previous decade of AIDS activism. However, the Pool is just one of a broad set of policies needed to ensure access to medicines for all; other key measures include sufficient and reliable financing, research and development of new products targeted for use in resource-poor settings, and use of patent law flexibilities. Governments must live up to their obligations to protect access to medicines as a fundamental component of the human right to health.
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                Author and article information

                Contributors
                +61 8 7221 8410 , fran.baum@flinders.edu.au
                Journal
                Global Health
                Global Health
                Globalization and Health
                BioMed Central (London )
                1744-8603
                15 June 2016
                15 June 2016
                2016
                : 12
                : 27
                Affiliations
                [ ]Southgate Institute of Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA 5001 Australia
                [ ]School of Public Health, University of the Western Cape, Bellville, 7535 South Africa
                [ ]School of Public Health, City University of New York, New York, NY 10033 USA
                [ ]Regulatory Institutions Network, The Australian National University, Canberra, ACT 2601 Australia
                [ ]School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario KIH 8M8, Canada
                [ ]School of Public Health and Family Medicine, University of Cape Town, Cape Town, Observatory, 7925, South Africa
                [ ]Center for Epidemiological Research in Nutrition and Health, University of São Paulo, Sao Paulo, SP Brazil
                [ ]Department of Public Health and Policy, University of Liverpool, Liverpool, L69 3GB, UK
                [ ]People’s Health Movement, New Delhi, 110017 India
                Article
                164
                10.1186/s12992-016-0164-x
                4908801
                27301248
                30d9b3a8-8ae9-4916-b540-884c39e08d12
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 November 2015
                : 9 May 2016
                Funding
                Funded by: FundRef http://dx.doi.org/http://dx.doi.org/10.13039/100000877, Rockefeller Foundation;
                Categories
                Methodology
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                health impact assessment,health inequalities,public health policy,health promotion,methodology

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