A report released last month discussed the rising profile of BRICS countries–Brazil, Russia, India, China, and South Africa–in health and development assistance and called upon the group to further their cooperation for better global health in the developing world. “Shifting Paradigm: How the BRICS are Shaping Global Health and Development” (PDF), written by the NGO Global Health Strategies Initiative (GHSi) to coincide with the 2012 BRICS Summit in India, found that BRICS have vastly expanded their foreign assistance spending, their aid budget growth (though not dollar amounts) outstripping G7 countries by ten percent over the past five years. With rapidly growing economies as well as the experience of major public health issues of their own, BRICS are in a unique position to influence the global health landscape–if they can band together.
Emerging economies Brazil, Russia, India, and China founded BRIC in 2006 at the United Nations General Assembly meeting and added South Africa in 2011, indicating the country’s prominence on the African continent despite its much lower gross domestic product (GDP). The World Bank ranks four of the five BRICS countries in the top 15 world economies, with China at number two, Brazil at seven, India at nine, Russia at 11, and South Africa at 28 as of 2010. According to the BRICS (PDF), they account for 40 percent of the world’s population and grew from contributing to 16 percent of the global GDP in 2000 to 25 percent in 2010.
BRICS’ global economic, political, and policy clout should be nearly boundless. As a recent New York Times article points out, however, “the new BRIC[S] era has yet to arrive,” as country-specific agendas and rivalries have prevented the alliance from realizing its potential. The article describes China’s outsize influence in BRICS, Indian-Chinese tensions, and differences of opinion on geopolitical issues and modes of government as hindering factors. Despite their divergences, however, BRICS are a strong voice for a shift away from the West’s dominance in international economic, political, and development strategies.
GHSi’s report is a clear call for BRICS to step up their role in the global health and development agendas. The United States and European Union have shrunk their global health budgets, opening a gap that desperately needs to be filled. BRICS’ focus on South-South collaboration and their valuable experiences with development and global health within their own borders could shift the way in which aid is distributed and global health and development challenges are met in a good way. As the GHSi report writes, this “equips them with unique perspective [sic] on improving health outcomes in developing countries.” The report profiles the five countries and their contributions to global health, from India’s robust pharmaceutical manufacturing sector, which has provided low-cost drugs and vaccines to much of the developing world, to South Africa’s emerging TB diagnostics research, to Brazil’s groundbreaking commitment in 1996 to free, universal access to antiretroviral drugs for people living with HIV. The report indicates that BRICS are a “potentially transformative source of new resources and innovation for global health and development” and argues that the alliance must increase its coordination and cooperation to transform the global health environment.
The BRICS Summit came and went, and the resulting Delhi Declaration was just a step above toothless. The summit was punctuated by anti-China, pro-Tibet protests and the Indian government’s crackdown on dissent, as FPA blogger David J. Karl detailed, which does little to assuage concerns about China’s dominance of BRICS. The declaration also mentioned India’s pet project, a BRICS Development Bank (which FPA blogger Richard Basas discusses here), although it indicates no concrete actions beyond convening BRICS’ finance ministers. The forty-second point of the declaration directed BRICS country health ministers to continue meeting on global health strategies, which is heartening in that health was mentioned at all. A good portion of the rhetoric in the declaration focused on criticizing Western countries’ economic models and political stances toward existing and potential conflicts in the Middle East. Although much of this had just cause, it cemented the opinion that BRICS is a “photo op” for “the idea that the West is no longer or should no longer be viewed as the only center of gravity,” as MIT Professor of global economics and management Yasheng Huang told the New York Times in the article linked above.
BRICS represents the enormous potential of emerging economies to change the current geopolitical landscape, especially in the realm of global health. As countries that once relied on aid and that have faced, though not surmounted, complex and damaging public health problems, BRICS can and should shape the development agenda, informed by their experiences. Unfortunately, cooperation and coordination among BRICS countries is still sparse, and the danger of putting self-interest before the greater good is omnipresent. Isobel Coleman of the Council on Foreign Relations points out that most of BRICS’ aid “is tied to specific business outcomes–such as access to natural resources for the donor country, or contracts for donor-country companies,” with a focus on what BRICS as donors can extract from developing countries. In this light, health will naturally take a back seat to infrastructural and economic investments, even though good health is central to economic and political development. Furthermore, countries like China have proved time and again that they will put profits over people and the environment almost every time. It would be a shame to have the pro-business, short-sighted policies of Western donor governments replaced by the pro-business, short-sighted policies of BRICS and emerging economies. It is accepted fact that BRICS will influence the global agenda going forward. It remains to be seen whether they will also commit to supporting developing countries in their own struggles for greater economic development and improved public health.
Header photo: BRICS heads of state at the 2012 Summit in New Delhi. From left to right, President Dilma Rousseff of Brazil, President Dmitry Medvedev of Russia, Prime Minister Manmohan Singh of India, President Hu Jintao of China, and President Jacob Zuma of South Africa. Photo by Roberto Stuckert Filho – Presidency of the Republic of Brazil (Agência Brasil). Via Wikimedia Commons, CC BY 3.0.