BRICS’ contributions to the global health agenda

We are currently witnessing a seminal shift in between world's countries. Pascal Lamy, former head of World Trade Organization (WTO), recently drew attention to fact that, as Brazil* Russian Federation, India, China and South Africa--the so-called BRICS group of countries--gain in economic and political influence, they will no longer remain policy takers but will shape future on their own terms. (1) However, positions that these five countries will take in future global health issues remain unclear. How closely will they align their health and foreign policies? What alliances will they seek? Will they set agendas that are different from present global health priorities? They may well want to approach global health challenges in new ways. Many analysts want BRICS to be more active in global health. As Sridhar et al. stated, the fact that relatively economically stable BRICS have not stepped up their commitments to Global Fund, GAVI Alliance, or World Health Organization has raised questions about their commitment to global health leadership in long term. (2) BRICS have, however, positioned themselves on a new trajectory for development and as Chinese foreign minister expressed participating in world affairs on an equal footing and working actively to build international systems.' They have recently increased their cooperation in fields of social development, environmental protection and health, institutionalized regular meetings of their health ministers and identified common health priorities --with stated goal of addressing emerging health threats not only within their own populations but also on a global level. BRICS appear to be less interested in simply providing financial contributions for development assistance than in very political and more structural bilateral and multilateral approaches to global health. They are, for example, jointly promoting access to affordable, safe and efficacious medical products of high quality through use of WTO's Agreement on Trade Related Aspects of Intellectual Property Rights. (4) They are also emphasizing importance of technology transfer as a way to empower developing countries through international cooperation--and have underlined need to establish a BRICS network of technological cooperation. While a focus on trade agreements could have a beneficial impact on health of millions of individuals in developing world, such agreements are vulnerable to political conflicts, international disputes and often conflicting interests of transnational drivers such as tobacco and food industries. It has been encouraging to observe Brazil's leadership in Framework Convention on Tobacco Control and recent moves by China to increase tobacco regulation at national level. High expectations despite some major problems In 2011, Director-General of World Health Organization commented that BRICS represent a block of countries with a ... great potential to move global public health in right direction ... towards reducing current vast gaps in health outcomes and introducing greater fairness in way benefits of medical and scientific progress are distributed. (5) BRICS span several continents and important regional groupings and could, in principle, bring their health agendas to all of high-level policy forums in which they participate, such as those of United Nations Security Council and Group of Twenty (G20). Of course, each BRICS country has its own foreign policy goals and astutely uses health as a soft power strategy. BRICS have studied approaches used by current key players in global health, show great interest in tripartite cooperation--e.g. between a BRICS country, a non-BRICS African country and a European or American donor--and have no interest in being only junior partners in development of a global health agenda. …