Editorial
Tsinghua University
China-Africa Health Collaboration
For the 5th China-Africa Health Roundtable see www.phrc. tsinghua.edu.cn For the African Union manufacturing plans see http:// sa.au.int/en/content/businessplan-pharmaceuticalmanufacturing-plan-africa and http://www.au.int/en/sites/ default/files/Shared_Res_ Roadmap_Rev_F%5B1%5D.pdf For Liu Peilong and colleagues’ Review see Lancet 2014; 384: 793–804
The 5th International Roundtable on China-Africa Health Collaboration: Contributing to Universal Health Coverage (UHC), Expanding Access to Essential Medicines, convened by Tsinghua University and the China Chamber of Commerce for Import and Export of Medicines and Health Products, took place in Beijing last week (March 26–28). The roundtable was attended by 350 Chinese, African, and international health delegates, including Chinese drug companies. The roundtable endorsed the Beijing Policy Recommendations 2015— calling for collaboration to reflect local country priorities, enhanced production and access to new health commodities, increased accountability, and investments in research, development, and health financing. The recommendations will inform the Ministerial Forum of China-Africa Health Development and the Forum on China-Africa Cooperation later this year. How should the global community engage with this relationship? Although scepticism is healthy in observing private sector engagement in UHC goals anywhere, China is in a unique position to make important contributions
to increasing access to essential medicines. China’s health partnerships in African countries long preceded trade relations, as reported by Liu Peilong and colleagues in a recent Lancet Review. Besides being the source of artemisinin, China is the world’s largest producer of active pharmaceutical ingredients. Accelerating WHO prequalification of Chinese drugs for export should be encouraged, but reform of China’s Food and Drug Administration to become a stringent regulatory agency would ensure that all products for export and local use meet international standards. Technology transfer by China to Africa in line with African Union plans is vital to ensure sustainable local production. Missing in the roundtable was discussion of the environment and health and the development of guiding principles on equity to assist debate between such diverse stakeholders. With a broadening array of health predicaments in Africa, the China-Africa Health Collaboration is very welcome and needs the active engagement of the global community to succeed in its vision. The Lancet
Mark Jenkinson/CORBIS
Ending the death penalty
For Amnesty International’s report Death Sentences and Executions 2014 see www.amnesty.org.uk/ deathpenalty
1262
“There is no evidence that the death penalty has a greater deterrent effect on crime than terms of imprisonment”, according to Amnesty International’s report Death Sentences and Executions 2014, published on April 1, this year. Worldwide, by the end of 2014, at least 19 094 individuals were under a death sentence. The number of people known to have been sentenced to death increased by 28% from 1925 in 57 countries in 2013 to at least 2466 in 55 countries in 2014, largely because of mass sentencing in Egypt and Nigeria. Alarmingly, in most countries, the death penalty was given after trials that did not meet international standards of fairness. Amnesty International recorded executions in 22 countries in 2014, no change in the number from 2013 but a large reduction from 41 countries in 1995. The number of executions fell by nearly 22% to at least 607 in 2014 from 778 in 2013. Data for the use of the death penalty were not available for China because they are a state secret. Despite the absence of transparency, the number of executions in China is thought to be
higher than the total for the rest of the world. Compared with 2013, the numbers of recorded executions were reduced in 2014 in sub-Saharan Africa (by 28%, from 64 executions in five countries to 46 in three countries), the Middle East and North Africa (by 23%, from 638 to 491 executions), and the USA (by 10%, from 39 to 35 executions). As of Dec 31, 2014, 140 countries had abolished the death penalty in law or practice and 98 in law for all crimes. However, all countries should abolish the death penalty for all crimes. In March, this year, the Governor of Utah, USA, Gary Herbert signed a bill that will allow the use of firing squads if drugs for lethal injection are not available. The USA is the only country in the Americas to use the death penalty, which has been abolished in 18 states. Execution is not proven to be an effective deterrent and, with so many miscarriages of justice and reports of botched executions, surely it cannot be right to teach people that killing is wrong by killing them. The Lancet www.thelancet.com Vol 385 April 4, 2015
Tsinghua University
China-Africa Health Collaboration
For the 5th China-Africa Health Roundtable see www.phrc. tsinghua.edu.cn For the African Union manufacturing plans see http:// sa.au.int/en/content/businessplan-pharmaceuticalmanufacturing-plan-africa and http://www.au.int/en/sites/ default/files/Shared_Res_ Roadmap_Rev_F%5B1%5D.pdf For Liu Peilong and colleagues’ Review see Lancet 2014; 384: 793–804
The 5th International Roundtable on China-Africa Health Collaboration: Contributing to Universal Health Coverage (UHC), Expanding Access to Essential Medicines, convened by Tsinghua University and the China Chamber of Commerce for Import and Export of Medicines and Health Products, took place in Beijing last week (March 26–28). The roundtable was attended by 350 Chinese, African, and international health delegates, including Chinese drug companies. The roundtable endorsed the Beijing Policy Recommendations 2015— calling for collaboration to reflect local country priorities, enhanced production and access to new health commodities, increased accountability, and investments in research, development, and health financing. The recommendations will inform the Ministerial Forum of China-Africa Health Development and the Forum on China-Africa Cooperation later this year. How should the global community engage with this relationship? Although scepticism is healthy in observing private sector engagement in UHC goals anywhere, China is in a unique position to make important contributions
to increasing access to essential medicines. China’s health partnerships in African countries long preceded trade relations, as reported by Liu Peilong and colleagues in a recent Lancet Review. Besides being the source of artemisinin, China is the world’s largest producer of active pharmaceutical ingredients. Accelerating WHO prequalification of Chinese drugs for export should be encouraged, but reform of China’s Food and Drug Administration to become a stringent regulatory agency would ensure that all products for export and local use meet international standards. Technology transfer by China to Africa in line with African Union plans is vital to ensure sustainable local production. Missing in the roundtable was discussion of the environment and health and the development of guiding principles on equity to assist debate between such diverse stakeholders. With a broadening array of health predicaments in Africa, the China-Africa Health Collaboration is very welcome and needs the active engagement of the global community to succeed in its vision. The Lancet
Mark Jenkinson/CORBIS
Ending the death penalty
For Amnesty International’s report Death Sentences and Executions 2014 see www.amnesty.org.uk/ deathpenalty
1262
“There is no evidence that the death penalty has a greater deterrent effect on crime than terms of imprisonment”, according to Amnesty International’s report Death Sentences and Executions 2014, published on April 1, this year. Worldwide, by the end of 2014, at least 19 094 individuals were under a death sentence. The number of people known to have been sentenced to death increased by 28% from 1925 in 57 countries in 2013 to at least 2466 in 55 countries in 2014, largely because of mass sentencing in Egypt and Nigeria. Alarmingly, in most countries, the death penalty was given after trials that did not meet international standards of fairness. Amnesty International recorded executions in 22 countries in 2014, no change in the number from 2013 but a large reduction from 41 countries in 1995. The number of executions fell by nearly 22% to at least 607 in 2014 from 778 in 2013. Data for the use of the death penalty were not available for China because they are a state secret. Despite the absence of transparency, the number of executions in China is thought to be
higher than the total for the rest of the world. Compared with 2013, the numbers of recorded executions were reduced in 2014 in sub-Saharan Africa (by 28%, from 64 executions in five countries to 46 in three countries), the Middle East and North Africa (by 23%, from 638 to 491 executions), and the USA (by 10%, from 39 to 35 executions). As of Dec 31, 2014, 140 countries had abolished the death penalty in law or practice and 98 in law for all crimes. However, all countries should abolish the death penalty for all crimes. In March, this year, the Governor of Utah, USA, Gary Herbert signed a bill that will allow the use of firing squads if drugs for lethal injection are not available. The USA is the only country in the Americas to use the death penalty, which has been abolished in 18 states. Execution is not proven to be an effective deterrent and, with so many miscarriages of justice and reports of botched executions, surely it cannot be right to teach people that killing is wrong by killing them. The Lancet www.thelancet.com Vol 385 April 4, 2015
