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SECTION 1 2 3 TIME TO ACT • Only grant tax breaks where there has been an impact assessment of added-value to the country and a binding process to disclose and make public all tax incentives; • Promote the establishment of a global governance body for tax matters to ensure tax systems and the international tax architecture works in the public interests of all countries, to ensure effective cooperation and close tax loopholes. Corporations should agree to: • Stop using tax havens; • Support national, regional and global efforts to promote tax transparency at all levels, including publishing where they make profits and where they pay taxes (mandatory country-by-country reporting that is publicly available). 6) ACHIEVE UNIVERSAL FREE PUBLIC SERVICES FOR ALL BY 2020 The high cost of healthcare and medicines drives a hundred million people into poverty every year. When user fees are charged for schooling, some children can access high-quality private education, but the majority make do with poor-quality state education, creating a two-tiered system. Privatization further entrenches the disparities between the poorest and the richest, and undermines the ability of the state to provide for all. Governments and international institutions should agree to: • Guarantee free high-quality healthcare and education for all citizens, removing all user fees; • Implement national plans to fund healthcare and education, by spending at least 15 percent of government budgets on healthcare and 20 percent on education. Donor governments must mirror these allocations in bilateral aid, and international institutions should promote equivalent social spending floors; • Implement systems of financial-risk pooling to fund healthcare via tax and avoid health insurance schemes that are based on voluntary contributions; • Stop new and review existing public incentives and subsidies for healthcare and education provision by private for-profit companies; • Implement strict regulation for private sector healthcare and education facilities to ensure safety and quality, and to prevent them from stopping those who cannot pay from using the service; • Exclude healthcare, medicines, medical technologies, knowledge and education from all bilateral, regional or international trade and investment agreements, including those which lock national governments into private healthcare and education provision; 118
SECTION 1 2 3 TIME TO ACT • Ensure that women’s health needs are prioritized, sexual and reproductive rights are upheld, and that bilateral aid is not permitted to constrain women’s access to reproductive health services. Corporations should agree to: • Stop lobbying for the privatization of vital public services, including healthcare and education; • Work with government efforts to regulate private healthcare providers to ensure their positive contribution to Universal Health Coverage. 7) CHANGE THE GLOBAL SYSTEM FOR RESEARCH AND DEVELOPMENT (R&D) AND FOR PRICING OF MEDICINES, TO ENSURE ACCESS FOR ALL TO APPROPRIATE AND AFFORDABLE MEDICINES Relying on intellectual property as the only stimulus for R&D keeps the monopoly on making and pricing medicines in the hands of big pharmaceutical companies. This endangers lives and leads to a wider gap between rich and poor. Governments and international institutions should agree to: • Agree a global R&D treaty which makes public health – not commercial interest – the decisive factor in financing R&D; • Allocate a percentage of their national income to scientific research, including R&D for medicines; • Exclude strict intellectual property rules from trade agreements and refrain from all measures that limit government’s policy space to implement public health measures and increase their access to medicine, medical technologies, knowledge, health and education services; • Break monopolies and encourage affordable pricing of medicines via generic competition; • Scale-up investment in national medicine policy development and drug supply chains. Pharmaceutical companies should agree to: • Be transparent about the cost of R&D, and look for new ways to finance R&D beyond intellectual property; • Stop national and international lobbying for private corporate gains at the expense of public health. 119
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