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Inequality refers to the extent to which income is evenly distributed across a population (IMF, 2022). The World Inequality Report (WIR, 2022) reveals the latest trends in global income inequality. It shows that the richest 10% of the global population currently earns 52% of global income, while the poorest half of the population takes 8.5% of it. In emerging market economies, indications are that income inequality is rising; sometimes accompanied by accelerating economic growth. Reports reveal that Brazil's six richest individuals command the same wealth associated with the poorest 50% of the population, or about 100 million people. The World Inequality Report (2021) reveals India as a poor and unequal country, with the bottom half of the population earning only 13% of the nation's income, while the top 10% controls 57% by 2021. In South Africa, the IMF (2020) acknowledges that the nation's inequality has remained at high levels, perhaps the highest in the world. This is characterized by a highly skewed income distribution pattern, with the top 20% of the population controlling 68% of national income. These developments hold grave implications for emerging markets, particularly their ability to meet the 2030 Sustainable Development Goals. The main objective of this paper is to explore income inequality in emerging market economies, with a multi-country study of Brazil, India and South Africa. The methodological approach to the study involves both qualitative and quantitative analytical techniques. It relies on secondary data in publications from various sources, complemented by interviews of stakeholders in the study areas. Findings reveal the income inequality is undermining economic growth and development in emerging markets, fueling conflicts and triggering migration in some countries. The paper presents recommendations, underpinned by progressive taxation, social safety nets, gender equality, development of social services, and leveraging economic and financial incentives for labour-intensive industries. [ABSTRACT FROM AUTHOR]

Urbanization can challenge sustainable development if it produces unequal outcomes. Infrastructure is an important urbanization dimension, providing services to support diverse urban activities. However, it can lock in unequal outcomes due to its durable nature. This paper studies inequalities in infrastructure distributions to derive insights into the structure and characteristics of unequal outcomes associated with urbanization. We analyzed infrastructure inequalities in two emerging economies in the Global South: India and South Africa. We developed and applied an inequality measure to understand the structure of inequality in infrastructure provisioning (based on census data) and infrastructure availability (based on satellite nighttime lights [NTLs] data). Consistent with differences in economic inequality, results show greater inequalities in South Africa than in India and greater urban inequalities than rural inequalities. Nevertheless, inequalities in urban infrastructure provisioning and infrastructure availability increase from finer to coarser spatial scales. NTL-based inequality measurements additionally show that inequalities are more concentrated at coarse spatial scales in India than in South Africa. Finally, results show that urban inequalities in infrastructure provisioning covary with urbanization levels conceptualized as a multidimensional phenomenon, including demographic, economic, and infrastructural dimensions. Similarly, inequalities in urban infrastructure availability increase monotonically with infrastructure development levels and urban population size. Together, these findings underscore infrastructure inequalities as a feature of urbanization and suggest that understanding urban inequalities requires applying an inequality lens to urbanization. [ABSTRACT FROM AUTHOR]

In light of the devastation caused by COVID-19, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and vaccine research and development (R&D) have been occupying a prominent position in the field of global health diplomacy (GHD). Most countries, international organizations, and charitable organizations have been engaged in the R&D of COVID-19 vaccines to ensure timely affordability and accessibility to all countries. Concomitantly, the World Trade Organization (WTO) provides some provisions and enforcements regarding copyrights, patents, trademarks, geographical indications, and industrial designs. Given these safeguards, it is considered that intellectual property rights (IPRs) have become major barriers to the affordability and accessibility of vaccines/medicines/technology, particularly to the developing/least developed countries. Realizing the gravity of the pandemic impact, as well as its huge population and size, India has elevated this issue in its global health diplomacy by submitting a joint proposal with South Africa to the World Trade Organization (WTO) for a temporary waiver of IPRs to ensure timely affordability and accessibility of COVID-19 medical products to all countries. However, the issue of the temporary waive off had become a geopolitical issue. Countries that used to claim per se as strong advocates of human rights, egalitarianism, and healthy democracy have opposed this proposal. In this contrasting milieu, this paper is aimed at examining how the TRIPS has become a barrier for developing countries' development and distribution of vaccines/technology; secondly, how India strategizes its role in the WTO in pursuant of its global health diplomacy? We conclude that the IPRs regime should not become a barrier to the accessibility/affordability of essential drugs and vaccines. To ensure access, India needs to get more engaged in GHD with all the involved global stakeholders to get strong support for their joint proposal. The developed countries that rejected/resisted the proposal can rethink their full support. [ABSTRACT FROM AUTHOR]

Global health diplomacy has gained significant importance and undoubtedly remained high on the agendas of many nations, regional and global platforms amid the coronavirus disease 2019 (COVID-19) pandemic. Many countries have realized the importance of the health sector and the value of a healthy workforce. However, there is little control on issues related to trade that impact on human health due to the dominance of profit-oriented business lobbies. A balance, however, needs to be struck between economic profits and a healthy global population. This paper aimed to highlight the importance of building capacity in global health diplomacy, especially during the COVID-19 pandemic so that health personnel may effectively negotiate on the multisectoral stage to secure the resources they need. The recent proposal to waive off certain provisions of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement for the prevention, containment and treatment of COVID-19 by India and South Africa at the World Trade Organization (WTO) presents an important opportunity for all governments to unite and stand up for public health, global solidarity, and equitable access at the international level so that both developed and developing nations may enjoy improved health outcomes related to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Untreated hearing loss is recognized as a growing global health priority because of its prevalence and harmful effects on health and well-being. Until recently, little progress had been made in expanding hearing care beyond traditional clinic-based models to incorporate public health approaches that increase accessibility to and affordability of hearing care. As demonstrated in numerous countries and for many health conditions, sharing health-care tasks with community health workers (CHWs) offers advantages as a complementary approach to expand health-service delivery and improve public health. This paper explores the possibilities of task shifting to provide hearing care across the life course by reviewing several ongoing projects in a variety of settings -- Bangladesh, India, South Africa and the United States of America. The selected programmes train CHWs to provide a range of hearing-care services, from childhood hearing screening to management of age-related hearing loss. We discuss lessons learnt from these examples to inform best practices for task shifting within community-delivered hearing care. Preliminary evidence supports the feasibility, acceptability and effectiveness of hearing care delivered by CHWs in these varied settings. To make further progress, community-delivered hearing care must build on established models of CHWs and ensure adequate training and supervision, delineation of the scope of practice, supportive local and national legislation, incorporation of appropriate technology and analysis of programme costs and cost--effectiveness. In view of the growing evidence, community-delivered hearing care may now be a way forward to improve hearing health equity. [ABSTRACT FROM AUTHOR]

In this paper, we examine patterns of self-reported diagnosis of noncommunicable diseases (NCDs) and prevalences of algorithm/measured test-based, undiagnosed, and untreated NCDs in China, Ghana, India, Mexico, Russia, and South Africa. Nationally representative samples of older adults aged ≥50 years were analyzed from wave 1 of the World Health Organization's Study on Global Ageing and Adult Health (2007-2010; n = 34,149). Analyses focused on 6 conditions: angina, arthritis, asthma, chronic lung disease, depression, and hypertension. Outcomes for these NCDs were: 1) self-reported disease, 2) algorithm/measured test-based disease, 3) undiagnosed disease, and 4) untreated disease. Algorithm/measured test-based prevalence of NCDs was much higher than self-reported prevalence in all 6 countries, indicating underestimation of NCD prevalence in low- and middle-income countries. Undiagnosed prevalence of NCDs was highest for hypertension, ranging from 19.7% (95% confidence interval (CI): 18.1, 21.3) in India to 49.6% (95% CI: 46.2, 53.0) in South Africa. The proportion untreated among all diseases was highest for depression, ranging from 69.5% (95% CI: 57.1, 81.9) in South Africa to 93.2% (95% CI: 90.1, 95.7) in India. Higher levels of education and wealth significantly reduced the odds of an undiagnosed condition and untreated morbidity. A high prevalence of undiagnosed NCDs and an even higher proportion of untreated NCDs highlights the inadequacies in diagnosis and management of NCDs in local health-care systems. [ABSTRACT FROM AUTHOR]

Brazil, the Russian Federation, India, China and South Africa -- the countries known as BRICS -- are currently undergoing a deep epidemiological transition that is mainly driven by rapid economic growth and technological change. The changes being observed in the distribution of the burden of diseases and injuries -- such as recent increases in the incidence of road traffic injuries -- are matters of concern. BRICS may need stronger institutional capacity to address such changes in a timely way. In this paper, we present data on road traffic injuries in BRICS and illustrate the enormous challenge that these countries currently face in reducing the incidence of such injuries. There is an urgent need to improve road safety indicators in every country constituting BRICS. It is imperative for BRICS to invest in system-wide road safety interventions and reduce the mortality and morbidity from road traffic injuries. [ABSTRACT FROM AUTHOR]

This paper presents international co-inventor networks as both a predictor variable of countries' ability to produce and disseminate internationally green inventions, and an alternative mechanism to support development of relevant programmes and policies in that regard. It includes cases from three developing countries with limited resources for clean technology development, Brazil, India and South Africa, which have shown successes owing to the potentials of co-inventor networks. It contributes the extent literature on this topic, which predominantly emphasizes firms' responses to conventional governments' interventions (subsidies, market price, standards, and interagency cooperation) to achieve cleaner production plans and particularly the Targets 17.6; 17.7 and 17.8 of the sustainable development goals. Broadly, such targets aim at enhancing countries' technological capabilities through partnership. The paper finds various correlations between co-inventor networks and growth of patents in solar energy, air pollution management and biofuels in the sample countries. Correlations are linear in India, followed by Brazil owing to the larger sizes of co-inventor networks but nonlinear in South Africa, which has smaller networks. The paper argues that co-inventor networks accelerate transnational exchanges of core human capital, and are fitting predictors of production and flows of green inventions. They are worth adopting in national and transnational industrial and innovation cluster policies globally to support sustainable production plans. [ABSTRACT FROM AUTHOR]

Background: Resource allocation in health is universally challenging, but especially so in resource-constrained contexts in the Global South. Pursuing a strategy of evidence-based decision-making and using tools such as Health Technology Assessment (HTA), can help address issues relating to both affordability and equity when allocating resources. Three BRICS and Global South countries, China, India and South Africa have committed to strengthening HTA capacity and developing their domestic HTA systems, with the goal of getting evidence translated into policy. Through assessing and comparing the HTA journey of each country it may be possible to identify common problems and shareable insights. Objectives: This collaborative paper aimed to share knowledge on strengthening HTA systems to enable enhanced evidence-based decision-making in the Global South by: Identifying common barriers and enablers in three BRICS countries in the Global South; and Exploring how South-South collaboration can strengthen HTA capacity and utilisation for better healthcare decision-making. Methods: A descriptive and explorative comparative analysis was conducted comprising a Within-Case analysis to produce a narrative of the HTA journey in each country and an Across-Case analysis to explore both knowledge that could be shared and any potential knowledge gaps. Results: Analyses revealed that China, India and South Africa share many barriers to strengthening and developing HTA systems such as: (1) Minimal HTA expertise; (2) Weak health data infrastructure; (3) Rising healthcare costs; (4) Fragmented healthcare systems; and (5) Significant growth in non-communicable diseases. Stakeholder engagement and institutionalisation of HTA were identified as two conducive factors for strengthening HTA systems. Conclusion: China, India and South Africa have all committed to establishing robust HTA systems to inform evidence-based priority setting and have experienced similar challenges. Engagement among countries of the Global South can provide a supportive platform to share knowledge that is more applicable and pragmatic. [ABSTRACT FROM AUTHOR]