Air transport, which is both a beneficiary of growth and a vector of globalisation, is to become a player in the health of the world. On 1 July 2006, France implemented a tax on airline tickets that will go to fund the fight against AIDS, tuberculosis and malaria in the long term, through an “International Drug Purchase Facility (IPPF)”. 18 partner countries have taken measures to adopt an equivalent mechanism and are thus joining in the “UNITAID, united to treat those in need” initiative.

If, for once, globalisation were more an advantage than a disadvantage... If the whole world were in it together, if we all did something so that everywhere in the world access to healthcare were really possible... This might sound like just more talk, yet another cry of anger, a hymn filled with good intentions, the umpteenth aid for poor countries. But no, it is a global civic initiative. The first act in a globalisation that is finally showing a different face, that of solidarity.

Why a tax on airline tickets?

Because while drugs exist and can treat and cure many illnesses, they are only accessible to part of the world, since the populations of developing countries cannot buy them due to lack of money. The principle of the UNITAID initiative is therefore to facilitate access to drugs, by two means: by buying them more cheaply and by funding them in a sustainable way through an airline ticket solidarity levy.

This is the outcome of an idea launched in 2004 by France and Brazil, joined by Chile, Norway and the United Kingdom, during discussions on ways of sourcing “innovative development funding”. Since then, forty-four countries have become involved in the initiative. France is the first to have implemented this international solidarity levy, in force since 1 July 2006. It will make it possible to invest in healthcare access programmes and to obtain better prices for treatments for AIDS, tuberculosis and malaria in the long term. The French Minister of Foreign Affairs, Philippe Douste-Blazy, who has been electedpresident of the board of governors of UNITAID, anticipates that the tax might bring in 300 million euros a year in France and, with the participation of other countries, reach “400 to 500 million in the next few years, or even in the longer term, 1 billion euros”; a sum that really would enable the treatment of millions of victims of pandemics in the world.

The figures of a global state of emergency

There’s no doubt that we all feel overwhelmed by statistics. There are so many that some of them end up seeming unreal. We read them in an anecdotal, fragmented, “dehumanised” way. Worse still is when they relate to a distant reality, and come into the comfort of our rich countries as raw data. Some of these humanly unacceptable figures no longer call just for our compassion, they call for vigorous political action: those relating to the health gap are such statistics. They express a global state of emergency and call for large-scale action, whose first lines have been drawn by France and the countries that have just joined the UNITAID initiative.

In the countries of the South and primarily in Africa, diseases such as AIDS, malaria and tuberculosis, but many others too that were thought to have died out, are taking a terrible toll. AIDS affects 40 million people worldwide, 2.3 million of them children under the age of 15. It causes 3 million deaths, 570,000 among children. In Africa, 12 million children have lost their mother or father to AIDS. 5 million new infections occur every year and nearly 2000 children are affected each day. The tragedy is that out of 6 million sufferers who need urgent treatment if they are not to die within three months, only 1 million have access to it. In the case of malaria, the weaknesses of the health systems in Africa mean that precise data is impossible to obtain, but it is believed to affect between 350 and 500 million people. It is the cause of 58% of deaths among the 20% poorest people in the world. A child dies of this disease every 30 seconds, whilst immediate treatment could reduce the number of deaths, estimated at 1 to 3 million a year, by half. The curable disease of tuberculosis, which can be treated with drugs in 6 months in the West, also causes the death of 2 million people.

Unitaid IPPF. How does it work?

19 countries have already promised to institute a voluntary contribution. 4 countries have joined France in levying a tax on airline tickets: Chile, Ivory Coast, Gabon and Mauritius. 12 other countries have begun inter-ministerial or parliamentary procedures to adopt it. Norway is going to allocate part of its air tax on carbon dioxide to UNITAID, and the United Kingdom has committed itself to participating in this solidarity initiative long-term by paying a budgetary contribution for a period of 20 years. Other states have already given their public support to UNITAID and yet others should be getting involved soon.

With regard to the amount of the tax paid when buying airline tickets, this varies according to the destination of the flight and the class of fare. One euro for domestic and inter-European flights, 10 euros for business or first class. Four times higher on international flights: i.e. 4 euros for economy class and 40 euros for business and first class. A tax that is clearly based on a simple, flexible and fair mechanism. Fair in more than one way since, on the one hand, it is legitimate for air transport, a great beneficiary of globalisation with an average annual growth of 5%, to contribute to distributing the fruits of this. On the other hand, it is for once no longer a system of charity but rather one of parity in which all countries are called upon to participate, regardless of their place in the world economic arena. Fair too, because given the low level of the tax, it is absolutely painless. The system does not penalise air transport in relation to other modes of transport and does not give rise to competition between airlines. It is hard to see how, in fact, a tax of 1 to 40 euros could have any damaging repercussions on air traffic, on the airlines or on passengers’ choices.

The first results of an international solidarity initiative

Indeed, existing international organisations - WHO, UNICEF, the Global Fund to fight AIDS, Tuberculosis and Malaria - non-governmental organisations and private foundations such as the Clinton Foundation, but also many personalities from the world of arts, culture and sport have already supported the initiative. Since its launch, it has benefited from the support of the Association des maires des grandes villes de France (Association of French City Mayors), but also of FIFA which promoted it during the Football World Cup in June 2006. Large French media and mobile telephone groups have also made their distribution networks available to UNITAID. So every citizen can support UNITAID by sending their name and surname by SMS to 33333 or by registering on the site www.unitaid.eu.

During his trip to India from 30 November to 1 December 2006, on the eve of World AIDS Day, the French Minister of Foreign Affairs, Philippe Douste-Blazy, along with Bill Clinton, former president of the United States and president of the Clinton Foundation, and Sonia Gandhi, president of the Congress Party, presented a sum of 35 million euros in support of a programme that will enable Indian children to benefit from anti-retrovirals tailored to their needs. This initiative is being carried out in partnership with the Clinton Foundation, and in conjunction with Indian pharmaceutical laboratories producing generic drugs.

In addition to this particular example, UNITAID’s first actions will enable 100,000 children to be treated for AIDS and 150,000 for tuberculosis, from 2007 onwards. It will also enable developing countries to access second generation anti-retroviral or anti-malarial treatments, and treatments for multi-resistant tuberculosis.

Written by Mélina Gazsi taken from Actualité en France (magazine of the ministry of Foreign Affairs)