The inaugural session of the 8^th Biennial Conference of CUTS International in collaboration with Brazil, Russia, India, China, and South Africa (BRICS), the Organisation for Economic Cooperation and Development OECD and the European University Institute (EUI) deliberated upon some socially sensitive sectors and issues. The session addressed the multifold tensions going on in the face of climate change, armed conflicts and the pandemic. The discussion dwelled upon some common global socially sensitive issues, like food price rise, poverty, unemployment, inflation, post-pandemic stress and climate change threats, from a developing country perspective.
 
The panellists drew our attention to the role of competition policy in accommodating the mentioned issues. The session strongly criticised the sanctions and market distortive import-export policies. To improve economic growth and efficiency, government policies must be more inclined towards collaboration (bi/multilateral) and cooperation. There is a need for a safe space for trade. Climate change has already posed enough threat to crop production and food security amidst which restrictive trade regulations would magnify global hunger.
 
Besides food security and agriculture, political instability and terror activities equally grab our attention. The underlying reasons for terrorism are threefold 1. Poverty, 2. Discrimination in Healthcare and Education, and 3. Exclusion refers to the interrelations and complexity of the ongoing issues that cannot be assessed in isolation. The Sustainable Development Goals present a promising picture in front of us, but unfortunately, only 15 percent of the goals have been achieved so far. The statistics are indicative of the need to prioritise ‘Polycrisis’ as a theme of discussion at the National and International levels.
 
The session briefly dwelled upon the broken supply chains, growing unemployment, high inflation rates, and decreasing income opportunities that are core to the polycrises affecting equity and welfare of the society. The post-COVID crisis and disruption of the health sector, particularly in developing countries, has widened the inequality gap. The digital market also made an important place in the discussion, where the unequal development of digitalisation and the digital divide were flagged.
 
Starting from environmental degradation to the consumer’s right, the session has briefly touched upon a wide range of burning global issues. The conference has left a significant landmark in knowledge sharing and brainstorming to elevate labour efficiency and skills, providing a platform for the voice of developing countries.
 
On the panel were: Pradeep S Mehta, Secretary General, CUTS International and Chairman, CUTS Institute for Regulation & Competition (CIRC); Bhubaneswar Kalita, Member of Parliament and Chairperson Parliamentary Standing Committee on Health and Family Welfare, India; Teresa Moreira, Head, Competition and Consumer Policy Branch, Division on International Trade and Commodities, United Nations Conference on Trade and Development (UNCTAD); Willard Mwemba, Director and Chief Executive Officer, Common Market for Eastern and Southern Africa (COMESA) Competition Commission; Simeon Konan Koffi, Executive Director, Economic Community of West African States (ECOWAS) Regional Competition Authority; Mahmoud Momtaz, Chairman, Egyptian Competition Authority; Andrey Tsyganov, Deputy Head, Federal Antimonopoly Service, Russia; Víctor Oliveira Fernandes, Commissioner, Administrative Council for Economic Defence (CADE), Brazil; Hardin Ratshisusu, Deputy Commissioner, Competition Commission of South Africa; and Alexey Ivanov, Director, BRICS Competition Law and Policy Centre.

The session delved into the critical importance of innovation and access to healthcare services on a global scale, as underscored by the ongoing COVID-19 pandemic. Distinguished panellists engaged in insightful discussions on competition and pricing policies, analysing their impact and the challenges faced by nations in ensuring accessibility to healthcare services. A key focus was placed on promoting equitable access to healthcare across countries. In the pharmaceutical and healthcare sectors, the consequences of inefficiency go beyond economic loss to human lives. Against this backdrop, the session shed light on various pertinent topics.
 
There are many challenges posed in the path of accessibility to healthcare. Countries do not always follow a competition policy approach to enhance access to healthcare. There are many countries which are dependent on pharmaceutical imports. There is a need to remove barriers to exports and imports.  The panellists discussed the issues of high costs and delays associated with registrations and certifications, and lengthy approval processes for drugs, including those related to imports.
 
South Africa can be a good example where competition enforcement has been used quite frequently to enhance access to healthcare. According to the World Health Organisation, half of the world’s population lacks access to affordable healthcare. Over 800 million people incur out-of-pocket expenditures for healthcare.
 
Another important point discussed in the session was whether price control and competition go together. There may be situations where price control, because of its market distortionary effects, can pose anti-competitive effects.
 
There are regulatory barriers in pharmaceutical exports, which impact access to healthcare in countries like the US and UK. Key barriers pertain to market authorisation, high cost of registration, Intellectual Property Rights regimes and pricing. While discussing the issue of market authorisation, the main problem that Indian pharmaceutical companies face is in Australia where there is a requirement for a ‘local sponsor’ to be registered in Australia. In the US, Indian pharma exports face barriers in terms of patent tickets and product hopping. Regulatory convergence and mutual recognition can be part of solutions to a few barriers.
 
Regulations of biosimilars and their impact on competition was another important topic discussed in this session. Biosimilars are biological drugs which are equivalent to the same in terms of composition, safety and efficacy and can be produced and marketed after the patent expiry. In India, there have been over 90 approvals of biosimilar drugs, which, in turn, have brought down prices significantly.
 
However, as biologics are complex, so are its approval processes. It was suggested that countries can group to collectively approve biologics and biosimilars for marketing. This can enhance access to such drugs.
 
Lastly, on the discussion of the pre-competition intellectual property policy, it opined that a balance between competition and IP needs to be achieved. Certain restrictive practices to voluntary licencing were also flagged. Though India is cited as an example of having a pro-competition patent law, some recently suggested amendments to this regime may not be desired. 
 
On the panel were: Vikas Kathuria, Associate Professor, BML Munjal University; Simeon Konan Koffi, Executive Director, ECOWAS Regional Competition Authority; Hardin Ratshisusu, Deputy Commissioner, Competition Commission of South Africa; Milind Antani, Leader, Pharma and Life Sciences Practice and Social Sector Practice, Nishith Desai Associates, India; Archana Jatkar, Associate Secretary General, Indian Pharmaceutical Alliance; Samir Kulkarni, Head, Department of Biological Sciences and Biotechnology, Institute of Chemical technology, Mumbai; and Leena Menghaney, Global IP Advisor, Médecins sans Frontières (MSF) - Access Campaign.
 

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Global food security is under threat due to a multitude of factors, such as the COVID-19 pandemic and the Russia-Ukraine war, which in turn lead to global agricultural value chain disruptions and rising food inflation. In this background, effective competition and trade policies at national and international levels can ensure efficient resource allocation, diversification of supply sources and maintain price stability.
 
The session underscored the vital role that competition regulatory measures and trade policies play in ensuring fair, efficient, and affordable agricultural production, with the ultimate goal of bolstering global food security. The session highlighted a troubling development where food inflation is on the rise, notably in the global South. Furthermore, it was pointed out that the major importers of food predominantly come from countries in the global South.
 
The session pointed out the escalating volatility in grain markets, where prices fluctuate drastically despite relatively stable production and consumption patterns, posing challenges for food security. Speculative activities emerged as a key driver of price volatility in food markets, further complicating the issue. The financialisation of agricultural markets was identified as a factor hindering competition and promoting market concentration, raising concerns about fairness and equitable access to resources.
 
The session also examined the challenges faced within global food value chains, with a focus on the distress of farmers caught between concentrated nodes of input sellers and agri-produce buyers. This squeeze contributes to price volatility, impacting farmers significantly. Moreover, it noted how consumers, particularly in the developed world, are shielded from the adverse impacts of price volatility through subsidies leaving the farmers in the developing countries to bear the brunt.
 
The session underscored the crucial need for a level playing field in agricultural competition. Farmers in both developing countries and least-developed countries (LDCs) confront a myriad of challenges, including inadequate infrastructure, marketing issues, credit constraints, farm distress, and competition from imports due to subsidised products from developed nations. These challenges adversely affect the livelihoods of farmers, especially those in developing and least developed countries where support is significantly lower.
 
Highlighting a stark disparity, the session revealed that rich countries provide substantial annual support to their farmers, amounting to an average of US$16,000 per farmer per annum, while their counterparts in LDCs receive a mere US$100 per farmer per annum. This glaring contrast has a disproportionate impact on the income of impoverished farmers, particularly in countries like India, where more than 99 percent of farmers have land holdings of less than 10 hectares.
 
Criticism was raised regarding the fairness of the rules of the World Trade Organisation (WTO) concerning agricultural subsidies. The session argued that the flexibilities under the WTO do not adequately favour the interests of developing nations, exacerbating disparities in global agricultural trade.
 
Tariffs, often used as a tool to discourage countries in the global South, were identified as potential barriers to accessing affordable food imports. Export bans, intended to safeguard national consumption, were noted to inadvertently affect the availability of food in countries heavily reliant on imports. These trade issues were found to be closely intertwined with competition concerns, as significant mergers and acquisitions occur despite existing market regulation mechanisms, disrupting the balance of market forces.
 
The session emphasised the importance of competition enforcement in the agricultural sector. This involves vigilant monitoring of food prices and conducting comprehensive screenings of the entire value chains. Addressing the abuse of dominance, particularly evident in cartels operating within the fertilisers market, was highlighted as a priority.
 
The session also highlighted the relevance of public stockholding programmes to address food security concerns of developing and least developed countries. For example, India provides subsidised food grains to a staggering 800 million people annually through its public stockholding programme.
 
On the panel were: Tembinkosi Bonakele, former Chairperson, South Africa Competition Commission; Mahmoud Momtaz, Chairman, Egyptian Competition Authority; Andrey Tsyganov, Deputy Head, Federal Antimonopoly Service (FAS), Russia; Alexey Ivanov, Director, BRICS Competition Law and Policy Centre; Dina Waked, Associate Professor, Sciences Po Paris’ Law School; Sachin Kumar Sharma, Associate Professor, Centre for WTO Studies, India; and Claudio Lombardi, Lecturer, School of Law, University of Aberdeen.