The Trans-Pacific Partnership: Is It Everything We Feared for Health?

Document Type : Original Article


Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada


Negotiations surrounding the Trans-Pacific Partnership (TPP) trade and investment agreement have recently concluded. Although trade and investment agreements, part of a broader shift to global economic integration, have been argued to be vital to improved economic growth, health, and general welfare, these agreements have increasingly come under scrutiny for their direct and indirect health impacts.
We conducted a prospective health impact analysis to identify and assess a selected array of potential health risks of the TPP. We adapted the standard protocol for Health impact assessments (HIAs) (screening, scoping, and appraisal) to our aim of assessing potential health risks of trade and investment policy, and selected a health impact review methodology. This methodology is used to create a summary estimation of the most significant impacts on health of a broad policy or cluster of policies, such as a comprehensive trade and investment agreement.
Our analysis shows that there are a number of potentially serious health risks associated with the TPP, and details a range of policy implications for the health sector. Of particular focus are the potential implications of changes to intellectual property rights (IPRs), sanitary and phytosanitary measures (SPS), technical barriers to trade (TBT), investor-state dispute settlement (ISDS), and regulatory coherence provisions on a range of issues, including access to medicines and health services, tobacco and alcohol control, diet-related health, and domestic health policymaking.
We provide a list of policy recommendations to mitigate potential health risks associated with the TPP, and suggest that broad public consultations, including on the health risks of trade and investment agreements, should be part of all trade negotiations.


Commentaries Published on this Paper

  • Current Models of Investor State Dispute Settlement Are Bad for Health: The European Union Could Offer an Alternative; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

          Abstract | PDF

  • Trade Policy and Health: Adding Retrospective Studies to the Research Agenda; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?”

          Abstract | PDF

  • Is It Time to Say Farewell to the ISDS System?; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

          Abstract | PDF

  • Assessing the Health Impact of Trade: A Call for an Expanded Research Agenda; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?”

          Abstract | PDF

  • Advancing Public Health on the Changing Global Trade and Investment Agenda; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

          Abstract | PDF

  • The Trans-Pacific Partnership: Should We “Fear the Fear”?; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

          Abstract | PDF

  • Just Say No to the TPP: A Democratic Setback for American and Asian Public Health; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?"

          Abstract | PDF


Authors' Response to the Commentary

  • The TPP Is Dead, Long Live the TPP? A Response to Recent Commentaries

          Abstract | PDF


Watch the Video Summary here



Main Subjects



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