International Journal of Health Policy and Management

International Journal of Health Policy and Management

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

Document Type : Commentary

Authors
Anne Marie Thow 1
Deborah Gleeson 2
1 Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
2 School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
10.15171/ijhpm.2016.129
Abstract
Concerns regarding the Trans-Pacific Partnership (TPP) have raised awareness about the negative public health impacts of trade and investment agreements. In the past decade, we have learned much about the implications of trade agreements for public health: reduced equity in access to health services; increased flows of unhealthy commodities; limits on access to medicines; and constrained policy space for health. Getting health on the trade agenda continues to prove challenging, despite some progress in moving towards policy coherence. Recent changes in trade and investment agendas highlight an opportunity for public health researchers and practitioners to engage in highly politicized debates about how future economic policy can protect and support equitable public health outcomes. To fulfil this opportunity, public health attention now needs to turn to strengthening policy coherence between trade and health, and identifying how solutions can be implemented. Key strategies include research agendas that address politics and power, and capacity building for both trade and health officials.

Highlights

 

 

Watch the Video Summary here. 

 

Keywords
International Trade Agreements
Health
Policy Coherence
Policy Space
Subjects

 

 

  1. Labonté R, Schram A, Ruckert A. The Trans-Pacific Partnership: Is It Everything We Feared for Health? Int J Health Policy Manag. 2016;5(8):487-496. doi:10.15171/ijhpm.2016.41
  2. United Nations Conference on Trade and Development. Trade and Development Report. Geneva: UNCTAD;2014.
  3. Ruckert A, Schram A, Labonté R, Friel S, Gleeson D, Thow AM. Policy coherence, health and the sustainable development goals: a health impact assessment of the Trans-Pacific Partnership. Crit Public Health. 2016:1-11. doi:10.1080/09581596.2016.1178379
  4. Organization for Economic Cooperation and Development. Policy framework for policy coherence for development. Paris: OECD; 2012.
  5. United Nations (UN). Transforming our world: the 2030 Agenda for Sustainable Development. New York: UN; 2015.
  6. Hirono K, Haigh F, Gleeson D, Harris P, Thow AM, Friel S. Is health impact assessment useful in the context of trade negotiations? A case study of the Trans Pacific Partnership Agreement. BMJ Open. 2016;6(4). doi:10.1136/bmjopen-2015-010339
  7. Baker P, Friel S, Schram A, Labonte R. Trade and investment liberalization, food systems change and highly processed food consumption: a natural experiment contrasting the soft-drink markets of Peru and Bolivia. Global Health. 2016;12:24. doi:10.1186/s12992-016-0161-0
  8. Weiss M. Trading Health? UK Faculty of Public Health Policy Report on the Transatlantic Trade and Investment Partnership. London: UK Faculty of Public Health; 2015.
  9. Smith RD. The health system and international trade. Health systems in low- and middle-income countries: An economic and policy perspective. 2012. doi:10.1093/acprof:oso/9780199566761.001.0001
  10. Schram A, Labonte R, Baker P, Friel S, Reeves A, Stuckler D. The role of trade and investment liberalization in the sugar-sweetened carbonated beverages market: a natural experiment contrasting Vietnam and the Philippines. Global Health. 2015;11:41. doi:10.1186/s12992-015-0127-7
  11. Schram A, Labonté R, Sanders D. Urbanization and International Trade and Investment Policies as Determinants of Noncommunicable Diseases in Sub-Saharan Africa. Prog Cardiovasc Dis. 2013;56(3):281-301.
  12. Baker BK. Trans-Pacific Partnership Provisions in intellectual property, transparency, and investment chapters threaten access to medicines in the US and elsewhere. PLoS Med. 2016;13(3):e1001970. doi:10.1371/journal.pmed.1001970
  13. Gleeson D, Lopert R, Reid P. How the Trans Pacific Partnership Agreement could undermine PHARMAC and threaten access to affordable medicines and health equity in New Zealand. Health Policy. 2013;112. doi:10.1016/j.healthpol.2013.07.021
  14. Thow AM, Snowdon W, Labonté R, et al. Will the next generation of preferential trade and investment agreements undermine implementation of the Global Action Plan for Prevention and Control of Noncommunicable Diseases? A prospective policy analysis of the Trans Pacific Partnership Agreement. Health Policy. 2015;119:88-96. doi:10.1016/j.healthpol.2014.08.002
  15. Thow AM, McGrady B. Protecting policy space for public health nutrition in an era of international investment agreements. Bull World Health Organ. 2014;92:139-145.
  16. Koivusalo M. Policy space for health and trade and investment agreements. Health Promot Int. 2014;29(suppl 1):i29-i47. doi:10.1093/heapro/dau033
  17. Lexchin J, Gagnon M-A. CETA and pharmaceuticals: impact of the trade agreement between Europe and Canada on the costs of prescription drugs. Global Health. 2014;10:30. doi:10.1186/1744-8603-10-30
  18. Abbott RB, Bader R, Bajjali L, et al. The price of medicines in Jordan: the cost of trade-based intellectual property. J Generic Med. 2012;9(2):75-85. doi:10.1177/1741134312447499
  19. McGrady B. Implications of Ongoing Trade and Investment Disputes Concerning Tobacco: Philip Morris v. Uruguay. In: Voon T, Mitchell A, Liberman J, Ayres G, eds. Public Health and Plain Packaging of Cigarettes: Legal Issues. Edward Elgar; 2012.
  20. Voon T, Mitchell A. Implications of international investment law for plain tobacco packaging: lessons from the Hong Kong–Australia BIT. In: Voon T, Mitchell A, Liberman J, Ayres G, eds. Public Health and Plain Packaging of Cigarettes: Legal Issues. Edward Elgar; 2012.
  21. World Trade Organization (WTO). General Agreement on Tariffs and Trade 1994. Geneva: WTO; 1994.
  22. Bennet N. Health concerns raised over EU-US trade deal. The Lancet. 2014;384(9946):843-844. doi:10.1016/S0140-6736(14)61492-6
  23. Gleeson DH, Neuwelt P, Monasterio E, Lopert R. How the transnational pharmaceutical industry pursues its interests through International Trade and Investment agreements: a case study of the Trans Pacific Partnership. In: Jonge AD, Tomasic R, eds. Handbook of Research on Transnational Corporations. Edward Elgar Publishing Ltd; Forthcoming.
  24. McCambridge J, Hawkins B, Holden C. Vested Interests in Addiction Research and Policy. The challenge corporate lobbying poses to reducing society's alcohol problems: insights from UK evidence on minimum unit pricing. Addiction. 2014;109(2):199-205.
  25. Lee S, Ling PM, Glantz SA. The vector of the tobacco epidemic: tobacco industry practices in low and middle-income countries. Cancer Causes Control. 2012;23(1):117-129. doi:10.1007/s10552-012-9914-0
  26. Friel S, Ponnamperuma S, Schram A, et al. Shaping the discourse: What has the food industry been lobbying for in the Trans Pacific Partnership trade agreement and what are the implications for dietary health? Crit Public Health. 2016;26(5):518-529. doi:10.1080/09581596.2016.1139689
  27. Hirono K, Gleeson D, Freeman B. To what extent does a tobacco carve-out protect public health in the Trans-Pacific Partnership Agreement? Public Health Res Pract. 2016;26(2):e2621622.
  28. Legge DG, Gleeson DH, Löfgren H, Townsend B. Australia's position on medicines policy in international forums: Intellectual property protection and public health. The Journal of Australian Political Economy. 2014(73):103.
  29. Lexchin J, Gleeson D. The Trans Pacific Partnership Agreement and Pharmaceutical Regulation in Canada and Australia. Int J Health Serv. 2016; forthcoming.
  30. Gleeson DH, Moir H, Lopert R. Costs to Australian taxpayers of pharmaceutical monopolies and proposals to extend them in the Trans-Pacific Partnership Agreement. Med J Aust. 2015;202(6):306-308.
  31. World Trade Organization (WTO). Nairobi Ministerial Declaration, adopted on December 19, 2015. Geneva: WTO; 2015.
  32. Banga R. New Issues in Multilateral Trade Negotiations. Econ Polit Wkly. 2016;II(21):28-32.
  33. Baldwin R. The World Trade Organization and the Future of Multilateralism. J Econ Perspect. 2016;30(1):95-116.
  34. Hammond A. Why Barack Obama wants to push TTIP through before he leaves the White House. International Business Times. September 15, 2016. http://www.ibtimes.co.uk/why-barack-obama-wants-push-ttip-through-before-he-leaves-white-house-1581527
  35. United Nations Conference on Trade and Development. Taking stock of IIA Reform. Geneva: UNCTAD; 2016.
  36. Ostry JD, Loungani P, Furceri D. Neoliberalism: Oversold? Finance Dev. 2016;53(2):38-41.
  37. Stiglitz JE. Reconstructing macroeconomic theory to manage economic policy. In: Laurent É, Le Cacheux J, eds. Fruitful Economics: Papers in Honor of and by Jean-Paul Fitoussi. London: Palgrave Macmillan UK; 2015:20-56.
  38. Grabel I. Global Financial Governance and Development Finance in the Wake of the 2008 Financial Crisis. Fem Econ. 2013;19(3):32-54. doi:10.1080/13545701.2013.798021
  39. Grabel I. Not your grandfather's IMF: global crisis, ‘productive incoherence’ and developmental policy space. Cambridge J Econ. 2011;35(5):805-830. doi:10.1093/cje/ber012
  40. Labonté R. Health Promotion in an Age of Normative Equity and Rampant Inequality. International Journal of Health Policy and Management. 2016: forthcoming. doi:10.15171/ijhpm.2016.95
  41. Walls H, Baker P, Smith R. Commentary: Moving towards policy coherence in trade and health. J Public Health Policy. 2015;36(4):491-501.
  42. Blouin C. Trade policy and health: from conflicting interests to policy coherence. Bull the World Health Organ. 2007;85(3):169-173. doi:10.2471/BLT.06.037143
  43. Drahos P. Four lessons for developing countries from the trade negotiations over access to medicines. Liverpool Law Rev. 2007;28:11-39.
  44. Schrecker T. Bringing (domestic) politics back in: global and local influences on health equity. Public Health. 2015;129(7):843-848. doi:10.1016/j.puhe.2015.05.007
  45. Kickbusch I. The political determinants of health—10 years on. BMJ  2015;350:h81. doi:10.1136/bmj.h81
  46. Walls HL, Smith RD, Drahos P. Improving regulatory capacity to manage risks associated with trade agreements. Global Health. 2015;11(1):1-5. doi:10.1186/s12992-015-0099-7
  47. 47.  Gleeson D, Friel S. Emerging threats to public health from regional trade agreements. Lancet. 2013;381(9876):1507-1509. doi:10.1016/S0140-6736(13)60312-8
  48. Thow AM, Sanders D, Drury E, et al. Regional trade and the nutrition transition: opportunities to strengthen NCD prevention policy in the Southern African Development Community. Glob Health Action. 2015;8:28338. doi:10.3402/gha.v8.28338
International Journal of Health Policy and Management
Volume 6, Issue 5
2017
Pages 295-298

  • Received Date 15 August 2016
  • Revised Date 20 September 2016
  • Accepted Date 21 September 2016
  • First Published Date 01 May 2017
  • Published Date 01 May 2017