Addressing NCDs: Protecting Health From Trade and Investment Law; Comment on “Addressing NCDs: Challenges From Industry Market Promotion and Interferences”

Document Type : Commentary


1 Washington, DC, USA

2 Paul H. Nitze School of Advanced International Studies, Johns Hopkins University, Washington, DC, USA


Building on Tangcharoensathien and colleagues’ description of four tactics used by the tobacco, alcohol, processed food, and breast milk substitute industries to interfere with the development and implementation of health policies, we present a fifth tactic: trade and investment disputes. We describe recent examples of trade and investment claims filed by the tobacco industry to challenge plain packaging legislation, which may serve as a model for future claims by this and other industries. Next, we clarify specific areas of potential conflict between non-communicable disease (NCD) control policies and trade and investment agreement (TIA) commitments, identifying possible vulnerabilities that may be exploited by industry to challenge the legality of these policies. We conclude with ideas to strengthen the position of health policies vis à-vis commitments in TIAs.


Main Subjects

  1. Tangcharoensathien V, Chandrasiri O, Kunpeuk W, Markchang K, Pangkariya N. Addressing NCDs: challenges from industry market promotion and interferences. Int J Health Policy Manag. 2019;8(5):256-260. doi:10.15171/IJHPM.2019.02
  2. Wellhausen RL. Recent Trends in Investor–State Dispute Settlement. J Int Dispute Settl. 2016;7(1):117-135.
  3. McGrady B. Implications of Ongoing Trade and Investment Disputes Concerning Tobacco: Philip Morris v. Uruguay (Report No.: ID 2046261). Rochester, NY: Social Science Research Network; 2011. Accessed May 4, 2019.
  4. Puig S. Tobacco litigation in international courts. Harv Int Law J. 2016;57(2):383–432.
  5. Global Legal Center: Litigation Spotlight Philip Morris v. Uruguay. Campaign for Tobacco-Free Kids. Accessed May 4, 2019. Published 2018.
  6. Tackling NCDs: “Best buys” and other recommended interventions for the prevention and control of noncommunicable diseases. WHO; 2017.
  7. WTO. Regional Trade Agreements gateway. Accessed May 4, 2019.
  8. International Investment Agreements Navigator. Accessed May 4, 2019.
  9. WTO. Understanding the WTO - principles of the trading. Accessed May 4, 2019.
  10. Drewnowski A, Popkin BM. The nutrition transition: new trends in the global diet. Nutr Rev. 1997;55(2):31–43.
  11. Bilano V, Gilmour S, Moffiet T, et al. Global trends and projections for tobacco use, 1990-2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control. Lancet Lond Engl. 2015;385(9972):966-976. doi:10.1016/S0140-6736(15)60264-1
  12. WHO. Global status report on alcohol and health 2018 Accessed May 4, 2019.
  13. Freire WB, Waters WF, Rivas-Mariño G, Nguyen T, Rivas P. A qualitative study of consumer perceptions and use of traffic light food labelling in Ecuador. Public Health Nutr. 2017;20(5):805-813.  doi:10.1017/S1368980016002457
  14. Pérez‐Escamilla R, Lutter CK, Rabadan‐Diehl C, Rubinstein A, Calvillo A, Corvalán C, et al. Prevention of childhood obesity and food policies in Latin America: from research to practice. Obes Rev. 2017;18(S2):28-38.
  15. Specific Trade Concerns - Technical Barriers to Trade. Accessed May 4, 2019.
  16. Specific Trade Concerns - Technical Barriers to Trade. Accessed May 4, 2019.
  17. Specific Trade Concerns - Technical Barriers to Trade. Accessed May 4, 2019.
  18. Specific Trade Concerns - Technical Barriers to Trade. Accessed May 4, 2019.
  19. In Nafta Talks, U.S. Tries to Limit Junk Food Warning Labels. The New York Times. March 20, 2018. Accessed May 4, 2019.
  20. Puig S. The Internationalization of Tobacco Tactics. Duke Journal of Comparative & International Law. 2018;28:495-520.
  21. Bastiani D. Who Framework Convention on Tobacco Control. Geneva: WHO; 2005.
  22. International trade versus public health during the FCTC negotiations, 1999-2003. BMJ website. Accessed May 4, 2019.
  23. Taylor AL, Dhillon IS. An international legal strategy for alcohol control: not a framework convention--at least not yet. Addict Abingdon Engl. 2013;108(3):450-455. doi:10.1111/j.1360-0443.2012.03919.x
  24. Swinburn B, Sacks G, Lobstein T, et al. The “Sydney Principles” for reducing the commercial promotion of foods and beverages to children. Public Health Nutr. 2008;11(9):881-886. doi:10.1017/S136898000800284X
  25. Jacobs A. Opposition to Breast-Feeding Resolution by U.S. Stuns World Health Officials. The New York Times. July 8, 2018. Accessed May 4, 2019.