Abstract
The commitments that states make within international trade and investment agreements have both direct and indirect effects on the health of the population. For example, these treaties can influence food environments and dietary health, regulatory policy space for alcohol control measures, as well as costs of medicines and access to healthcare. This chapter provides an introduction to the international trade and investment regime and how it intersects with important issues in global health including access to medicines and health services, noncommunicable diseases, and the broader social determinants of health, including the environment. It will introduce readers to the key elements of trade and investment agreements, the impacts they can have, and the risks and opportunities for improving health and health equity. This chapter will also provide a political economy analysis of trade and investment agreements to reveal vested interests in the system and the dynamics of negotiations. Finally, it will review advances that have been made around the protection of public health as a result of significant efforts from health and trade advocacy groups and introduce ideas for further reform to support a global health agenda.
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References
Abbott RB, Bader R, Bajjali L, ElSamen TA, Obeidat T, Sboul H, Shwayat M, Alabbadi I (2012) The price of medicines in Jordan: the cost of trade-based intellectual property. J Generic Med. https://doi.org/10.1177/1741134312447499
Ankersmit L (2018, April 24) Achmea: the beginning of the end for ISDS in and with Europe? Investment Treaty News. https://www.iisd.org/itn/2018/04/24/achmea-the-beginning-of-the-end-for-isds-in-and-with-europe-laurens-ankersmit/
Australian Fair Trade and Investment Network (2018, June 4) Veolia loses ISDS case against Egypt – after six years and millions in costs. Australian Fair Trade and Investment Network. https://aftinet.org.au/cms/node/1585
Australian Government Department of Health (2014) Tobacco plain packaging – your guide. Australian Government Department of Health. http://www.health.gov.au/internet/main/publishing.nsf/Content/tppbook
Baker BK, Geddes K (2017) The incredible shrinking victory: Eli Lilly v. Canada, success, judicial reversal, and continuing threats from pharmaceutical ISDS. Loyola Univ Chicago Law J 49(2):479–514
Barlow P, McKee M, Basu S, Stuckler D (2017) The health impact of trade and investment agreements: a quantitative systematic review and network co-citation analysis. Glob Health 13. https://doi.org/10.1186/s12992-017-0240-x
Bastiaens I, Postnikov E (2017) Greening up: the effects of environmental standards in EU and US trade agreements. Environ Politics 26(5):847–869
Battams S, Townsend B (2019) Power asymmetries, policy incoherence and noncommunicable disease control – a qualitative study of policy actor views. Crit Public Health 29(5):596–609. https://doi.org/10.1080/09581596.2018.1492093
Bergh A, Nilsson T (2010) Good for living? On the relationship between globalization and life expectancy. World Dev 38(9):1191–1203
Bernasconi-Osterwalder N, Cosbey A, Johnson L, Vis-Dunbar D (2012) Investment treaties and why they matter to sustainable development: questions and answers. International Institute for Sustainable Development. https://www.iisd.org/sites/default/files/publications/investment_treaties_why_they_matter_sd.pdf
Blouin C, Drager N, Smith R (2005) International trade in health services and the GATS. The World Bank. https://doi.org/10.1596/978-0-8213-6211-2
Blouin C, Chopra M, van der Hoeven R (2009) Trade and social determinants of health. Lancet 373(9662):502–507. https://doi.org/10.1016/S0140-6736(08)61777-8
Centers for Disease Control and Prevention (2019, June 7) National Health Statistics Reports. https://www.cdc.gov/nchs/products/databriefs/db329.htm
Chanda R (2011) India-EU relations in health services: prospects and challenges. Glob Health 7(1):1
Chapman S (2015) Australian government’s $50m investment in defending against Big Tobacco legal thuggery. The Conversation. http://theconversation.com/australian-governments-50m-investment-in-defending-against-big-tobacco-legal-thuggery-45427
Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, Bergeron A, Cutler D (2016) The association between income and life expectancy in the United States, 2001-2014. JAMA 315(16):1750–1766. https://doi.org/10.1001/jama.2016.4226
Colchero MA, Rivera-Dommarco J, Popkin BM, Ng SW (2017) In Mexico, evidence of sustained consumer response two years after implementing a sugar-sweetened beverage tax. Health Aff 36(3):564–571
Commission on Social Determinants of Health (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/43943/9789241563703_eng.pdf?sequence=1
Cornia GA, Rosignoli S, Tiberti L (2008) Globalization and health: impact pathways and recent evidence. WIDER Research Paper
Corrigall J, Plagerson S, Lund C, Myers J (2008) Global trade and mental health. Glob Soc Policy 8(3):335–358. https://doi.org/10.1177/1468018108095632
Davey WJ, Sapir A (2009) The soft drinks case: the WTO and regional agreements. World Trade Rev 8(1):5–23
European Commission (2019) Declaration of the Member States of 15 January 2019 on the legal consequences of the Achmea judgment and on investment protection. https://ec.europa.eu/info/sites/info/files/business_economy_euro/banking_and_finance/documents/190117-bilateral-investment-treaties_en.pdf
Friel S, Baker P, Thow A-M, Gleeson D, Townsend B, Schram A (2019) An exposé of the realpolitik of trade negotiations: implications for population nutrition. Public Health Nutr 22(16):3083–3091. https://doi.org/10.1017/S1368980019001642
Gaston N, Khalid AM (2010) Globalization and economic integration: winners and losers in the Asia-Pacific. Edward Elgar Publishing, Cheltham
Gill S (2000) Toward a postmodern prince? The battle in Seattle as a moment in the new politics of globalisation. Millennium 29(1):131–140
Gleeson D, Lexchin J, Labonté R, Townsend B, Gagnon M-A, Kohler J, Forman L, Shadlen KC (2019) Analyzing the impact of trade and investment agreements on pharmaceutical policy: provisions, pathways and potential impacts. Glob Health 15(1):78
Gruszczynski L, Melillo M (2018) The FCTC and its role in WTO law: some remarks on the WTO plain packaging report. Eur J Risk Regul 9(3):564–574. https://doi.org/10.1017/err.2018.44
Hall PA (1997) The role of interests, institutions, and ideas in the comparative political economy of the industrialized nations. In: Lichbach MI, Zuckerman AS (eds) Comparative politics: rationality, culture, and structure. Cambridge University Press, Cambridge, UK, pp 174–207
Harrison J, Barbu M, Campling L, Richardson B, Smith A (2019) Governing labour standards through free trade agreements: limits of the European Union’s trade and sustainable development chapters. JCMS: J Common Mark Stud 57(2):260–277
Hurst D (2015, December 18) Australia wins international legal battle with Philip Morris over plain packaging. The Guardian. https://www.theguardian.com/australia-news/2015/dec/18/australia-wins-international-legal-battle-with-philip-morris-over-plain-packaging
InfoCuria (2018, March 6) Case C 284/16 Slowakische Republik (Slovak Republic) v Achmea BV. InfoCuria. http://curia.europa.eu/juris/document/document.jsf?docid=199968&doclang=EN
italaw (n.d.) Eli Lilly and Company v. The Government of Canada, UNCITRAL, ICSID Case No. UNCT/14/2 | italaw. Retrieved February 14, 2020, from https://www.italaw.com/cases/1625
Jinnah S (2011) Strategic linkages: the evolving role of trade agreements in global environmental governance. J Environ Dev 20(2):191–215
Johnston M (2015, March 1) Pressure to bring in tobacco plain-packaging. NZ Herald. https://www.nzherald.co.nz/business/news/article.cfm?c_id=3&objectid=11410127
Jones A (2017, January 26) Food security: how drought and rising prices led to conflict in Syria. The Conversation. http://theconversation.com/food-security-how-drought-and-rising-prices-led-to-conflict-in-syria-71539
Kessomboon N, Limpananont J, Kulsomboon V, Maleewong U, Eksaengsri A, Paothong P (2010) Impact on access to medicines from trips-plus: a case study of Thai-US FTA. Southeast Asian J Trop Med Public Health 41(3):11
Labonté R (2019) Trade, investment and public health: compiling the evidence, assembling the arguments. BioMed Central
Labonte R, Blouin C, Chopra M, Lee K, Packer C, Rowson M, Schrecker T, Woodward D (2007) Towards health-equitable globalization: rights, regulation and redistribution. Globalization knowledge network final report to the Commission on Social Determinants of Health. https://www.who.int/social_determinants/resources/gkn_report_06_2007.pdf
Labonté R, Cobbett E, Orsini M, Spitzer D, Schrecker T, Ruckert A (2015) Globalization and the health of Canadians: ‘Having a job is the most important thing.’. Glob Health 11(1):19
Lencucha R, Thow AM (2019) How neoliberalism is shaping the supply of unhealthy commodities and what this means for NCD prevention. Int J Health Policy Manag 8(9):514. https://doi.org/10.15171/ijhpm.2019.56
Lo C (2012) External regime coherence: WTO/BIT and public health tension as an illustration. Asian J WTO Int Health Law Policy 7:263
Mabey N, McNally R (1999) Foreign direct investment and the environment: from pollution havens to sustainable development. https://pdfs.semanticscholar.org/26f2/3f7304e34d7a7a05ba6b8fc1e239015c81d0.pdf
Mara K (2009, March 5) Concerns continue over generic drug seizures as legality debates begin. Intellectual Property Watch. https://www.ip-watch.org/2009/03/05/concerns-continue-over-generics-drug-seizures-as-legality-debates-begin/
Marx A, Lein B, Brando N (2016) The protection of labour rights in trade agreements: the case of the EU-Colombia agreement. J World Trade 50(4):587–610
McNamara C (2015) Trade liberalization, social policies and health: an empirical case study. Glob Health 11(1):42
McNamara C (2017) Trade liberalization and social determinants of health: a state of the literature review. Soc Sci Med 176:1–13. https://doi.org/10.1016/j.socscimed.2016.12.017
Menon J (2009) Dealing with the proliferation of bilateral free trade agreements. World Econ 32(10):1381–1407
Mohara A, Yamabhai I, Chaisiri K, Tantivess S, Teerawattananon Y (2012) Impact of the introduction of government use licenses on the drug expenditure on seven medicines in Thailand. Value Health 15(1, Supplement):S95–S99. https://doi.org/10.1016/j.jval.2011.11.016
Mukherjee N, Krieckhaus J (2012) Globalization and human well-being. Int Polit Sci Rev 33(2):150–170
New W (2014, November 20) Australia accuses tobacco industry of “Regulatory Chill” in WTO plain packaging case. Intellectual Property Watch. https://www.ip-watch.org/2014/11/20/australia-accuses-tobacco-industry-of-regulatory-chill-in-wto-plain-packaging-case/
Pastor L, Veronesi P (2018) Inequality aversion, populism, and the backlash against globalization. National Bureau of Economic Research, Cambridge, Massachusetts
Pritchett L, Summers LH (1993) Wealthier is healthier. World Bank Publications, Washington, DC
Public Citizen (2015) Only one of 44 attempts to use the GATT article XX/GATS article XIV ‘General Exception’ has ever succeeded: replicating the WTO exception construct will not provide for an effective TPP general exception. Global Trade Watch. https://www.citizen.org/wp-content/uploads/general-exception_1.pdf
Ranald P (2015) The trans-pacific partnership agreement: reaching behind the border, challenging democracy. Econ Labour Relat Rev 26(2):241–260. https://doi.org/10.1177/1035304615580721
Ranald P (2019, Mat) When even winning is losing. The surprising cost of defeating Philip Morris over plain packaging. The Conversation. http://theconversation.com/when-even-winning-is-losing-the-surprising-cost-of-defeating-philip-morris-over-plain-packaging-114279
Roberts A (2018) Incremental, systemic, and paradigmatic reform of investor-state arbitration. Am J Int Law 112(3):410–432
Roberts A, St. John T (2019, September 20) UNCITRAL and ISDS reforms: agenda-widening and paradigm-shifting. EJIL: Talk! https://www.ejiltalk.org/uncitral-and-isds-reforms-agenda-widening-and-paradigm-shifting/
Sachs L, Merrill E, Johnson L (2019, November 13) Environmental injustice: How treaties undermine the right to a healthy environment. Kluwer Arbitration Blog. https://isds.bilaterals.org/?environmental-injustice-how
Samberg L (2017, October 18) World hunger is increasing thanks to wars and climate change. The Conversation. http://theconversation.com/world-hunger-is-increasing-thanks-to-wars-and-climate-change-84506
Sanger M, Sinclair S (2004) Final report of the CCPA consortium on globalization and health. Canadian Centre for Policy Alternatives, Ottawa, Canada
Sapkota JB (2011) Impacts of globalization on quality of life: evidence from developing countries. MPRA Paper 37506, University Library of Munich, Germany
Schacherer S (2018, October 18) Clayton/Bilcon v. Canada – Investment Treaty News. Investment Treaty News. https://www.iisd.org/itn/2018/10/18/clayton-bilcon-v-canada/
Schram A (2018) When evidence isn’t enough: Ideological, institutional, and interest-based constraints on achieving trade and health policy coherence. Global Soc Policy 18(1):62–80
Sell SK (2007) TRIPS-plus free trade agreements and access to medicines. Liverpool Law Rev 28(1):41–75. https://doi.org/10.1007/s10991-007-9011-8
Smith RD, Chanda R, Tangcharoensathien V (2009) Trade in health-related services. Lancet 373(9663):593–601. https://doi.org/10.1016/S0140-6736(08)61778-X
Springer S, Birch K, MacLeavy K (2016) Handbook of neoliberalism. Routledge. https://books.google.com/books/about/Handbook_of_Neoliberalism.html?id=M5qkDAAAQBAJ
Stuckler D, McKee M, Ebrahim S, Basu S (2012) Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med 9(6):e1001235
Summers C (2001) The battle in Seattle: free trade, labor rights, and societal values. U Pa J Int Econ Law 22:61
Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, Schutter OD, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, … Dietz WH (2019) The global syndemic of obesity, undernutrition, and climate change: the lancet commission report. Lancet 393(10173):791–846. https://doi.org/10.1016/S0140-6736(18)32822-8
Tausch A (2012) A globalization-oriented perspective on health, inequality and socio-economic development. Int J Health Plann Manag 27(1):2–33
Teney C, Lacewell OP, De Wilde P (2014) Winners and losers of globalization in Europe: attitudes and ideologies. Eur Polit Sci Rev 6(4):575–595
The Nutritional Health Alliance (2016) Uncapping the truth: the Mexican sugar sweetened beverage tax works. The Nutritional Health Alliance: https://www.sidint.net/content/uncapping-truth-mexican-sugar-sweetened-beverage-tax-works
Townsend B, Schram A, Labonté R, Baum F, Friel S (2019) How do actors with asymmetrical power assert authority in policy agenda-setting? A study of authority claims by health actors in trade policy. Soc Sci Med 236:112430. https://doi.org/10.1016/j.socscimed.2019.112430
Townsend B, Schram A, Baum F, Labonté R, Friel S (2020) How does policy framing enable or constrain inclusion of social determinants of health and health equity on trade policy agendas? Crit Public Health 30(1):115–126. https://doi.org/10.1080/09581596.2018.1509059
United Nations Conference on Trade and Development (2011) Local production of pharmaceuticals and related technology transfer in developing countries: a series of case studies by the UNCTAD secretariat. United Nations Conference on Trade and Development. https://unctad.org/en/PublicationsLibrary/diaepcb2011d7_en.pdf
United Nations Conference on Trade and Development (2015) Investment policy framework for sustainable development. United Nations. http://unctad.org/en/PublicationsLibrary/diaepcb2015d5_en.pdf
United Nations Conference on Trade and Development (n.d.) International Investment Agreements Navigator. Investment Policy Hub. Retrieved February 15, 2020, from https://investmentpolicy.unctad.org/international-investment-agreements
Van Harten G (2013) Sovereign choices and sovereign constraints: judicial restraint in investment treaty arbitration. Oxford University Press, Oxford
Wan L, Watson E, Arthur R (2017, December 20) Sugar taxes: the global picture in 2017. Beveragedaily.Com. https://www.beveragedaily.com/Article/2017/12/20/Sugar-taxes-The-global-picture-in-2017
Withers P (2019, February 25) Canada ordered to pay U.S. concrete company $7M in NAFTA case | CBC News. CBC News. https://www.cbc.ca/news/canada/nova-scotia/nafta-bilcon-digby-neck-quarry-environmental-sovereignty-1.5032727
World Health Organization (2017) Taxes on sugary drinks: why do it? World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/260253/WHO-NMH-PND-16.5Rev.1-eng.pdf;sequence=1
World Health Organization (2018) Tobacco plain packaging: global status update. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/275277/WHO-NMH-PND-NAC-18.9-eng.pdf?ua=1
World Health Organization, World Trade Organization, & World Trade Organization Secretariat (2002) WTO agreements & public health: a joint study by the WHO and the WTO Secretariat. World health organization
World Trade Organization (2016a) Legal texts—Marrakesh agreement. World Trade Organization. https://www.wto.org/english/docs_e/legal_e/04-wto_e.htm
World Trade Organization (2016b) Understanding the WTO - a unique contribution. World Trade Organization. https://www.wto.org/english/thewto_e/whatis_e/tif_e/disp1_e.htm
World Trade Organization (2016c) Understanding the WTO - principles of the trading system. World Trade Organization. https://www.wto.org/english/thewto_e/whatis_e/tif_e/fact2_e.htm
World Trade Organization (2016d) Understanding the WTO - what is the world trade organization? World Trade Organization. https://www.wto.org/english/thewto_e/whatis_e/tif_e/fact1_e.htm
World Trade Organization (2019) Recent development regional trade agreements. July–December 2019. World Trade Organization. https://www.wto.org/english/tratop_e/region_e/rtajul_dec19_e.pdf
Yeung SLA, Lam TH (2019) Unite for a framework convention for alcohol control. Lancet 393(10183):1778–1779. https://doi.org/10.1016/S0140-6736(18)32214-1
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Schram, A., Townsend, B. (2020). International Trade Agreements and Global Health: Pathways and Politics. In: Haring, R., Kickbusch, I., Ganten, D., Moeti, M. (eds) Handbook of Global Health. Springer, Cham. https://doi.org/10.1007/978-3-030-05325-3_84-1
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