Trade and Health
April 1st, 2009
How does trade affect health?
- Unfair trade is one of the driving forces behind entrenched poverty and widening health disparities
- Trade policies impact health through their effects on the social determinants of health, as illustrated here:
Trade Effect on Health and Social Determinants of Health
(Lancet 2009;373:502-507)
- Trade policies – notably the General Agreement on Trade and Services (GATS) and the Agreement on Trade-related aspects of Intellectual Property Rights (TRIPS) – exert a strong, often negative on access to quality health care through their effects on the commercialisation of health services, availability of health professionals, and costs of key inputs such as essential medicines
- Bottom line: the current global economic system, which prioritises economic growth over equity and profit over the public good, must be reformed if we want to narrow global health disparities and achieve health for all
Why does trade and health governance matter?
- International governance of trade and health is grossly imbalanced, which results in global policies that generally favor commercial interests over health and the public good
- The considerable power and influence of the World Trade Organization (WTO) stands in contrast to the limited ability of the World Health Organization (WHO) to help ensure that trade is harnessed to support the health needs of the world
- Although WTO decisions have critical effects on health, they are not informed by health considerations, and the health sector has little or no influence over them
- Furthermore the WTO’s own decision-making process is, in practice, unfair and un-democratic, with a few wealthy nations enjoying a powerful advantage over the great majority of poorer nations
- Bottom line: in our current system, trade trumps health
What needs to change?
- The international health community needs better information about the complex interactions and effects between trade and health and should work at all levels (global and national governance, civil society, academics, etc.) to improve this evidence base
- We need better balance of power between trade and health governance, including health impact assessments of all existing and proposed trade agreements, and should build this capacity at all levels
- We need more democratic, transparent, and accountable governence of the WTO
- Most importantly, we need economic policies that specifically prioritize societal goals, including health and the social determinants of health
For anyone interested in reading further, we suggest:
