PHM-Exch> Trade, Growth and Population Health: An Introductory Review

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) ruglucia at paho.org
crossposted from: EQUIDAD at listserv.paho.org


 *Trade, Growth and Population Health: An Introductory Review

*

Caroline Andrew. Louise Bouchard, Ronald Labonté, Vivien Runnels (Editors)

Ronald Labonté,Canada Research Chair, Globalization and Health Equity,
Institute of Population Health, Professor, Department of Epidemiology and
Community Medicine, Faculty of Medicine, University of Ottawa

Chantal Blouin, Associate Director, Centre for Trade Policy and Law,
Carleton University, Ottawa

Lisa Forman, Assistant Professor, Dalla Lana School of Public Health,
Director, Comparative Program on Health and Society, Munk Centre for
International Studies, University of Toronto

*Vol. 2(1) 2010 Transdisciplinary Studies in Population Health Series*




Available online as PDF [94p.] at: http://bit.ly/bXbnYl

“……..Human societies have long histories of trade with each other. One might
describe barter and exchange as inherently human social qualities. When such
barter extends beyond the village marketplace, however, issues of power and
elite interests inevitably surface. Trade between societies has been marked
by conflict as much as by equanimity: witness the forced opening of the
closed economies of China by the British in the 19th century, Japan by the
USA in the early 20th century, and the allegations of more contemporary
coercion exercised by powerful countries over weaker ones in today’s free
trade negotiations, a point addressed later in this paper.

This paper focuses on one central question: *What are the actual or
potential implications of today’s global trade regime on health?*

*
*We do not address this question through detailed examination of the
multiplicity and complexity of trade rules, the proper treatment of which
would be book length. Rather, we approach the question indirectly through an
examination of a broad range of health-trade relationships. This reflects
the paper’s intent, which is to familiarize researchers and students across
a range of disciplines engaged in population health with some of the key
health issues and controversies associated with contemporary trade.

We begin by examining how trade liberalization is thought to improve social
welfare, generally, and health, specifically. This includes an assessment of
trade liberalization as part of the larger neoliberal economic orthodoxy
that has dominated international policy-making for the past three decades.
This deconstruction of the dominant historical and current arguments
supporting liberalized trade is important since its basic premise –
increasing economic growth, development and ‘trickle-down’ poverty reduction
– has failed to live up to its theoretical promise and is flawed by its
absence of any reference to ecological scale.


The paper then turns to the actual and potential constraints trade treaties
impose on the policy space and capacity of governments to regulate for
health goals. This assessment is followed by more detailed accounts of trade
agreements that directly affect health through liberalization of trade in
health and other health-determining services, and through the global
expansion of intellectual property rights. Most population health
discussions of trade begin and end with these two issues. But, as this paper
next argues, treaties and ongoing negotiations related to tariffs reduction,
agriculture, investment, government procurement and standards-setting are
likely to have more long-term, if indirect, health impacts.


One of the acknowledged innovations of today’s global trading system is its
formalization of dispute settlements when one country perceives another as
breaking agreed upon trade rules. Because dispute settlements can penalize
countries that break the rules economically, trade treaties are amongst the
‘harder’ of international laws governing inter-state relations.


This raises questions about how well trade law accommodates public and
global health equity concerns. Although this theme runs throughout the
entire paper, we conclude with a discussion of trade and global governance
issues, and offer a brief account of reforms to the global trading system
that have been mooted by a number of researchers and development economists
to  ‘put trade in its place:’ that is, to ensure that trade liberalization
retains its place as a means to other development goals (including health)
and not as an end in itself to which other goals should be
subordinated……………..”



*Table of Contents

*

Introduction

Shrinking policy space meets diminishing policy capacity to create greater
economic insecurity

>From the general to specific: trade treaties’ direct effects on policy space
and capacity on health

Agreements with direct health effects

Agreements with indirect health effects

Health in dispute

Reforming global economic governance: redistribution, regulation and rights

References
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