Φινανχινγ οφ ηεαλτη χαρε φορ ΥΚ χιτιζενσ ιν τηε ΕΥ ανδ ϖιχε ϖερσα ισ τηρεατενεδ, ασ ισ αχχεσσ το σοmε χαπιταλ φυνδσ, ωηιλε Βρεξιτ τηρεατενσ οϖεραλλ εχονοmιχ περφορmανχε. Αχχεσσ το πηαρmαχευτιχαλσ, τεχηνολογψ, βλοοδ, ανδ οργανσ φορ τρανσπλαντ αρε αλλ ατ ρισκ, ωιτη α παρτιχυλαρ χονχερν αβουτ ραδιοισοτοπεσ βεχαυσε οφ τηε δεχισιον το λεαϖε Ευρατοm. Ινφορmατιον υσεδ φορ ιντερνατιοναλ χοmπαρισονσ ισ τηρεατενεδ, βψ βοτη εξχλυσιον φροm νετωορκσ ανδ νον−χονφορmιτψ οφ στανδαρδσ. Τηρεατσ το Σερϖιχε Dελιϖερψ ινχλυδε ασπεχτσ δελιϖερεδ τηρουγη Ευροπεαν Ρεφερενχε Νετωορκσ ανδ χροσσ−βορδερ χαρε, εσπεχιαλλψ ιν Νορτηερν Ιρελανδ. Γοϖερνανχε χονχερνσ ρελατε το πυβλιχ ηεαλτη, χοmπετιτιον ανδ τραδε λαω, ανδ ρεσεαρχη. Ηοωεϖερ, ωε ωερε αβλε το ιδεντιφψ α σmαλλ νυmβερ οφ ποτεντιαλ οππορτυνιτιεσ, σηουλδ α γοϖερνmεντ χηοοσε το τακε αδϖανταγε οφ τηεm, ιν αρεασ συχη ασ χοmπετιτιον λαω ανδ φλεξιβιλιτψ οφ τραινινγ. Οϖεραλλ, α σοφτ ϖερσιον οφ Βρεξιτ mινιmισεσ ηεαλτη τηρεατσ ωηιλε φαιλεδ Βρεξιτ ισ τηε ρισκιεστ. Εφφεχτιϖε παρλιαmενταρψ σχρυτινψ οφ πολιχψ ανδ λεγαλ χηανγεσ ωιλλ βε εσσεντιαλ, βυτ τηε σχαλε οφ τηε τασκ ρισκσ οϖερωηελmινγ παρλιαmεντ ανδ τηε χιϖιλ σερϖιχε.
In 2011, the Australian Government passed landmark legislation requiring tobacco manufacturers to adopt 'plain packaging', a government-mandated design standardized across all brands of tobacco products. In response, plain packaging policy in Australia has faced multiple, simultaneous challenges from a global, well-resourced industry able to use all available fora to seek redress. Generalizing from the Australian experience, we analyze four types of challenges to plain packaging from the tobacco industry. We characterize three ways in which industry questions public health policies through international trade and investment law, on: (i) the intent or purpose of the policy; (ii) the economic consequences of it; and (iii) the regulatory authority behind it. We make recommendations and suggest that public health policymakers can know with some precision what attacks will be launched on tobacco control policies, and prepare their strategies and legislation accordingly.
All forms of Brexit are bad for health, but some are worse than others. This paper builds on our analysis using the WHO health system building blocks framework to assess the likely effects of Brexit on the NHS in the UK. We consider four possible futures: (1) a "No Deal" Brexit under which the UK leaves the EU on 29 March 2019 without any formal agreement on the terms of withdrawal; (2) the Withdrawal Agreement, as negotiated between the UK and EU and awaiting (possible) formal agreement, which provides a transition period until the end of December 2020; (3) if the Northern Ireland Protocol's 'Backstop' comes into effect after the end of that period; and (4) the Political Declaration on the Future Relationship between the UK and the EU. Our analysis shows that a No Deal Brexit is significantly worse for the NHS than a future involving the Withdrawal Agreement, which provides certainty and continuity in legal relations while the Future Relationship is negotiated and put into legal form. The Northern Ireland 'Backstop' has variable impact, with continuity in some areas, such as health products, but no continuity in others. The Political Declaration envisages a future relationship which is centred around a free trade agreement, in which wider healthrelated issues are largely absent. All forms of Brexit, however, involve negative repercussions for the UK's leadership and governance of health, both in Europe and globally, and significant harmful consequences for the ability of parliament and other stakeholders to scrutinize and oversee governmental actions.
Trade policies affect determinants of health as well as the options and resources available to health policymakers. There is therefore a need for health policymakers and related stakeholders in all contexts to understand and connect with the trade policymaking process. This paper uses the TAPIC (transparency, accountability, participation, integrity, capacity) governance framework to analyze how trade policy is commonly governed. I conclude that the health sector is likely to benefit when transparency in trade policymaking is increased, since trade negotiations to date have often left out health advocates and policymakers. Trade policymakers and negotiators also tend to be accountable to economic and trade ministries, which are in turn accountable to economic and business interests. Neither tend to appreciate the health consequences of trade and trade policies. Greater accountability to health ministries and interests, and greater participation by them, could improve the health effects of trade negotiations. Trade policies are complex, requiring considerable policy capacity to understand and influence. Nevertheless, investing in understanding trade can pay off in terms of managing future legal risks.
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