Trade policy governance: What health policymakers and advocates need to know

Abstract

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.

The nexus between international trade, food systems, malnutrition and climate change

“…Nutrition and climate change actors have reported constraints on their ability to engage in the policy development processes with trade policymakers. Barriers identified at the national level include limited opportunities for consultation and input, lack of transparency around trade agreement negotiations, and a broader lack of public deliberation about the social, environmental and health impacts of trade agreements 61,67,76 .…”

What Generates Attention to Health in Trade Policy-Making? Lessons From Success in Tobacco Control and Access to Medicines: A Qualitative Study of Australia and the (Comprehensive and Progressive) Trans-Pacific Partnership

“…The analysis suggests that institutional changes are urgently needed to formally include health representation, and echoes calls for greater transparency, accountability, participation, integrity and capacity in the governance of trade policy. 17 Thailand has been a leader in this regard with its interdepartmental International Trade and Health Programme to generate evidence-based analyses of the potential health impacts of trade negotiations for government. 37 Thailand's former Constitution included requirements for parliamentary approval of trade negotiation frameworks but these constitutional protections were unfortunately after the 2014 coup d' état.…”

“…Key trade governance challenges noted in the literature include issues of transparency, accountability, participation, integrity and capacity. 17 Analysis of framing in trade policy has highlighted the power of a dominant neoliberal market-oriented discourse that privileges exporter interests and market liberalisation. 18 This dominant framing aligns with the interests of exporters including multinational pharmaceutical companies and ultraprocessed food and alcohol exporters.…”

Factors associated with the recruitment of foreign nurses in Japan: a nationwide study of hospitals

“…For example, it may lead to potential de-skilling [ 9 ] and render them vulnerable to the global economic crisis [ 3 , 10 ]. Previous studies have indicated an insufficient involvement of health professionals in trade negotiations relating to public health [ 8 , 11 ]; this may adversely impact nurses and healthcare institutions. Therefore, it is important to analyze the provision of bilateral agreements from the perspective of the healthcare industry.…”