FACT SHEET Trade and Health: 101 The concern over the interactions between international trade and health policy has increased substantially in recent years. In the past, the interactions of trade and health have predominantly centered on the increased transmission of communicable diseases resulting from greater trade of food and more international travel. While food security and preventing the spread of infectious diseases remain integral components of international trade, in recent years, the implications of trade on health and health policy have grown substantially. Some common issues concerning trade and health are:
A concern over intellectual property law and its impact on the regulation and dissemination of pharmaceuticals and medical devices; The prevalence of counterfeit and substandard drugs in the global market; An increase in the cross-national spread of health workers and training opportunities; Reducing tariffs may lead to lower prices for medical equipment and health products; Changes in international rules concerning patent protection that may affect the prices of medicines and vaccines; The link between freer trade and economic growth, which can lead to reduced poverty and higher standards of living, including better health.1
www.globalhealth.org
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Global Health Implications of Intellectual Property (IP) and TRIPS Patents, copyrights, and trademarks are the key types of IP, but what do they mean in the global health context? The cost and availability of patented drugs and the ability to generate generic drugs at lower costs are key issues for developing countries. TRIPS seeks to safeguard undisclosed information, such as test data and new drug compounds, and to protect the global market from counterfeit and substandard pharmaceuticals. In addition to increased morbidity and mortality, counterfeit and substandard drugs have an adverse economic cost to communities. The mistrust and ill-will generated when counterfeit and substandard drugs enter a market can have legal repercussions for stakeholders and the nations where the drugs originated. Global Health Implications of Services and GATS Workforce issues, education and telecommunications are relevant to GATS, which establishes international standards for medical care services. Movement of health care professionals from one country to another and outsourcing of certain services, such as medical record transcription, are subject to GATS. Although many aspects of workforce migration, including “brain drain” and movement of physicians, have received attention within the global health community over the past several years, the connection with trade in terms of international standards and policies has received less discussion. Additionally, within-country movement has significant implications for rural-urban health and for equitable distribution of goods and services. WHO and WTO in Trade: Roles and Responsibilities Although WTO has the responsibility for regulating trade among its members, WHO also plays a role in facilitating trade in health. What is WHO’s role in trade and how does it relate to and influence GATT, GATS and TRIPS? How does the Doha Development Round of the WTO talks fit in? What about International Health Regulations – what do they do? The WHO and WTO recently released a joint report outlining the major health implications of international trade treaties and what precautions need to be taken to promote international health and safety as globalization and international trade increases.8 GATT and Medical Products Several barriers are encountered in selling or donating medical products; obstacles include tariffs (taxes) and non-tariff barriers (e.g. imposition of language standards or fees related to transporting goods). What are the policies and practices concerning the sale of new or used medical products in developing countries? How does this vary by region/country? What are the potential solutions? Trade, Nutrition and Food Security The impact of trade on the food we eat is a basic concern. Both in terms of quantity and quality, the availability of food is critical in terms of security and health. Do imported foods change the disease prevalence in developing countries – changes in diet, increases in chronic diseases, reliance on imported food? Further Reading: Lancet Series on Trade and Health: http://www.thelancet.com/series/trade-and-health WHO Reports on Trade: http://www.who.int/trade/en/
References 1
WHO, WTO, 2002. WTO agreements and Public Health. Available from: http://www.wto.org WHO 2010. The WHO Agenda. Available from: http://www.who.int 3 WTO 1994. Article XX(b) of the GATT. Available from: http://www.wto.org 4 Drager N, Fidler D, 2004. GATS and Health Related Services. Available from: http://www.searo.who.int 5 WTO 2009. Principles of the Trading System. Available from: http://www.wto.org WTO. 6 Article 7 TRIPS Agreement Available from: http://www.wto.org 7 WTO 2009. Principles of the Trading System. Available from: http://www.wto.org
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