Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
Background Negotiations surrounding the Trans-Pacific Partnership (TPP) trade and investment agreement have recently concluded. Although trade and investment agreements, part of a broader shift to global economic integration, have been argued to be vital to improved economic growth, health, and general welfare, these agreements have increasingly come under scrutiny for their direct and indirect health impacts.
Methods We conducted a prospective health impact analysis to identify and assess a selected array of potential health risks of the TPP. We adapted the standard protocol for Health impact assessments (HIAs) (screening, scoping, and appraisal) to our aim of assessing potential health risks of trade and investment policy, and selected a health impact review methodology. This methodology is used to create a summary estimation of the most significant impacts on health of a broad policy or cluster of policies, such as a comprehensive trade and investment agreement.
Results Our analysis shows that there are a number of potentially serious health risks associated with the TPP, and details a range of policy implications for the health sector. Of particular focus are the potential implications of changes to intellectual property rights (IPRs), sanitary and phytosanitary measures (SPS), technical barriers to trade (TBT), investor-state dispute settlement (ISDS), and regulatory coherence provisions on a range of issues, including access to medicines and health services, tobacco and alcohol control, diet-related health, and domestic health policymaking.
Conclusion We provide a list of policy recommendations to mitigate potential health risks associated with the TPP, and suggest that broad public consultations, including on the health risks of trade and investment agreements, should be part of all trade negotiations.
Dollar D. Is globalization good for your health? Bull World Health Organ. 2001;79(9):827-833.
Baker P, Kay A, Walls H. Trade and investment liberalization and Asia’s noncommunicable disease epidemic: a synthesis of data and existing literature. Glob Health. 2014;10(1):66.
Friel S, Gleeson D, Thow AM, et al. A new generation of trade policy: potential risks to diet-related health from the trans pacific partnership agreement. Glob Health. 2013;9(1):46.
Friel S, Hattersley L, Snowdon W, et al. Monitoring the impacts of trade agreements on food environments. Obes Rev. 2013;14:120-134. doi:10.1111/obr.12081
Labonte R, Sanger M. Glossary of the World Trade Organisation and public health: part 1. J Epidemiol Community Health. 2006;60(8):655-661. doi:10.1136/jech.2005.037895
Labonte R, Sanger, M. Glossary on the World Trade Organisation and public health: part 2. J Epidemiol Community Health. 2006;60(9):738-744. doi:10.1136/jech.2005.038950
Schram A, Labonté R, Sanders D. Urbanization and international trade and investment policies as determinants of noncommunicable diseases in Sub-Saharan Africa. Prog Cardiovasc Dis. 2013;56(3):281-301.
Schram A, Labonté R, Baker P, Friel S, Reeves A, Stuckler D. The role of trade and investment liberalization in the sugar-sweetened carbonated beverages market: a natural experiment contrasting Vietnam and the Philippines. Glob Health. 2015;11(1):1.
Thow AM, Snowdon W, Labonté R, et al. Will the next generation of preferential trade and investment agreements undermine prevention of noncommunicable diseases? A prospective policy analysis of the Trans Pacific Partnership Agreement. Health Policy. 2015;119(1):88-96.
Thow AM. Trade liberalisation and the nutrition transition: mapping the pathways for public health nutritionists. Public Health Nutr. 2009;12(11):2150-2158.
Hirono K, Haigh F, Gleeson D, et al. Is health impact assessment useful in the context of trade negotiations? A case study of the Trans Pacific Partnership Agreement. BMJ Open. 2016;6:e010339. doi:10.1136/bmjopen-2015-010339
Hirono K, Haigh F, Gleeson D, Harris P, Thow AM. Negotiating Healthy Trade in Australia: A Health Impact Assessment of the Proposed Trans-Pacific Partnership Agreement. Liverpool, NSW: Centre for Health Equity Training Research and Evaluation; 2015. http://hiaconnect.edu.au/research-and-publications/tpp_hia/. Accessed March 11, 2015.
Faunce TA. The Trans-Pacific Partnership Agreement: challenges for Australian health and medicine policies. Med J Aust. 2011;194(2):83-86.
Van Harten G. Sovereign Choices and Sovereign Constraints: Judicial Restraint in Investment Treaty Arbitration. United Kingdom: Oxford University Press; 2013.
Chapman S. Australian government’s $50m investment in defending against Big Tobacco legal thuggery. The Conversation website. http://theconversation.com/australian-governments-50m-investment-in-defending-against-big-tobacco-legal-thuggery-45427. Accessed January 29, 2016. Published July 2015.
Tienhaara K. Regulatory chill and the threat of arbitration: a view from political science. In: Brown C, Miles K, eds. Evolution in Investment Treaty Law and Arbitration. United Kingdom: Cambridge University Press; 2011.
Eberhardt P, Olivet C. Profiting from Injustice: How Law Firms, Arbitrators and Financiers Are Fuelling an Investment Arbitration Boom. Brussels/Amsterdam: Corporate Europe Observatory and the Transnational Institute; 2012. http://www.tni.org/briefing/profiting-injustice. Accessed March 25, 2014.
Capaldo J, Izurieta A, Sundaram J. Trading down: Unemployment, Inequality and Other Risks of the Trans-Pacific Partnership Agreement. Medford, MA: Tufts University; 2016. http://ase.tufts.edu/gdae/. Accessed January 20, 2016.
Schram A, Ruckert A, Miller B, Labonté R. Media and Neoliberal Hegemony: Canadian Newspaper Coverage of the Trans-Pacific Partnership Agreement. Stud Polit Econ. Forthcoming.