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Hassan MU, Rana AT, Khan M, Gillani S. Trade agreements and CO 2 emissions in Asian countries: accounting for institutional heterogeneity. Environ Sci Pollut Res Int 2024; 31:9197-9217. [PMID: 38191733 DOI: 10.1007/s11356-023-31684-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024]
Abstract
This paper aims to measure the impact of environmental provisions in free-trade agreements on pollution levels in 40 Asian economies for the period 1990-2019. Following the failure of WTO negotiations, there has been a rapid proliferation of preferential trade agreements incorporating various types of environmental clauses. We exploit such changes to assess their influence on pollution emissions. We use a DOLS approach that considers the potential endogeneity of environmental clauses. Further, panel vector error correction models (VECM) are employed for examining the presence of a cointegration relationship among the variables studied. Overall, our findings indicate that these environmental clauses have heterogenous effects on CO2 emissions. We do not find significant effects of environmental clauses on pollution. However, this result is driven by environmental provisions that are not legally enforceable. We do find a positive effect of environmental clauses with a higher level of legalism on the environmental quality. These results show that the inclusion of environmental provisions in trade agreements is not sufficient by itself. Such provisions should incorporate a legally enforceable framework to effectively address environmental concerns. These findings have significant policy implications for Asian countries.
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Affiliation(s)
- Mehboob Ul Hassan
- Department of Economics, College of Business Administration, King Saud University, Riyadh, Saudi Arabia.
| | - Arslan Tariq Rana
- Department of Economics, Faculty of Arts and Social Sciences, University of Central Punjab (UCP), Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, Pakistan
| | - Muhammad Khan
- Department of Social Sciences, IQRA University (Islamabad Campus), 05 Khayaban-E-Johar, H-9, Islamabad, Pakistan
| | - Samreen Gillani
- Department of Economics, Faculty of Arts and Social Sciences, University of Central Punjab (UCP), Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, Pakistan
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Yuan W, Lu W, Zhang J. The impact of depth of environmental provisions and CO 2 emissions embodied in international trade. Environ Sci Pollut Res 2023; 30:108301-108318. [PMID: 37749474 DOI: 10.1007/s11356-023-29940-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023]
Abstract
The construction of trade power and green low-carbon transformation are common high-quality development goals for countries worldwide. The depth of the environmental provisions contained in different countries' intercountry trade agreements and the implicit carbon data of intercountry trade are accurately measured based on the textual analysis of trade agreement rules, and it is empirically found that enhancing the depth of the environmental provisions contained in trade agreements can significantly reduce CO2 emissions embodied in international trade. The capacity of intercountry green technology cooperation to strengthen the internal environmental governance capacity of countries and to enhance carbon productivity is an important transmission mechanism. The effect of the environmental provisions in different types of trade agreements on reducing trade-implied carbon is obviously heterogeneous; the higher the level of correlation with carbon emissions is, the stronger the effect of trade agreement provisions, and that effect is more significant in developed countries and in the reduction of foreign carbon emissions that are embedded in export products. In this paper, the impact of the depth of the environmental provisions of trade agreements on trade-implied carbon under the same framework is directly studied, which not only advances the measurement of the depth of the environmental provisions of trade agreements and expands the research field on the scope of influence of existing trade agreements but also fully accounts for the role of the effectiveness of environmental provisions in different contexts and provides a theoretical basis for the optimization of future environmental provisions.
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Affiliation(s)
- Wenhua Yuan
- Institute of International Economy, University of International Business and Economics, No. 10 Huixin Street, Chaoyang District, Beijing, 100029, China
| | - Weixiao Lu
- Business School, Yangzhou University, No. 196, Huayang West Road, Yangzhou, 225127, Jiangsu, China.
| | - Junyan Zhang
- Institute of Economics, Shanxi University of Finance and Economics, No. 696 Wucheng Road, Taiyuan City, 030006, Shanxi, China
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Townsend B, Tenni BF, Goldman S, Gleeson D. Public health advocacy strategies to influence policy agendas: lessons from a narrative review of success in trade policy. Global Health 2023; 19:60. [PMID: 37612767 PMCID: PMC10463651 DOI: 10.1186/s12992-023-00960-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Despite accumulating evidence of the implications of trade policy for public health, trade and health sectors continue to operate largely in silos. Numerous barriers to advancing health have been identified, including the dominance of a neoliberal paradigm, powerful private sector interests, and constraints associated with policymaking processes. Scholars and policy actors have recommended improved governance practices for trade policy, including: greater transparency and accountability; intersectoral collaboration; the use of health impact assessments; South-South networking; and mechanisms for civil society participation. These policy prescriptions have been generated from specific cases, such as the World Trade Organization's Doha Declaration on TRIPS and Public Health or specific instances of trade-related policymaking at the national level. There has not yet been a comprehensive analysis of what enables the elevation of health goals on trade policy agendas. This narrative review seeks to address this gap by collating and analysing known studies across different levels of policymaking and different health issues. RESULTS Sixty-five studies met the inclusion criteria and were included in the review. Health issues that received attention on trade policy agendas included: access to medicines, food nutrition and food security, tobacco control, non-communicable diseases, access to knowledge, and asbestos harm. This has occurred in instances of domestic and regional policymaking, and in bilateral, regional and global trade negotiations, as well as in trade disputes and challenges. We identified four enabling conditions for elevation of health in trade-related policymaking: favourable media attention; leadership by trade and health ministers; public support; and political party support. We identified six strategies successfully used by advocates to influence these conditions: using and translating multiple forms of evidence, acting in coalitions, strategic framing, leveraging exogenous factors, legal strategy, and shifting forums. CONCLUSION The analysis demonstrates that while technical evidence is important, political strategy is necessary for elevating health on trade agendas. The analysis provides lessons that can be explored in the wider commercial determinants of health where economic and health interests often collide.
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Affiliation(s)
- Belinda Townsend
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Australian National University, Canberra, Australia.
| | - Brigitte Frances Tenni
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
- Nossal Institute for Global Health, The School of Population and Global Health, The University of Melbourne, Carlton, VIC, 3010, Australia
| | - Sharni Goldman
- Australian Research Centre for Health Equity, School of Regulation and Global Governance, Australian National University, Canberra, Australia
| | - Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia
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Ravuvu A, Lui JP, Bani A, Tavoa AW, Vuti R, Win Tin ST. Analysing the impact of trade agreements on national food environments: the case of Vanuatu. Global Health 2021; 17:107. [PMID: 34530860 PMCID: PMC8447725 DOI: 10.1186/s12992-021-00748-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/30/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND A large body of literature exists on trade liberalisation and the ways in which trade agreements can affect food systems. However, the systematic and objective monitoring of these and their impact on national food environments has been limited. Using a case study, this paper undertakes a systematic analysis of how Vanuatu's obligations under WTO agreements has impacted its food environment. RESULTS Data collection was guided by the INFORMAS trade monitoring framework's minimal approach and seven selected indicators outlined in three domains: trade in goods, trade in services and FDI, and policy space. Strong associations between trade liberalisation and imported foods, especially ultra-processed foods were evident in measured indicators as follows: (i) food trade with 32 WTO countries showing high levels of import volumes; (ii) a marked increase in 'less healthy' focus food imports namely fatty and other selected meat products, sugar, savoury snacks, ice-cream and edible ices and energy-dense beverages; (iii) actual and bound tariff rates impacting import trends of ice-cream and edible ices, bakery products and confectionary; and in other instances, a sharp increase in import of crisps, snacks and noodles despite tariff rates remaining unchanged from 2008 to 2019; (iv) policies regulating food marketing, composition, labelling and trade in the domestic space with relatively limited safeguard measures; (v) 49 foreign-owned food-related companies involved in food manufacturing and processing and the production of coffee, bakery products, confectionary, food preservatives, fish, local food products and meat, and the manufacturing, processing and packaging of palm oil, coconut oil, cooking oil, water, cordial juice, flavoured juices, soft drinks and alcoholic beverages. These were largely produced for local consumption; (vi) 32 domestic industries engaged in food and beverage production; and (vii) an assessment of WTO provisions relating to domestic policy space and governance showing that the current legal and regulatory environment for food in Vanuatu remains fragmented. CONCLUSIONS The analysis presented in this paper suggest that Vanuatu's commitments to WTO agreements do play an important role in shaping their food environment and the availability, nutritional quality, and accessibility of foods.
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Affiliation(s)
- Amerita Ravuvu
- Non-Communicable Disease Policy & Planning Adviser, Public Health Division, Pacific Community (SPC), Private Mail Bag, Suva, Fiji
| | - Joe Pakoa Lui
- Department of External Trade, Ministry of Foreign Affairs, International Cooperation and External Trade, Government of the Republic of Vanuatu, Port Vila, Vanuatu
| | - Adolphe Bani
- Department of External Trade, Trade Negotiation Division, Ministry of Foreign Affairs, International Cooperation and External Trade, Government of the Republic of Vanuatu, Port Vila, Vanuatu
| | - Anna Wells Tavoa
- International Trade Merchandise Statistics, Vanuatu Statistics Office, Ministry of Finance and Economic Management, Government of the Republic of Vanuatu, Port Vila, Vanuatu
| | - Raymond Vuti
- Vanuatu Investment Promotion Authority, Port Vila, Vanuatu
| | - Si Thu Win Tin
- Non-Communicable Diseases, Public Health Division, Pacific Community (SPC), Suva, Fiji
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Milsom P, Smith R, Baker P, Walls H. Corporate power and the international trade regime preventing progressive policy action on non-communicable diseases: a realist review. Health Policy Plan 2021; 36:493-508. [PMID: 33276385 PMCID: PMC8128013 DOI: 10.1093/heapol/czaa148] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2020] [Indexed: 12/21/2022] Open
Abstract
Transnational tobacco, alcohol and ultra-processed food corporations use the international trade regime to prevent policy action on non-communicable diseases (NCDs); i.e. to promote policy 'non-decisions'. Understanding policy non-decisions can be assisted by identifying power operating in relevant decision-making spaces, but trade and health research rarely explicitly engages with theories of power. This realist review aimed to synthesize evidence of different forms and mechanisms of power active in trade and health decision-making spaces to understand better why NCD policy non-decisions persist and the implications for future transformative action. We iteratively developed power-based theories explaining how transnational health-harmful commodity corporations (THCCs) utilize the international trade regime to encourage NCD policy non-decisions. To support theory development, we also developed a conceptual framework for analysing power in public health policymaking. We searched six databases and relevant grey literature and extracted, synthesized and mapped the evidence against the proposed theories. One hundred and four studies were included. Findings were presented for three key forms of power. Evidence indicates THCCs attempt to exercise instrumental power by extensive lobbying often via privileged access to trade and health decision-making spaces. When their legitimacy declines, THCCs have attempted to shift decision-making to more favourable international trade legal venues. THCCs benefit from structural power through the institutionalization of their involvement in health and trade agenda-setting processes. In terms of discursive power, THCCs effectively frame trade and health issues in ways that echo and amplify dominant neoliberal ideas. These processes may further entrench the individualization of NCDs, restrict conceivable policy solutions and perpetuate policymaking norms that privilege economic/trade interests over health. This review identifies different forms and mechanisms of power active in trade and health policy spaces that enable THCCs to prevent progressive action on NCDs. It also points to potential strategies for challenging these power dynamics and relations.
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Affiliation(s)
- Penelope Milsom
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, Kings Cross, London WC1H 9SH, UK
| | - Richard Smith
- College of Medicine and Health, University of Exeter, Magdalen Road, Exeter, EX1 2LU, UK
| | - Phillip Baker
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Victoria 3125 Australia
| | - Helen Walls
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, Kings Cross, London WC1H 9SH, UK
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Chatellier V. Review: International trade in animal products and the place of the European Union: main trends over the last 20 years. Animal 2021; 15 Suppl 1:100289. [PMID: 34312091 DOI: 10.1016/j.animal.2021.100289] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/24/2022] Open
Abstract
This article presents an analysis of the evolution of international trade in animal products over the period 2000 to 2018, using customs data from the "BACI" database. Firstly, this article presents the evolution of global trade in animal products for the top five exporting countries (in decreasing order: the European Union (EU), the United States, New Zealand, Brazil and Australia) and then for the two largest importers (China and Japan). It then looks at the world trade situation for four major animal products: poultry meat, pig meat, beef and dairy products. Animal products account for 16% of world agro-food trade; this rate has remained fairly stable throughout the period. The growing imbalance between supply and demand for animal products in Asian countries, particularly in China, is stimulating international trade to the benefit of the major exporting countries. The EU is the world's leading exporter of animal products (with 21% of the total in 2018) and the fourth importer (with 6% of the total). It is in surplus in dairy products and pig meat, but in deficit (in value) in beef and poultry meat. Dairy products, which are exported by very few countries (mainly the EU, New Zealand and the United States), account for almost a third of all trade in animal products. They are thus ahead of beef (23%), pork (12%) and poultry meat (12%). Trade in live animals remains low (5%).
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Affiliation(s)
- V Chatellier
- INRAE, UMR SMART-LERECO, Rue de la Géraudière, 44300 Nantes, France.
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Gleeson D, Lexchin J, Labonté R, Townsend B, Gagnon MA, Kohler J, Forman L, Shadlen KC. Analyzing the impact of trade and investment agreements on pharmaceutical policy: provisions, pathways and potential impacts. Global Health 2019; 15:78. [PMID: 31775767 PMCID: PMC6882307 DOI: 10.1186/s12992-019-0518-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Trade and investment agreements negotiated after the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) have included increasingly elevated protection of intellectual property rights along with an expanding array of rules impacting many aspects of pharmaceutical policy. Despite the large body of literature on intellectual property and access to affordable medicines, the ways in which other provisions in trade agreements can affect pharmaceutical policy and, in turn, access to medicines have been little studied. There is a need for an analytical framework covering the full range of provisions, pathways, and potential impacts, on which to base future health and human rights impact assessment and research. A framework exploring the ways in which trade and investment agreements may affect pharmaceutical policy was developed, based on an analysis of four recently negotiated regional trade agreements. First a set of core pharmaceutical policy objectives based on international consensus was identified. A systematic comparative analysis of the publicly available legal texts of the four agreements was undertaken, and the potential impacts of the provisions in these agreements on the core pharmaceutical policy objectives were traced through an analysis of possible pathways. Results An analytical framework is presented, linking ten types of provisions in the four trade agreements to potential impacts on four core pharmaceutical policy objectives (access and affordability; safety, efficacy, and quality; rational use of medicines; and local production capacity and health security) via various pathways. Conclusions The analytical framework highlights provisions in trade and investment agreements that need to be examined, pathways that should be explored, and potential impacts that should be taken into consideration with respect to pharmaceutical policy. This may serve as a useful checklist or template for health and human rights impact assessments and research on the implications of trade agreements for pharmaceuticals.
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Affiliation(s)
- Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Joel Lexchin
- School of Health Policy & Management, York University, Toronto, Canada
| | - Ronald Labonté
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Belinda Townsend
- School of Regulation and Global Governance, Australian National University, Canberra, Australia
| | - Marc-André Gagnon
- School of Public Policy & Administration, Carleton University, Ottawa, Canada
| | - Jillian Kohler
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Lisa Forman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kenneth C Shadlen
- Department of International Development, London School of Economics and Political Science, London, UK
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Friel S, Baker P, Thow AM, Gleeson D, Townsend B, Schram A. An exposé of the realpolitik of trade negotiations: implications for population nutrition. Public Health Nutr 2019; 22:3083-91. [PMID: 31439059 DOI: 10.1017/S1368980019001642] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the formal and informal ways in which different actors involved in shaping trade agreements pursue their interests and understand the interactions with nutrition, in order to improve coherence between trade and nutrition policy goals. DESIGN The paper draws on empirical evidence from Australian key informant interviews that explore the underlying political dimensions of trade agreements that act as barriers or facilitators to getting nutrition objectives on trade agendas. SETTING Countries experiencing greater availability and access to diets full of energy-dense and nutrient-poor foods through increased imports, greater foreign direct investment and increasing constraints on national health policy space as a result of trade agreements. PARTICIPANTS Interviews took place with Australian government officials, industry, public-interest non-government organizations and academics. RESULTS The analysis reveals the formal and informal mechanisms and structures that different policy actors use both inside and outside trade negotiations to pursue their interests. The analysis also identifies the discourses used by the different actors, as they attempt to influence trade agreements in ways that support or undermine nutrition-related goals. CONCLUSIONS Moving forward requires policy makers, researchers and health advocates to use various strategies including: reframing the role of trade agreements to include health outcomes; reforming the process to allow greater access and voice to health arguments and stakeholders; establishing cross-government partners through accountable committees; and building circles of consensus and coalitions of sympathetic public-interest actors.
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Ravuvu A, Friel S, Thow AM, Snowdon W, Wate J. Monitoring the impact of trade agreements on national food environments: trade imports and population nutrition risks in Fiji. Global Health 2017; 13:33. [PMID: 28610575 PMCID: PMC5470202 DOI: 10.1186/s12992-017-0257-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/07/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Trade agreements are increasingly recognised as playing an influential role in shaping national food environments and the availability and nutritional quality of the food supply. Global monitoring of food environments and trade policies can strengthen the evidence base for the impact of trade policy on nutrition, and support improved policy coherence. Using the INFORMAS trade monitoring protocol, we reviewed available food supply data to understand associations between Fiji's commitments under WTO trade agreements and food import volume trends. METHODS First, a desk review was conducted to map and record in one place Fiji's commitments to relevant existing trade agreements that have implications for Fiji's national food environment under the domains of the INFORMAS trade monitoring protocol. An excel database was developed to document the agreements and their provisions. The second aspect of the research focused on data extraction. We began with identifying food import volumes into Fiji by country of origin, with a particular focus on a select number of 'healthy and unhealthy' foods. We also developed a detailed listing of transnational food corporations currently operating in Fiji. RESULTS The study suggests that Fiji's WTO membership, in conjunction with associated economic and agricultural policy changes have contributed to increased availability of both healthy and less healthy imported foods. In systematically monitoring the import volume trends of these two categories of food, the study highlights an increase in healthy foods such as fresh fruits and vegetables and whole-grain refined cereals. The study also shows that there has been an increase in less healthy foods including fats and oils; meat; processed dairy products; energy-dense beverages; and processed and packaged foods. CONCLUSION By monitoring the trends of imported foods at country level from the perspective of trade agreements, we are able to develop appropriate and targeted interventions to improve diets and health. This would enable national health interventions to both identify areas of concern, and to ensure that interventions take into account the trade context.
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Affiliation(s)
- Amerita Ravuvu
- School of Regulation and Global Governance (RegNet), The Australian National University, H.C. Coombs Extension Building #8, Fellows Road ACT, Canberra, 0200 Australia
| | - Sharon Friel
- School of Regulation and Global Governance (RegNet), The Australian National University, H.C. Coombs Extension Building #8, Fellows Road ACT, Canberra, 0200 Australia
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, School of Public Health, The University of Sydney, Sydney, Australia
| | - Wendy Snowdon
- Centre for Population Health Research, Deakin University, Burwood, Australia
| | - Jillian Wate
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
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Hirono K, Haigh F, Gleeson D, Harris P, Thow AM, Friel S. 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. [PMID: 27044579 PMCID: PMC4823461 DOI: 10.1136/bmjopen-2015-010339] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The Trans Pacific Partnership Agreement (TPP) is a recently concluded free trade agreement involving Australia and 11 other Pacific-rim nations, which has the potential for far-reaching impacts on public health. A health impact assessment (HIA) was carried out during the negotiations to determine the potential future public health impact in Australia and to provide recommendations to mitigate potential harms. This paper explores the findings and outcomes of the HIA, and how this approach can be used to provide evidence for public health advocacy. DESIGN A modified version of the standard HIA process was followed. The HIA was led by technical experts in HIA, trade policy, and health policy, in collaboration with advocacy organisations concerned with the TPP and health. The HIA reviewed the provisions in leaked TPP text in order to determine their potential impact on future health policy. As part of this process, researchers developed policy scenarios in order to examine how TPP provisions may affect health policies and their subsequent impact to health for both the general and vulnerable populations. The four policy areas assessed were the cost of medicines, tobacco control, alcohol control and food labelling. RESULTS In all areas assessed, the HIA found that proposed TPP provisions were likely to adversely affect health. These provisions are also likely to more adversely affect the health of vulnerable populations. CONCLUSIONS The HIA produced relevant evidence that was useful in advocacy efforts by stakeholders, and engaging the public through various media platforms.
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Affiliation(s)
- Katherine Hirono
- Centre for Health Equity Training, Research and Evaluation, University of New South Wales, A Member of the Ingham Institute, Liverpool, New South Wales, Australia
| | - Fiona Haigh
- Centre for Health Equity Training, Research and Evaluation, University of New South Wales, A Member of the Ingham Institute, Liverpool, New South Wales, Australia
| | - Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Patrick Harris
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales, Australia
| | - Sharon Friel
- RegNet School of Regulation and Global Governance, Australian National University, Canberra, Australian Capital Territory, Australia
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Gleeson D, Lopert R, Reid P. How the Trans Pacific Partnership Agreement could undermine PHARMAC and threaten access to affordable medicines and health equity in New Zealand. Health Policy 2013; 112:227-33. [PMID: 23992756 DOI: 10.1016/j.healthpol.2013.07.021] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Revised: 07/16/2013] [Accepted: 07/23/2013] [Indexed: 11/25/2022]
Abstract
New Zealand's Pharmaceutical Management Agency (PHARMAC) has been highly successful in facilitating affordable access to medicines through a combination of aggressive price negotiations, innovative procurement mechanisms, and careful evaluation of value for money. Recently the US government, through the establishment of a series of bilateral and plurilateral "free" trade agreements, has attempted to constrain the pharmaceutical access programs of other countries in order to promote the interests of the pharmaceutical industry. The Trans Pacific Partnership Agreement (TPPA) represents the latest example; through the TPPA the US is seeking to eliminate therapeutic reference pricing, introduce appeals processes for pharmaceutical companies to challenge formulary listing and pricing decisions, and introduce onerous disclosure and "transparency" provisions that facilitate industry involvement in decision-making around coverage and pricing of medicines (and medical devices). This paper argues that the US agenda, if successfully prosecuted, would be likely to increase costs and reduce access to affordable medicines for New Zealanders. This would in turn be likely to exacerbate known inequities in access to medicines and thus disproportionately affect disadvantaged population groups, including Māori and Pacific peoples.
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Affiliation(s)
- Deborah Gleeson
- School of Public Health and Human Biosciences, La Trobe University, VIC 3086, Australia.
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