Trade policies are plans and actions that affect the international commercial exchange of goods or services and, in particular, the regulation of exchanges and multilateral agreements governing the application of tariffs or non-tariff barriers to trade. These policies have a profound impact on health.
Trade can affect health in various ways. The impact may be direct, as when a disease crosses a border together with a traded good, or when a disease outbreak causes disruptions in trade and traffic. Today, direct affect issue of great concern are the increasing international flows of health professionals, which exacerbate health worker shortages. The impact may also be indirect, for example, reducing trade tariffs may lead to lower prices for medical equipment and health-related products, such as drugs and blood products. On the other hand, fluctuations in international prices can affect the social determinants of health, as the recent role of trade in rising food and energy prices demonstrates. Equally important are issues of access, which are created by changing international rules concerning the patent protection of essential medicines, diagnostic devices and the transfer of technology. Conversely, national and international health standards and rules can have important implications for trade, such as the Codex Alimentarius standards, the International Health Regulations, and the Framework Convention on Tobacco Control.
Europe, therefore, needs a coherent strategy on trade and health in relation to trade within the EU and with other countries. Equally important is the need for efforts to better understand the impact of European trade policies on health.
More on European Trade Policy and Global Health
Trade within the European Union:
Trade is determined by treaty obligations interpreted by the European Court of Justice (ECJ) and the policies and directives of the EU. In relation to health services there have been few clear policy directives governing trade within the EU, as health care services are regarded as a matter of subsidiarity, where power is exercised at national government level. In general, governments have resisted opening health care markets. However, this has been challenged in the ECJ by a series of cases which have generally ruled in favour of an open European market, allowing patients from one country to obtain services in another. Indeed, in the summer of 2008, the Commission put forward a proposal for an EU directive on cross-border patient mobility. However, the document will not go through the co-decision process during the remainder of the Barroso Commission, and it will need to be taken up once again following the June 2009 Parlimentary elections. By contrast the EU has generated a series of policies and directives since 1985 aimed at completing the single market in pharmaceuticals, a project which is still uncompleted. These experiences should be valuable in providing insights into the global problems of regulating the market in health and pharmaceuticals.
Trade with other countries:
The EU and its Member States played an active role in Doha discussions concerning access to medicines. The proposal which it put forward would have taken a broader view of health needs providing access to a range of drugs and not just those defined as meeting the needs of specific medical emergency conditions. The declaration represented a compromise reached with the US which had demanded more stringent controls on intellectual property rights.
- Interesting Oxfam paper from 2008, still very relevant: “Partnership or Power Play? How Europe should bring development into its trade deals with African, Caribbean and Pacific countries” http://www.oxfam.org/sites/www.oxfam.org/files/bp110_europe_EPAs_trade _deals_with_acp_countries_0804.pdf