Environmental Engineering Reference
In-Depth Information
affairs, trade, intellectual property, justice, and regulatory drug authorities, as well as
national trade negotiators from the Geneva-based World Trade Organization (WTO)
and other intergovernmental organisations (IGwG 2008). In addition, as trade is
dealt with by the european commission, the european Union intervened on behalf
of its members as well as countries acceding to the eU. this expansion of actors,
coupled with the continuing strong negotiating position of developing countries,
reflects the continuing paradigm shift of global health diplomacy in the governance
of the wHo. civil society has played an important role in participating in, reporting
on, and disseminating the proceedings.
Health and Trade: Forging the Link
examining the relationship between trade and health reveals both conflict and
ambitious efforts to increase policy coherence. Historically, countries focussed on
ensuring that international trade was not restricted or impeded by health concerns.
today, the 'wHo's work on trade and health policy coherence reveals increasing
country-level commitment to, and sophistication about, strategies to promote trade
and protect health in ways that are politically feasible, economically attractive,
epidemiologically informed and ethically sound' (Drager and Fidler 2007).
Four of the multilateral trade agreements of wto that may affect public health
are particularly important to the wHo's work: the GatS, the agreement on the
application of Sanitary and Phytosanitary Measures (SPSagreement), theagreement
on technical barriers to trade (tbt agreement), and the trIPS agreement.
there is a clear linkage between trade and health in terms of patent law and
food safety regulations (see Drager and Sunderland 2007, 76). conversely, there are
health rules that affect trade, such as the IHr. although the revisions to the IHrwere
negotiated at the wHo, it was important to include the wto in order to ensure that
both organisations were on board with the outcomes. to maintain a good working
relationship and close cooperation, the wHo and wto continue to carry out joint
missions, training sessions, and senior-level meetings.
trade in health services is another major issue for domestic concern, second
only to the issues of trIPS and accession to the wto. trade in health services
is a trillion-dollar industry, ruled by the GatS. there are four modes of trade
that pose risks to health while simultaneously providing opportunities to improve
health: cross-border supply of services, consumption abroad, commercial presence,
and presence of persons (see Drager and Sunderland 2007, 75). each mode also
competes for prominence within the larger domestic economy. a case to consider
is e-health, where one benefit is the ability of consumers to stay in the country to
seek treatment via electronic communication; but consumers may also go abroad to
seek treatment, and there is significant migration of health professionals. Mode 4
of the GatS includes the globalisation of health services, which will happen more
as patients look for the least expensive treatment: occasionally it costs less to fly to
another country and spend tourism money there than to get treatment at home. the
