Public Health Association of Australia: Policy-at-a-glance Trade Agreements & Health Policy

Transcription

1 Public Health Association of Australia: Policy-at-a-glance Trade Agreements & Health Policy Key message: 1. Trade agreements should not limit or override a Government s ability to legislate and regulate systems and infrastructure that contribute to the health and well-being of its citizens. 2. The ability of governments to develop and implement policy that protects public health needs to be preserved in trade agreements. 3. PHAA advocates a trade regime that ensures ecological sustainability and equity in population health as well as economic development. Summary: PHAA will advocate at the national and international levels to promote and protect public health within international trade agreements and limit adverse impacts of trade agreements on human and planetary health in Australia and internationally. Audience: Responsibility: Australian Government, policy makers and international public health organisations. PHAA s Political Economy of Health Special Interest Group (SIG) Date policy adopted: September 2015 Contact: Dr Deborah Gleeson, Convenor, Political Economy of Health SIG d.gleeson@latrobe.edu.au 1

2 TRADE AGREEMENTS AND HEALTH POLICY The Public Health Association of Australia notes that: 1. Trade agreements include those administered through the World Trade Organization (WTO). They also include bilateral and plurilateral agreements negotiated outside the WTO. 2. Health status is affected by factors within and outside the health sector, including macroeconomic policy. 3. Recent trade negotiations have gone beyond goods and services to include areas that affect government regulation including investment, economic and technical cooperation, and expanded intellectual property rights. Thus, trade agreements have the potential to affect many aspects of health care and public health. 1,2 These include, but are not limited to: access to affordable medicines; the equitable provision and quality of health care services; the ability of governments to regulate health damaging products such as tobacco, alcohol, gambling products, ultra/highly-processed foods, and unsafe medicines; access to sufficient and safe nutritious food; capacity to legislate or regulate to protect the natural environment; and other determinants of health such as employment and working conditions. 4. PACER Plus, the Pacific Agreement on Closer Economic Relations, is a plurilateral agreement being negotiated between Australia, New Zealand and the Pacific islands. It has potential to damage the health of Pacific Islanders through: loss of government revenues from significantly reduced tariffs thereby limiting government expenditure on health and social services; increasing exposure to ultra-processed food, alcohol and tobacco; increasing foreign investment in healthcare; increasing medicine costs; and exacerbating the brain drain of health workers Leaks from the Trans Pacific Partnership Agreement (TPPA) negotiations indicate many risks to health. 3,4 These include proposals to expand and extend medicine monopolies that would delay the availability of affordable generics. A proposed investor-state dispute settlement mechanism would allow corporations to sue governments in international tribunals over policies and laws that they perceive harm their investments. Similar issues may arise in the negotiations for the Regional Comprehensive Economic Partnership (RCEP) with leaks indicating Japan and South Korea are seeking high levels of intellectual property protection. 5,6 6. The Trade in Services Agreement (TISA), a proposed agreement between 24 countries including Australia, seeks to liberalise services. A leaked paper proposes to promote the use of health insurance for medical tourism. Off-shoring of medical treatment would 2

3 have repercussions for Australia s health system as well as diverting health resources from public to private medical care in provider countries Trade agreements are currently negotiated in secret. Public health professionals and the public rely on leaked drafts for information about the issues under negotiation Alternative financing mechanisms that do not rely on intellectual property (IP) protection and monopoly pricing must be supported to facilitate access to essential medicines and the development of pharmaceuticals for diseases of the developing world. 10 Trade agreements should not further entrench and expand a global IP regime that fails to deliver affordable access to medicines for much of the world s population. The Public Health Association of Australia affirms the following principles, together with the Public Health Association of New Zealand: A fair regime of regulating trade, investment and intellectual property ( trade and investment agreements ) should prioritise health and social and ecological sustainability as well as economic development. Trade and investment agreements, and their dispute settlement mechanisms, should be consistent with international law with regard to health, human rights, the environment, and worker protection. Trade and investment agreements must: a. prioritise equity within and between countries for global population health improvement. b. not limit or override a country s ability to foster and maintain systems and infrastructure that contribute to the health and well-being of its citizens, nor penalise a government for doing so. c. preserve policy space for governments to regulate to protect public health. d. be negotiated in a transparent fashion, with opportunities for public and parliamentary scrutiny before commitments are made. e. be subject to health and environmental impact assessments, carried out by parties independent of corporate interests. The Public Health Association of Australia resolves to take the following actions: Advocate to appropriate Commonwealth politicians and agencies with a view to: Supporting implementation of WHO Resolution which mandates WHO to provide advice to governments regarding the implications of trade agreements for health; 9 3

4 Supporting moves within WHO to reform the funding of R&D to facilitate access to essential medicines and the development of pharmaceuticals for diseases of the developing world, 10 and ensuring that trade agreements do not further entrench a failed model of financing; Through the World Federation of Public Health Associations (WFPHA), the People s Health Movement, and other international public health and human rights groups, encourage the public health community to advocate to promote and protect public health within international trade agreements. Work with the Australian Fair Trade and Investment Network and other national organisations towards limiting adverse impacts of trade agreements on health in Australia and its trading partners. This includes making submissions to relevant government departments. Advocate for transparent trade negotiating practices and for the routine use of independent health, environmental and human rights impact assessment during negotiations, before agreements are finalised and after implementation. References: 1. Blouin C, Chopra M, van der Hoeven R. Trade and social determinants of health. Lancet. 2009;373: Legge D, Sanders D, McCoy D. Trade and health: the need for a political economic analysis. Lancet. 2009;373: Gleeson D, Friel S. Emerging threats to public health from regional trade agreements. Lancet. 2013;381: Hirono H, Haigh F, Gleeson D, Harris P, Thow, A M. Negotiating healthy trade in Australia: Health impact assessment of the proposed Trans Pacific Partnership Agreement. Liverpool, NSW: Centre for Health Equity Training Research and Evaluation, part of the Centre for Primary Health Care and Equity, Faculty of Medicine, UNSW Australia, Palmedo, P. Intellectual Property Provisions in the Leaked Japanese RCEP Proposal May Limit the Availability of Generic Medicines. Program on Information Justice and Intellectual Property, Public Health Association of Australia. Submission to the Foreign Affairs, Defence and Trade Reference Committee on the Commonwealth s treaty-making process, particularly in the light of the growing number of bilateral and multilateral trade agreements, Morgan, W. (2010). Public Forum on Trade and Health in the Pacific: PACER-Plus: Should we be Concerned? Final Report. Available from 8. Koivusalo M, Schrecker T, Labonte R. Globalization and policy space for health and social determinants of health. In: Labonte, R., Schrecker, T., Packer, C. and Runnels, V. (eds). Globalization and Health: Pathways, Evidence and Policy. Routledge, New York, World Health Assembly (2006). International trade and health. Resolution 59.26, 27 May World Health Organization Intergovernmental Working Group on Public Health (2007). Draft global strategy and plan of action on public health, innovation and intellectual 4

5 property; Interagency work on the interface between trade, intellectual property and public health. Geneva, WHO. ADOPTED 2004, REVISED AND RE-ENDORSED IN 2008 AND 2011 and 2015 First adopted at the PHAA Annual General Meeting held on 9 October 2004 following the IUHPE PHAA Policy forum in April Revised and re-endorsed as part of the 2008 and 2011 policy review processes. 5