This study provides a broad overview of the multiple connections between trade and health, including by reviewing the WTO framework from an health point of view. It also outlines the key elements on which the WTO has the competence to enhance health through trade-related policies.
Trade and health interlinkages have been strongly highlighted amidst the COVID-19 pandemic. Not only has trade in medical goods grown substantially between 2019 and 2021, but the deeper relationship between trade and health has also raised many interrogations. Among others, health-related discussions were initiated at the WTO while trade-related measures were put forward by the WHO. This study aims at giving a broad overview of the multiple connections between trade and health. By reviewing the whole WTO framework from an health point of view, the study provides key elements on which the WTO has the competence to enhance health through trade-related policies.
Health being a fundamental human right, it is important to reassess the essential determinants of a well-functioning health system. To fulfill the multiple goals of a health system, the following are needed: i) a transparent governance and good leadership practices, ii) health information systems, iii) health financing, iv) human resources for health, v) service delivery and vi) essential medical products and technologies. While all of them have relationships with trade, the study focusses on the two last points as they can be directly impacted by trade policies.
Indeed, many aspects of the access to medical goods, services and technologies is governed by the WTO agreements. The General Agreement on Tariffs and Trade (GATT) – and several subsidiary agreements to GATT – is applicable trade in medical goods also, among others. Trade in different types of goods can impact health through, for example, trade in foodborne diseases or trade in “health bads”. Hence, WTO agreements such as the Sanitary and Phytosanitary (SPS) Agreement as well as the Technical Barriers to Trade (TBT) Agreement help containing circulation of goods that could potentially endanger human health and life. In addition, the Pharmaceutical Agreement relates directly and only to trade in medical goods. On the other hand, the General Agreement on Trade in Services (GATS) of the WTO covers trade in health services. While the liberalisation commitments by WTO Members in health services have been limited so far, there is substantial growth potential in this sector through various modes of supply. Finally, Intellectual Property (IP) protection is a critical part of the debate revolving around access to medical goods and technologies, including vaccines. The WTO TRIPS Agreement aims at protecting innovation, including in the health sector, through IP rights while trying to balance it with the flexibilities required to deal with public health emergencies. It is therefore central to current discussions concerning affordable accessibility of COVID-19 prevention, containment, and treatment goods and technologies around the world.
The Trade and Health Initiative brought to the fore in 2020 at the WTO manifests the crucial need for policy makers to link trade and health matters. Furthermore, the COVID-19 pandemic demonstrated the importance of a strong collaboration between international organisations dealing with trade and health (i.e. the WTO and the WHO) respectively. The continuation and strengthening of such collaboration as well as an improved dialogue between trade and health policy makers have the potential to foster better health in the whole world for the years to come. This potential can be realised through an integrated framework approach to the world trade and health governance systems.