Evolving Norms at the Intersection of Health and Trade

Abstract

There has been growing tension at the intersection of health and economic policymaking as global governance has increased across sectors. This tension has been particularly evident between tobacco control and trade policy, as the international norms that frame them – particularly the Framework Convention on Tobacco Control and the World Trade Organization (WTO) – have continued to institutionalize. Using five case studies of major tobacco-related trade disputes from the principal multilateral system of trade governance – the WTO/General Agreement on Tariffs and Trade – we trace the evolution of these interacting norms over nearly 25 years. Our analytic framework particularly focuses on the actors that advance, defend and challenge these norms. We find that an increasingly broad network, which includes governments, intergovernmental organizations, non-governmental organizations and members of the epistemic community, is playing a more active role in seeking to resolve these tensions. Moreover, key economic actors are beginning to incorporate health more actively in their messaging and activities. We also demonstrate that the most recent resonant messages reflect a more nuanced integration of the two norms. The tobacco control example has direct relevance to related policy areas, including environment, safety, access to medicines, diet, and alcohol.

Trade Policy and Public Health

“…Tobacco-related disease kills nearly six million people each year, with populations in LMICs increasingly at risk (137). These health challenges will continue to grow rapidly as tobacco companies push aggressively into developing countries with young populations, growing incomes, and often relatively weak political systems (31). Trade liberalization has increased both the imports of tobacco products into countries worldwide and the levels of FDI by the tobacco industry.…”

“…The FCTC may be used to interpret international trade and investment agreements, making those agreements more sensitive to tobacco control (31). However, the provisions set out in the FCTC have been repeatedly challenged under international trade law (84).…”

Development goals in the post-2015 world: Whither Canada?

“…Canada has also been opposing almost every effort by the US to extend patent protection in the TPPA beyond provisions in the World Trade Organization's TRIPS (Trade-Related Aspects of Intellectual Property Rights) Agreement 16 and has used public health arguments to defend its ban on certain tobacco flavourings in committee meetings at the World Trade Organization. 17 So there may be some room for a stronger global public health presence in Canadian trade policy to guide how the post-2015 goals on trade are implemented.…”

Advancing progressive health policy to reduce NCDs amidst international commercial opposition: Tobacco standardised packaging in Australia

“…Efforts to generate global momentum for advanced tobacco packaging and labelling laws has some scholars labelling this progress as ‘too hot for regulatory chill’ (Lencucha, Labonte, & Drope, 2015). This success can be partially attributed to the evolution of the intersection between tobacco and trade (referred to as the tobacco-trade nexus), in which the global discourse on tobacco norms has been integrated in international trade and investment discussions and decisions (Drope & Lencucha, 2013, 2014). These norms have been further institutionalised through the adoption of the WHO Framework Convention on Tobacco Control (FCTC), which established a set of guidelines, obligations, and standards for treaty parties to reduce tobacco use (World Health Organization, 2003).…”