Trade and investment liberalization and Asia¿s noncommunicable disease epidemic: a synthesis of data and existing literature

Abstract

Background: Trade and investment liberalization (trade liberalization) can promote or harm health. Undoubtedly it has contributed, although unevenly, to Asia's social and economic development over recent decades with resultant gains in life expectancy and living standards. In the absence of public health protections, however, it is also a significant upstream driver of non-communicable diseases (NCDs) including cardiovascular disease, cancer and diabetes through facilitating increased consumption of the 'risk commodities' tobacco, alcohol and ultra-processed foods, and by constraining access to NCD medicines. In this paper we describe the NCD burden in Asian countries, trends in risk commodity consumption and the processes by which trade liberalization has occurred in the region and contributed to these trends. We further establish pressing questions for future research on strengthening regulatory capacity to address trade liberalization impacts on risk commodity consumption and health. Methods: A semi-structured search of scholarly databases, institutional websites and internet sources for academic and grey literature. Data for descriptive statistics were sourced from Euromonitor International, the World Bank, the World Health Organization, and the World Trade Organization.

Legal capacities required for prevention and control of noncommunicable diseases

“…Many of these recommended policies are legal interventions, requiring legislation or executive actions for effective implementation (Box 3). Sales of tobacco, alcohol, processed foods and sugar-sweetened drinks have expanded rapidly in low- and middle-income countries because of trade and investment liberalization, leading to greater foreign direct investment, imports and advertising 14 , 15 . Implementing WHO’s evidence-based, highly cost-effective policy interventions (called best-buys) should be a priority for governments, but requires political commitment, funding and strong legal capacity.…”

Food systems transformations, ultra-processed food markets and the nutrition transition in Asia

“…Although some TFBCs have had a presence in Asia for over a century (e.g. Coca-Cola entered the Philippines in 1912), many domestic markets have been targeted with vigour since the 1980s given their high economic growth rates, rapidly urbanizing lifestyles, young and growing populations, and the adoption of export-led growth strategies favourable to foreign investment [21, 22]. Trade and investment liberalization in Asia has also been extensive over recent decades thereby reducing barriers to the movement of investments, technologies, production capacity, raw materials and final products across borders, allowing TFBCs to more easily penetrate these markets [22–25].…”

International trade and investment: still the foundation for tackling nutrition related non-communicable diseases in the era of Trump?

“… 22 23 Especially concerning is the inclusion of the “investor-state dispute settlement mechanism,” through which companies can directly sue states if governments implement regulation that might lead to reduced profits. 24 …”