Academic journal article Bulletin of the World Health Organization

Global Trade and Health: Key Linkages and Future Challenges

Academic journal article Bulletin of the World Health Organization

Global Trade and Health: Key Linkages and Future Challenges

Article excerpt

Voir page 531 le resume en francais. En la pagina 532 figura un resumen en espanol.


Globalization of trade, involving cross-border movement of capital, technology, traded goods and information, is leading to economic integration transcending the state. The universalization of the norms of multilateralism, reciprocity and most-favoured nation status, coupled with an unprecedented rate of scientific advance, is resulting in the rapid expansion of cross-border trade. Technologies and knowledge are rapidly diffusing between countries and vast communications webs are being created. A major impetus for the liberalization of global trade has been the eight rounds of multilateral trade negotiations held over the past 50 years, the most recent being the Uruguay and Tokyo Rounds. The conclusion of the Uruguay Round, marked by the Final Act (1), transformed the General Agreement on Tariffs and Trade (GATT) into a permanent organization, the World Trade Organization (WTO). With about 90% of world trade carded out under its normative framework, WTO is the principal international institution for the management of international trade. The normative framework of GATT and WTO originally evolved because of the "devastating protectionist policies" of the 1930s, which led to the collapse of the world economy; the contagion of blind protectionism led to a "contracting spiral of world trade between 1929 and 1933" (2).

In the global economy of the 21st century, economic development will increasingly be linked to transnational access to knowledge and information networks and the exchange of information. Multinational conglomerates will be able to promote their "global commodities" in most countries of the world via sophisticated satellite links. The rapid evolution of new scientific knowledge, for example in biotechnology and genetic engineering, will be the subject of ongoing ethical debate. Concerns will continue to be raised that economic globalization should not be seen as an end in itself, but as an economic tool which should be adapted so that marginalized populations and broader social policies are not neglected. Moreover, a strong case can be made that the globalization of world markets carries with it a transnationalization of health risks, but also of benefits (3-5).

Why is trade and health an international policy issue?

The links between international trade and disease have been recognized for centuries: the path of the Black Death followed international trading routes in the 14th century, and the direct links between communicable diseases and trade/international travel were the catalyst for 12 countries to join in organizing the First International Sanitary Conference in Europe in 1851. Though many transnational challenges are not new, it has been argued that the global public health challenges of today exceed those of earlier periods by an order of magnitude (3, 4).

Trade/financial liberalization could offer benefits that improve health status. For example, the diffusion of technology such as telemedicine and distance learning for poor or remote communities and nations could have positive health implications. Information technologies are often seen as a motive force for economic and social development, and the importance of improving the capacity of developing countries to utilize information technology is widely recognized (4). Moreover, the globalization of trade and finance will increase the importance of international standards and legal instruments, both to achieve sustainable globalization and to ensure the safety of traded goods such as agricultural and food commodities. These standards have come into play, for example, in mediating disputes over such issues as the safety of genetically modified foods and hormone-treated beef products.

On the other hand, the negative health repercussions of trade and financial liberalization, such as the extended promotion and marketing of harmful commodities, especially tobacco, cannot be overlooked. …

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