The Future of Supranational Health-Trade Governance

By Lucia Fiestas Navarrete - November 23, 2014

The ultimate goals of public health, ensuring healthy lives and promoting well-being across the life course, are both a priority and a global challenge requiring international cooperation. Undoubtedly, the repercussions that global trade may incur on public health are of practical importance to the WTO’s work. This awareness resonated across the discussions at the 2014 Public Forum.

YDC OECD Public Forum Delegation 2014

YDC OECD Public Forum Delegation 2014

Intersecting public health and trade

The promotion of accessible medical technologies and innovation of health-related products and services are issues rooted at the intersection between public health, international trade and intellectual property rights. Moreover, in the international debate, the most contentious public health issues implicit in the work of supranational entities like the World Health Organization (WHO), are situated between market access and care solidarity.  As such, the rate of diffusion of new health technologies across national boundaries requires strong trade regulation in order to ensure the profitability of innovation, as well as, the equitable expansion of care services for all.

From an economic perspective, there is inherent value to human health, as well as, a large societal value to continuously improved access to quality health care systems. As such, health care is thricely a human development goal, a building block for human capital and a necessary investment for emerging economies. On the other hand, trade provides one of the most influential spaces for health diplomacy and international cooperation to take place. Within this paralleled context, there is much common ground to be explored in order to move towards trade and health policy coherence at national and international levels.

Among a myriad of possibilities, I have chosen to explore (a) the links between trade and access to affordable drugs, as well as, (b) the links between intellectual property, trade and health as a way to demonstrate contemporary issue-areas where health-trade coordination is not only important, but necessary when implementing policy solutions to global challenges.

Links between trade and access to affordable drugs

Reducing the cost of medicines is essential for low- and middle-income countries to gain access to essential drugs. The problem of accessibility is further exacerbated by the fact that most early-stage emerging economies lack health care insurance schemes based on risk solidarity. As such, most of the pharmaceutical expenses are borne out-of-pocket by individuals and households who are progressively priced-out of effective treatments. Some of the trade measures that have been in place focus on reducing pharmaceutical pricing by lower import duties, removing tariffs and even allowing a limited number of essential health products to enter developing countries duty free. One successful example of this policy is portrayed in the Ugandan government’s decision to bring down trade barriers in anti-malaria supplies, by reducing import taxes on mosquito nets. This, in turn, removed the detrimental effect of cost, as a major constraint to utilization, making preventive health measures more affordable.

Links between intellectual property, trade and health

Developing countries have a vast potential for becoming world leaders in the production of medical technologies stemming from traditional medical knowledge and medicinal plant use. In fact, a vast proportion of the developing world’s population has historically relied on medicinal plant use and ancestral medical knowledge passed intergenerationally. As the economic value of these products increases globally, the protection of traditional medicine knowledge is of great practical moment in order to ensure a fair and equitable trade environment.

However, one of the principal challenges arises from the fact that intellectual property rights mirror Western models of knowledge creation, which tend to individualize the patent holder. Instead, most traditional medicinal practitioners are temporal holders of ancestral knowledge without a clear sui generis from which to anchor intellectual property rights. These cases demonstrate that foreseeable social and technological advancements in health are likely to become trade issues needing close international cooperation and policy coherence.

Towards supranational health-trade governance

Considering the increasing interdependence of factors determining the qualities of life enjoyed by global populations, the future will demand greater international health-trade coordination between supranational entities, while ensuring policy coherence at national and international levels. Although the goals of the WHO and the WTO are not perfectly symmetrical, the challenges that these entities face would be best addressed in cooperation, by intersecting far-reaching human and social objectives. Across diverse issue-areas, there are important synergies to be explored between the WHO’s role in international health-related standard-setting and the WTO’s role in the formulation of multi-lateral trade-related obligations. While acknowledging the seemingly disparate organizational objectives, a shared vision for sustained human development must imbue the future of supranational health-trade cooperation.