scholarly journals International Trade and Investment Agreements as Barriers to Food Environment Regulation for Public Health Nutrition: A Realist Review

2020 ◽  
Author(s):  
Kelly Garton ◽  
Anne Marie Thow ◽  
Boyd Swinburn
Keyword(s):  
Public Health ◽  
International Trade ◽  
Food Environment ◽  
Policy Design ◽  
Realist Review ◽  
Nutrition Policy ◽  
Fiscal Policies ◽  
Policy Space ◽  
Investment Agreements ◽  
Trade And Investment

Background: Achieving healthy food systems will require regulation across the supply chain; however, binding international economic agreements may be constraining policy space for regulatory intervention in a way that limits uptake of ‘best-practice’ nutrition policy. A deeper understanding of the mechanisms through which this occurs, and under which conditions, can inform public health engagement with the economic policy sector. Methods: We conducted a realist review of nutrition, policy and legal literature to identify mechanisms through which international trade and investment agreements (TIAs) constrain policy space for priority food environment regulations to prevent non-communicable diseases (NCDs). Recommended regulations explored include fiscal policies, product bans, nutrition labelling, advertising restrictions, nutrient composition regulations, and procurement policies. The process involved 5 steps: initial conceptual framework development; search for relevant empirical literature; study selection and appraisal; data extraction; analysis and synthesis, and framework revision. Results: Twenty-six studies and 30 institutional records of formal trade/investment disputes or specific trade concerns (STCs) raised were included. We identified 13 cases in which TIA constraints on nutrition policy space could be observed. Significant constraints on nutrition policy space were documented with respect to fiscal policies, product bans, and labelling policies in 4 middle-income country jurisdictions, via 3 different TIAs. In 7 cases, trade-related concerns were raised but policies were ultimately preserved. Two of the included cases were ongoing at the time of analysis. TIAs constrained policy space through 1) TIA rules and principles (non- discrimination, necessity, international standards, transparency, intellectual property rights, expropriation, and fair and equitable treatment), and 2) interaction with policy design (objectives framed, products/services affected, nutrient thresholds chosen, formats, and time given to comment or implement). Contextual factors of importance included: actors/institutions, and political/regulatory context. Conclusion: Available evidence suggests that there are potential TIA contributors to policy inertia on nutrition. Strategic policy design can avoid most substantive constraints. However, process constraints in the name of good regulatory practice (investor-state dispute settlement (ISDS), transparency, regulatory coherence, and harmonisation) pose a more serious threat of reducing government policy space to enact healthy food policies.

scholarly journals Who influences nutrition policy space using international trade and investment agreements? A global stakeholder analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Kelly Garton ◽  
Boyd Swinburn ◽  
Anne Marie Thow
Keyword(s):  
Public Health ◽  
Economic Growth ◽  
Food Environment ◽  
Stakeholder Analysis ◽  
Nutrition Policy ◽  
Public Health Nutrition ◽  
Policy Space ◽  
Investment Agreements ◽  
Trade And Investment

Abstract Background Regulation of food environments is needed to address the global challenge of poor nutrition, yet policy inertia has been a problem. A common argument against regulation is potential conflict with binding commitments under international trade and investment agreements (TIAs). This study aimed to identify which actors and institutions, in different contexts, influence how TIAs are used to constrain policy space for improving food environments, and to describe their core beliefs, interests, resources and strategies, with the objective of informing strategic global action to preserve nutrition policy space. Methods We conducted a global stakeholder analysis applying the Advocacy Coalition Framework, based on existing academic literature and key informant interviews with international experts in trade and investment law and public health nutrition policy. Results We identified 12 types of actors who influence policy space in the food environment policy subsystem, relevant to TIAs. These actors hold various beliefs regarding the economic policy paradigm, the nature of obesity and dietary diseases as health problems, the role of government, and the role of industry in solving the health problem. We identified two primary competing coalitions: 1) a ‘public health nutrition’ coalition, which is overall supportive of and actively working to enact comprehensive food environment regulation; and 2) an ‘industry and economic growth’ focussed coalition, which places a higher priority on deregulation and is overall not supportive of comprehensive food environment regulation. The industry and economic growth coalition appears to be dominant, based on its relative power, resources and coordination. However, the public health nutrition coalition maintains influence through individual activism, collective lobbying and government pressure (e.g. by civil society), and expert knowledge generation. Conclusions Our analysis suggests that industry and economic growth-focussed coalitions are highly capable of leveraging networks, institutional structures and ideologies to their advantage, and are a formidable source of opposition acting to constrain nutrition policy space globally, including through TIAs. Opportunities for global public health nutrition coalitions to strengthen their influence in the support of nutrition policy space include strategic evidence generation and coalition-building through broader engagement and capacity-building.

Implications of international trade and investment agreements on policy space for restricting marketing of unhealthy food and beverages to children: Lessons from inter-disciplinary expert interviews

2021 ◽  
pp. 1-41
Author(s):  
Kelly Garton ◽  
Boyd Swinburn ◽  
Anne Marie Thow
Keyword(s):  
International Trade ◽  
Market Access ◽  
Policy Design ◽  
International Investment ◽  
Unhealthy Food ◽  
Policy Space ◽  
International Investment Law ◽  
Food And Beverages ◽  
Investment Agreements ◽  
Trade And Investment

Abstract Objective: To determine the implications of international trade and investment agreements (TIAs) for national governments’ policy space to restrict the marketing of unhealthy food and beverages to children. Design: In-depth interviews based on a series of policy scenario ‘vignettes,’ guided by an adapted scenario analysis methodology. Setting: Global Participants: Nine key informants from relevant sectors, with expertise regarding the intersection of public health nutrition policy, international trade law, and international investment law. Results: Participants consistently identified the relevance of several principles, common to many TIAs: non-discrimination, necessity and justification, market access requirements and quantitative restrictions, intellectual property rights and trademark protections, and fair and equitable treatment of investors. Two main policy design factors that interact heavily with TIA-related policy space were the framing of objectives, and regulatory distinctions drawn. Contextual factors may shape the analysis of TIA-related policy space on a case-by-case basis, while the relative power of the actors and institutions involved in both domestic and international policy spheres may influence whether and how such legal constraints to policy space are activated. Conclusions: Regulatory marketing restrictions run the risk of incurring challenges under World Trade Organization (WTO) agreements and other free trade and investment agreements. However, concerned policy makers should be aware of the difference between theoretical risk, threat of a challenge, and realistic initiation and/or loss of a formal dispute. Our findings indicate that there is policy space to adopt significant marketing restrictions, though an understanding of these legal risks, and strategic policy design, are important.

scholarly journals International Trade and Investment Impact on Global Health

2021 ◽  
Vol 7 (2) ◽  
pp. 50-57
Author(s):  
Hamza E Albaheth
Keyword(s):  
Public Health ◽  
International Trade ◽  
Global Health ◽  
Health Determinants ◽  
Negative Outcomes ◽  
Social Good ◽  
Contextual Framework ◽  
Health Need ◽  
Investment Agreements ◽  
Trade And Investment

Dealing with issues related to global health need the trade and investment laws. The global health is affected by the International Trade and Investment agreements or TIAs. It can have advantages on the factor like individuals and their wellbeing but, from the perspectives of social good and health range, also has some negative outcomes. This article emphasised on the changing the perspective towards contextual framework of public health and International Trade and Investment agreements or TIAs. There are a range of both positive and negative outcomes related to TIAs. They impact main health determinants in complex ways, for instance inequality and poverty and can elevate the inequalities factors within and between the nations. By analysing the highlighted issues, it has been suggested to re-structure the basic TIAs structure, as executed by the outlined comprehensive approach.

scholarly journals 17.B. Round table: Including public health considerations in trade and investment agreements

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Trade Agreements ◽  
Access To Medicines ◽  
Policy Space ◽  
Health Services Access ◽  
The Uk ◽  
Investment Agreements ◽  
Policy Engagement ◽  
Trade And Investment

Abstract There is widespread recognition that trade and investment agreements (TIAs) can affect health services, access to medicines, NCD prevention (particularly related to tobacco, alcohol and unhealthy food) and health systems structures. In addition, these binding international economic agreements can constrain the policy space available for innovative, evidence-based health policymaking. Although TIAs can have positive outcomes for employment and economic growth, these benefits are only likely to accrue when governments are pro-active in implementing complementary policies to mitigate impacts on other sectors and to address potential inequalities arising. The aim of this panel session is to examine the ways in which TIAs can be designed to achieve economic goals while also protecting public health, and identify complementary policy measures that may be needed as well as strategies for strategic policy engagement. This panel will be hosted by the UK-PRP PETRA Network (Prevention of the noncommunicable disease using trade agreements). The UK will be negotiating a range of new TIAs over the coming years, representing a window of opportunity for strategic engagement with policymakers regarding how public health can be protected and promoted within these agreements. There is an emerging global body of evidence regarding how consideration of health can be integrated into TIAs, both textually and through strategic engagement with policymakers before and during the negotiation phase. Experience to date indicates common global challenges and opportunities for health and trade, as well as significant potential for cross country learning regarding trade and health. The panel discussion will use the UK experience as a springboard to address these global issues. The expert panel, drawn from the PETRA Network with expertise in political economy, trade law, economics and public health advocacy, will provide brief overview of the current issues in trade and health and how public health can be protected in trade agreements. The 5-minute panel presentations will briefly summarise how inclusions in TIAs can support and protect policy space for health systems and health services, access to medicines, NCD prevention, and nutrition and food systems. The session will then open for a roundtable discussion among participants regarding 1) country-specific examples and questions regarding health protections; 2) experiences related to health-trade policy engagement; 3) lessons for elevating health on the political agenda, particularly regarding trade. (Note that if there are more than 16 participants, then the workshop will split into small groups for discussion with panel/ PETRA Network resource people. The panel session and discussion will provide the basis for a planned public health-oriented briefing note by the PETRA Network on including public health considerations in trade and investment agreements. Key messages Including consideration of health in trade and investment, agreements can protect policy autonomy for public health and promote good public health outcomes; In order to promote consideration of public health in trade and investment agreements, strategic engagement with trade policymakers before and during the negotiation period is critical.

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