If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart. (Nelson Mandela)

Pondering my learning from PETRA’s joint webinar with the UK Public Health Network on the public health implications of trade and investment laws, I began wondering how public health messages might better reach the heart of trade policy. It occurred to me that maybe insufficient attention is being given to the language being used around public health measures with the result that representation is failing to reach trade negotiators.

The webinar discussed the laws and rules around both trade and investment treaties and considered how the public health community could best engage with trade negotiations. The speakers pointed out that the aim of trade is broadly to reduce barriers to trade, increase free and fair flow of goods, and improve economic productivity with trade policies required to be transparent, proportional, consistent, reasonable, and non-discriminatory.

There is a temptation to see trade as inherently bad because of the commercial interests involved and the huge influence that is wielded by large multinational corporations but trade is not “the opposition.” Trade is actually essential to the economy and health of the country. Problems arise because it transpires that the focus of trade and investment laws is on how a policy is delivered and not its objective, public health or otherwise. Attention is entirely on the particular way in which an action has been taken and whether or not this results in unfair trading. For example, alcohol taxes must be applied fairly and not favour domestic producers, however inadvertently – as both Japan and Chile found when they restructured their alcohol taxation and were found to be discriminating against foreign suppliers. In fact, it seems that few disputes challenge the right of a government to instigate health-protecting measures, provided that these are not a disguised restriction on trade. So, an attempt by Samoa to ban the popular but high-fat turkey tails was not accepted and instead became a 300% tariff on their import to discourage access to and availability of the delicacy.

The conclusions of the webinar were that the public health community needed to take better advantage of the constructs that do exist in trade and investment agreements, for example, by progressive improvements to international standards such as the Codex Alimentarius and investigating an alcohol equivalent of the widely accepted Framework Convention on Tobacco Control. Investment treaties are starting to include clauses on human rights and the environment. This offers an opportunity to frame public health measures not as exceptions that might be construed as a barrier to trade but in terms of obligation, particularly as a human right. Adopting the latter approach reduces the burden of justification that is needed to prove an exception. Canada, for example, challenged a ban on white asbestos by France on the grounds that it was more reasonable just to control its use. Although France was found to be discriminating against Canada because the French made a substitute product, the World Trade Organization upheld the public health aspect, declaring that controlled use was not reasonable given the carcinogenic nature of asbestos. Why France was in this position in the first place is an entirely different question. PETRA and the UK Public Health Network will be exploring a rights-based approach to trade policy in more detail at a future webinar.

Advice emerging from the webinar was for the public health community to use the framing that exists in trade and investment laws to engage widely across Government, Parliament and civil society about the public health protections that could be included in trade agreements. This suggests that there is scope for picking up the conclusions from work previously done by the UK Public Health Network on reframing public health. It is worth remembering two points in particular from this reframing work: 1) “evidence does not always speak for itself; it needs packaging and promoting to reach policymakers in a timely fashion” and 2) the public’s tendency to interpret ‘health’ as a medical issue makes it difficult to put across messages about the wider determinants of health.

It seems to me that there is a pressing need for a public health framework that:

  • sets out core goals for the public health system (for example on sustainable prosperity, social justice, and wellbeing) that would chime with trade and investment agreements,
  • agrees the way in which these goals should be communicated, and
  • outlines how to speak about these goals to other sectors (including the general public).

This might just be a key step in helping public health professionals to speak the language of trade and enable the UK’s new trade and investment agreements to focus on improving the health and wellbeing of the country, its population, economy and environment.


Heather Lodge
Acting Coordinator, PETRA: preventing non-communicable diseases through trade and investment agreements

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