The Cambridge Dictionary defines manifesto as “a written statement of the beliefs, aims, and policies of an organization, especially a political party.” Hmmm. PETRA is, quite clearly, not a political party. It is an interdisciplinary expert network set up to look at whether trade policy and trade and investment agreements could be used to tackle non-communicable diseases such as cancer, diabetes, obesity etc, many causes of which lie in the accessibility and availability of highly-processed foods, tobacco and alcohol. Nevertheless, PETRA, along with the other UK Prevention Research Partnership Networks, was tasked with producing a manifesto. The difference being that this manifesto would not identify political aims but the research gaps and opportunities for greater use of the evidence base – in PETRA’s case on trade and health issues.
Developing this manifesto has been a lengthy process. Eighteen months long to be precise. During this period, PETRA held a wide-ranging evidence enquiry to gather views on current gaps either in trade and health research itself or in its implementation. A literature review and over a dozen position papers from international experts were commissioned to summarise the state of knowledge around trade and issues such as air pollution, health inequalities, alcohol, and unhealthy food. Summary papers were also commissioned to look at the implications for public health of trade and investment laws, trade disputes such as tobacco plain packaging, post-Brexit governance, and the Internal Market Act. A set of six video shorts by legal experts examined a range of trade-related issues including human rights, front-of-pack nutrition labelling, and medicine patents. A set of webinars, delivered jointly with the UK Public Health Network, enabled debate with key experts.
The enquiry culminated in a two day Sandpit in June 2021 to identify the research priorities with the final decisions made collectively by PETRA’s Co-Investigators and Expert Advisory Group. These were then used to draft the Manifesto.
The hope is that the Manifesto will, eventually, be published on PETRA’s website. In the meantime, the contents remain, like all manifestos, the subject of speculation. What can be divulged is that 16 key research questions were agreed; these cover topics such as the impacts of multi-level governance, the effect of a rights-based approach, the use of health impact assessments in assessing trade agreements, the use of modelling techniques to explore health and economic consequences of trade deals, case studies and multidisciplinary analysis to explore issues ranging from front-of-pack nutrition labelling to the impact of trade deals on areas of deprivation.
Once PETRA’s R&D Manifesto is published the next step will be to test and refine it with further stakeholders – plans are already in place, for example, to engage with the public. The ultimate aim is that funding bodies will see the value of commissioning this as a unique and pressing programme of work.
What have we learned? Despite the enthusiasm shown by Sandpit participants, creating this R&D Manifesto has been a task of Herculean complexities. Leaving Covid aside, forging new relationships between diverse academic disciplines with little track record of engaging with other, that lack a common language, and that have different approaches to research evidence, is not a quick process. On the positive side, Zoom and Teams have bridged geographic divides very successfully. Removing travel from the equation was a definite factor in the success of PETRA’s sandpit. The concentrated format of online conferencing led to fast-paced workshops that generated rich discussions and produced a wealth of material to inform the Manifesto. A shout-out to Hopkins Van Mil is needed here for achieving the Sandpit’s aims with truly impressive efficiency and effectiveness, especially mid-pandemic.
Manifestos are living documents, designed to respond to shifting policy circumstances; the urgency being shown by Government to sign both rollover and new trade deals makes this a fluid and fast-moving policy arena in which to work. However, defining a new R&D framework to support trade policy is only the beginning. It needs to be support by real-time research. Sadly, the length of time it takes for project proposals to be developed, secure funding and be completed presents a serious risk of missing the current tide of opportunity here. This, plus the secretive nature of trade deals, the lack of health input, and the heavy weighting in favour of economic outcomes are perhaps PETRA’s most significant hurdles to overcome.
However, PETRA has also been challenged extensively over its remit, raison d’etre, and progress on the grounds that long-standing mechanisms were already in place to do the work, that the Network has both too wide and too narrow a remit – should it include mental health for example – and that opportunities were being missed to comment on Brexit-related matters. PETRA has tried to address such concerns by demonstrating that an R&D Manifesto does not just fulfil the Network’s mandate, but will provide coherence to a presently siloed research agenda as well as offer the potential to align current government policy objectives post-pandemic.
As a final, consoling, thought, Churchill’s words in 1919 that “the difficulties we have to face are only the difficulties of circumstances and … the only opposition… is the opposition of events” serve as a reminder that this R&D Manifesto would probably have been neither commissioned nor produced had current circumstances been any different.
PS: These are the personal views of the Network Co-ordinator for PETRA who owes huge thanks to the many experts who contributed to the process and to PETRA’s Co-Investigators in particular for reading many drafts.