Title: The APHA Network on Globalization and Health Report: Fall 2003
Author:
Section/SPIG: Medical Care
Issue Date:
How does the global economy affect health status and disparities in health status, public health systems and policy, access to coverage within private and public health care systems, occupational health and safety, injury control, environmental health, access to pharmaceuticals and to safe water, and social and economic equality? What do international trade agreements have to do with public health?
Members of the APHA Network on Globalization and Public Health will address these and other issues during the APHA Annual Meeting in November 2003. A Town Hall meeting on Nov. 16, 2003 from 2 to 4 p.m. in San Francisco’s Moscone Convention Center will offer brief presentations, and a chance to network with some local and national research and advocacy groups based in the Bay Area. The meeting will include observers from the September meeting of the international World Trade Organization ministerial in Cancun, Mexico, and members of international Public Health Associations. Join the planning with an e-mail to Ellen Shaffer, <ershaffer@cpath.org>. (Please see final schedule for exact room location.)
This year’s APHA Annual Meeting takes place just before the international gathering of trade ministers in Miami for planning the Free Trade Area of the Americas (FTAA). FTAA would extend NAFTA to the entire western hemisphere (except Cuba). The Network will help sponsor a press conference and other FTAA-related events.
APHA has been actively involved in support of its 2001 resolution, which opposes including health care, water, and other vital human services in international trade agreements. Along with the Center for Policy Analysis on Trade and Health (CPATH) and the American Nurses Association, APHA alerted members of Congress in July that smaller scale nation-to-nation trade agreements were setting dangerous precedents for international agreements such as FTAA. The letter, which was circulated to the US House of Representatives by Rep. Sherrod Brown, explained that US agreements with Singapore and Chile will:
Impede access to life-saving medicines, contradicting Congress’ earlier support for policies that would modify the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). They will: allow patents to be extended beyond the 20-year term required by TRIPS; require a 5-year waiting period before governments can provide generic producers access to the test data produced by pharmaceutical companies, delaying affordable access to medicines; and restrict how governments provide marketing approval and sanitary permits for medicines. Pharmaceutical companies could block production of generic medicines.
Ease the terms of trade on tobacco products, reducing tobacco tariffs for Singapore to zero. While public health protections have reduced tobacco use in the United States, this provision will make it easier to dump tobacco products in Singapore.
Open the door to further privatization and deregulation of vital human services including standards for health care professionals, and provision of health care and water, sectors better addressed through open international collaboration rather than through commercial trade negotiations. While some services and some professions are exempted from coverage by some trade rules, these exemptions are too narrow to assure full protection. The United States has no exemptions for water and sanitation, leaving the country open to challenges from foreign private corporations and their subsidiaries.
Grant foreign private investors greater rights than U.S. investors. Under NAFTA, similar provisions have led to lawsuits by private companies that overturned important health and environmental protections. Again, this contradicts the negotiating objectives of the Trade Act of 2002.
Other social and public services are poorly defined, leaving trade tribunals rather than elected officials and regulators to decide whether basic public health protections are barriers to trade. Covered services include income security or insurance, social security or insurance, social welfare, public education, health, and child care. Trade panels are not required to have any expertise in health care or public health.
The letter urges Congress to advocate for trade agreements that exclude vital human services such as health care and water, that improve access to life-saving medications, and that do not threaten efforts to reduce exposure to dangerous substances. Further, it encourages support for enforceable commitments to advancing population health and to achieving universal access to health care and to safe, affordable water in the United States and internationally. The US-Singapore and US-Chile Free Trade Agreements do not meet these objectives, and, therefore, should not serve as models for other trade agreements, including the Free Trade Area of the Americas (FTAA) or the Central America Free Trade Area of the Americas (CAFTA).
The CPATH Web site, <www.cpath.org>, provides additional background information on economic globalization and health. APHA groups involved with the Network include: Medical Care Section, Mental Health Section, Environmental Health Section, International Health Section, Injury Control and Emergency Health Services Section, Occupational Health and Safety Section, Peace Caucus, Socialist Caucus, Spirit of 1848, DisAbility Forum, Hawai’i Public Health Association, and the Public Health Association of New York City.