Title: Update: The APHA Network on Globalization and Health Report: Winter 2004

Author:

Section/SPIG: Occupational Health and Safety

Issue Date:

---

Call for Health Accountability in Trade Agreements

The Free Trade Area of the Americas (FTAA) would apply to all 34 countries in the western hemisphere, except Cuba. It would threaten measures that protect health, that provide access to medications, and that assure the safety and affordability of vital human services, including health care, water and sanitation, education and energy. Under the FTAA, vital human services are tradable commodities. The FTAA would grant rights to foreign private corporations to legally challenge domestic policies assuring that these services are safe, affordable and accessible, as potential barriers to trade. Appointed trade tribunals, which deliberate secretly without public accountability, would have the power to decide whether regulatory protections of our health and of vital human services conflict with trade rules, and to impose financial penalties on the United States and other countries that exercise those protections. These troubling restrictions mirror provisions of the World Trade Organization (WTO), the General Agreement on Trade in Services (GATS), the Agreement on Trade-Related Aspects of Intellectual Property (TRIPS) and the North American Free Trade Agreement (NAFTA).

We are concerned that:

1. The Free Trade Area of the Americas (FTAA) and similar agreements place commercial interests above health.

2. The FTAA threatens to pre-empt a wide range of US laws, rules, policies and programs that protect or enhance the public’s health, and that provide or regulate vital human services. Weakening our right to protect health and vital human services puts our nation's health at risk. The FTAA could limit the ability of Congress, or any state or region, including health authorities, to enact and enforce standards for:

Hospitals, nursing homes, and home care, including quality and staffing;

Health insurance, including standards for performance and patient protections;

Health professional training and licensing, enabling downward harmonization of standards;

Affordable, accessible medications, including for crises such as AIDS and SARS;

Public subsidies for health and other vital human services;

Environmental protections;

Occupational safety and health

Tobacco, alcohol and firearms: tariffs and distribution;

Public administration of safe water and sanitation; and

Working conditions including living wage ordinances, which help protect economic security.

3. The FTAA would increase pressure to privatize health care systems, while weakening regulation of private corporations, with destructive effects on the practice and outcomes of medical care, and on quality, affordability and access.

4. Trade decisions are not democratic or transparent, and exclude public health representatives. Critical terms of the negotiations are not publicly known or debated in the public policy arena, and there is no voice for health care or public health in the negotiating process.

The policies and actions of the United States and other governments play a pivotal role in shaping the ground rules for global trade. The FTAA ministerial meeting presents an important opportunity to promote a safe and just global community with publicly accountable and sustainable health care, water supply, and other vital human services, and sound public health policies. To this end, we urge our elected representatives, the United States Trade Representative, and our allies around the globe advocating for fair trade agreements, to:

1. Assure that health takes priority over commercial interests.
2. Call for an assessment of the impact of the FTAA and GATS on population health, and assure based on such assessment that these agreements do not have an adverse impact on health.
3. Exclude vital human services such as health care and water, and intellectual property rules that affect affordable medications, from trade negotiations and challenge under the FTAA.
4. Include public health representatives in the negotiating advisory process, and promote transparency and democratic accountability at all levels of trade negotiations.
5. Support enforceable commitments to advancing population health, and to achieving universal access to health care, affordable medications, and safe, affordable water in the United States and internationally.