World Trade Organisation agreements should be subject to health impact assessment
BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7237.802 (Published 18 March 2000) Cite this as: BMJ 2000;320:802
- Margaret Douglas, senior registrar in public health (margaret.douglas{at}btinternet.com)
EDITOR—Drager's editorial reminds us that the international agreements negotiated in the World Trade Organisation have wide ranging implications for public health.1 The agreements are enforceable, unlike other international agreements on the environment, human rights, and social welfare. Governments can be challenged for implementing laws intended to protect public health if they restrict free trade. In settlements of World Trade Organisation disputes so far, trade issues have been placed above public health.2
The editorial made only passing reference to the likelihood of a new agreement on investment. The European Union is pressing for the World Trade Organisation to start negotiating an investment agreement.3 This would prevent countries placing any restrictions on foreign investment or implementing any regulations that might disadvantage a foreign investor. Last year negotiations on a similar investment agreement fell through after a campaign by a wide range of groups worried about the implications for the environment, health, and human rights.3
An investment agreement could be damaging to public health. Regulations to protect public health and the environment could be challenged if they disadvantaged a foreign company. For example, tobacco control is one measure that could be threatened.2 Tobacco firms could claim compensation for expropriation of trademark rights if advertising or sponsorship was restricted, or expropriation by taxation for losses from raised taxes. In 1997 the Canadian Public Health Association passed a resolution opposing the proposals for an agreement on investment, stating that it would “constrain governments' ability to regulate investment to achieve and protect citizens' social, economic, environmental, health and other national interests.”4 The latest proposals do not address these concerns.3
Saving Lives: Our Healthier Nation states that the government will undertake health impact assessment of major new government policies.5 The latest round of World Trade Organisation negotiations could produce agreements with major direct and indirect health impacts. The government should honour the commitment made in the white paper and undertake health impact assessment of all the organisation's proposals before signing any new agreements.