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#EAPM: The challenge of dovetailing improved trade with improved EU #health

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TTIP-Europe-ColinThe proposed Transatlantic Trade and Investment Partnership (known widely as TTIP) is never far from the news and complex negotiations  have been ongoing for several years writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

The deal will affect many areas and its enthusiastic proponents and those strongly against such an agreement are split down the middle.

The Brussels-based EAPM, which brings together a range of stakeholders including patients, healthcare professionals, researchers, academics, policymakers and more, is monitoring the situation closely, and especially its potential effects on health across Europe and specifically the EU member states.

A study in 2015 by the London School of Economics (LSE), backed by the European Public Health Alliance, the Royal College of Physicians and Cancer Research UK among others, looked into the likely benefits or otherwise of TTIP in health care.

Meanwhile a more recent look at TTIP in May 2016 by the Financial Times focused mainly on Britain’s National Health Service (the NHS), which is close to UK citizens’ hearts and one of the world’s largest employers.

All free trade agreements aim, of course, to increase global trade and boost economic growth. The latter has, down the years, led to improved health among general populations (although this is becoming less so comparatively). TTIP promises to be the largest free-trade agreement of its kind and could have significant impacts on the health and general well-being of the EU’s ageing population.

The LSE study states that: “The principles of international trade…are increasingly relevant to public health law. Whilst free trade agreements such as the North Atlantic Free Trade Agreement…allude to the idea of sustainability…there is limited specific mention of the promotion of health or societal well-being.

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“As a consequence some health policy issues such as access to medicines or tobacco control are challenged by the terms of trade law.”

The study contends that “it is possible to see how trade and health goals can align or even reinforce each other”. But it adds the proviso that “not only are there significant areas of potential conflict, but that such conflict could in fact generate fundamental discord”.

Asked whether TTIP could be mutually compatible in supporting the aims of trade and public health the study quotes Georgetown University’s Professor Robert Stumberg as saying that while “it may look like a ‘win-win’ from an orbit of 60,000 feet, this is far less the case when viewed from 60 feet”.

The World Health Organization's (WHO) given role is to provide leadership on public health matters. In article 25 of the Universal Declaration of Human Rights, the WHO says it “works to achieve greater policy coherence between trade and health policy so that international trade and trade rules maximize health benefits and minimize health risks, especially for poor and vulnerable populations.”

 

It remains to be seen how the international governance structures manage to oversee the TTIP process between public and business interests. How this turns out will be vital “in determining the extent to which international trade and health law can be aligned”, says the LSE study, adding that such issues “can underpin or provide challenge to them”.

In the UK, the Financial Times (FT) analysis noted that: “The potential implications for the National Health Service (of TTIP) are arguably the most politically sensitive.”

The respected newspaper notes that those against TTIP have described it in terms of being a ‘Trojan horse’ working on behalf of private health providers (already being used more and more in the NHS under the Conservative government’s policies).

The anti-TTIP lobby believes that such private companies may seek to, as the FT puts it, “exploit the agreement as a means of gaining greater access both to Britain’s taxpayer-funded health service and to other, similar systems in Europe”.

On the other side of the fence stands the pro-TTIP lobby which argues that the agreement will allow greater exportation to the US of UK products and “expertise in pharmaceuticals, innovative treatments and devices”. This would bring numerous benefits to British companies, as well as individuals, proponents argue.

Perhaps surprisingly, the NHS Confederation, meanwhile, is on record as stating that: “A more integrated transatlantic marketplace could foster economic growth, create jobs and stimulate fruitful collaboration in leading-edge technologies, to the benefit of patients.”

Yet, since the talks formally began in 2013, opponents have remained unmoved by the above arguments and fears still exist, in spite of European negotiators insisting again and again that safeguards will prevent interference in public-health policy.

EAPM’s stakeholders have looked at both sides of the coin, and the Alliance strongly believes that it is vital that the ‘safeguards’ that the negotiators tell us are there and that will be respected, turn out to be sufficient.

Yes, Europe can undoubtedly benefit from increased trade under TTIP - that’s why it’s there, after all - but the ultimate concern in a Europe of 500 million potential patients must remain the well-being of these citizens.

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