Trade and Health: An Agenda for Action

Health Policy Unit, Department of Public Health and Policy, and Centre on Global Change and Health, London School of Hygiene and Tropical Medicine, London, UK.
The Lancet (Impact Factor: 45.22). 02/2009; 373(9665):768-73. DOI: 10.1016/S0140-6736(08)61780-8
Source: PubMed

ABSTRACT The processes of contemporary globalisation are creating ever-closer ties between individuals and populations across different countries. The health of a population, and the systems in place to deliver health care, are affected increasingly by factors beyond the population and health system. The Lancet's Series on trade and health has provided an overview of these links between international trade, trade liberalisation, and health, and raised the key issues that face the health community. In this final paper in the Series, we call for a substantial and sustained effort by those within the health profession to engage with issues of trade, to strengthen institutional capacity in this area, and to place health higher on the agenda of trade negotiations. The rapid rise of trade agreements and treaties, as well as trade that occurs beyond these institutional boundaries, means that further action is required by a range of actors, including WHO, the World Bank, the World Trade Organization (WTO), regional agencies, foundations, national governments, civil society, non-governmental organisations, and academics. The stewardship of a domestic health system in the 21st century requires a sophisticated understanding of how trade affects, and will affect, a country's health system and policy, to optimise opportunities to benefit health and health care while minimising the risks posed though the assertion of health goals in trade policy. To acheive this will place a premium on all those engaged in health to understand the importance of trade and to engage with their counterparts involved in trade and trade policy. We hope that this Series has prompted the reader to become involved in these efforts.

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Available from: Kelley Lee, Dec 18, 2013
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    • "Increased trade and trade liberalization is a defining feature of globalization, directly and indirectly affecting health and health systems. Understanding how trade liberalization affects a country's health system and policy has been indicated as one of the complex tasks in the stewardship of a domestic health system in the 21st century [3]. Thus, global trade liberalization is analyzed in this article as policy that also affects the implementation of UHC, that is, ensuring accessible and affordable health services appropriate to the needs of all individuals within a population [4]. "
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    ABSTRACT: In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors.
    Value in Health 01/2013; 16(1 Suppl):S14-8. DOI:10.1016/j.jval.2012.10.002 · 2.89 Impact Factor
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    • "Such approaches might ensure that any internal " brain drain " is avoided and that gains will result in measurable improvements in Indonesia's health system. Development of linkages between the Indonesian public and private health care sectors could be a precondition for increased foreign presence (Smith et al., 2009b). Indonesia is internationally competitive in the export of health and related services labor. "
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    ABSTRACT: The worldwide increase in demand for health services offers developing countries, like Indonesia, significant opportunities to expand international trade in this area. However, policy aimed at achieving this objective must carefully consider the World Trade Organization's (WTO) General Agreement on Trade in Services (GATS). For signatory nations and those considering becoming signatory nations, the procedural, structural, and other effects of the GATS make it a formidable challenge for national health policy alongside its impact on trade liberalization. Invoking the four GATS health care trade modes, this article develops possible approaches to Indonesian health services in the context of trade liberalization.
    International Journal of Public Administration 07/2011; 34(8):528-538. DOI:10.1080/01900692.2011.583764
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