What TTIP might mean for evidence-based alcohol policy-making – a new report looks at the public health consequences of the Transatlantic Trade and Investment Partnership (TTIP). Here’s my take on the report…

The Transatlantic Trade and Investment Partnership (TTIP) is being negotiated right now. TTIP is frequent subject of news stories all over Europe. EU officials, especially the European Commission are trying hard to sell the benefits of TTIP, while other citizens and civil society and Members of the European Parliament from around Europe keep increasing the pressure in their criticism of TTIP. More and more evidence shows that the projected benefits of TTIP are overblown by some EU Parliamentarians (MEPs), the European Commission and some EU Member States.

Costs of alcohol harm dwarf TTIP benefits

We know that the projected benefits of TTIP, according the the Commission’s own model and calculations will not even amount to the costs of alcohol harm that burden Europe every year. You can read all about this topic in Maik’s blog.

We also know that TTIP as it looks today is set to challenge and undermine public health in Europe, the US and in countries around the world. The European Heart Network has recently published a paper to examine the impact of TTIP on cardiovascular health: “TTIP, international trade and cardiovascular health – a European Heart Network paper”.

“CVD remains the main cause of death in the EU and represents a major cause of disability. Over the past 30 years death rates from coronary heart disease (CHD) and stroke have fallen remarkably – by more than 50% in several European. Around 50-75% of the fall in CHD, the single most common cause of death in the EU, has been explained by risk factor improvements.

“Where death rates can go down they can also go up. If societies provide environments that are supportive of healthy lifestyles, e.g. a non-smoking culture, availability of healthy foods at affordable prices, measures to dissuade high intakes of alcohol and encouragement of regular physical activity, avoidable death and disease from CVD and several other major chronic diseases can be prevented. For example, sustained public policies to reduce intake of salt and saturated fats as well as reducing smoking and increasing physical activity could result in a reduction in mortality from CHD of about one third. But changes in societies can also put people’s health at risk.” 

TTIP threatens to undo these risk-factor improvements, for example through looming tariff reductions, through regulatory cooperation that would eliminate “barriers to trade”, especially the so-called Non-tariff barriers (or technical barriers to trade, TBT) and through the proposed Investor-State-Dispute-Settlement mechanism.

In the beginning of February, this year, a coalition of 169 civil society organisations released a statement on regulatory cooperation in EU-US trade talks, denouncing “regulatory cooperation” in the TTIP negotiations as a threat to democracy and an attempt to put the interests of big business before the protection of citizens, workers, and the environment.

A new landmark for evidence-based TTIP discourse

From our perspective, a landmark achievement in the public discourse and for the evidence-base concerning TTIP is a brand new scientific report. We are proud to contributed to a grant together with a number of partners to make the research possible (see below). The study was conducted by the London School of Economics and Political Science and Modus Europe. The abstract reads:

Free trade agreements (FTAs) have the declared aim of seeking to increase global trade and promote economic growth. Historically, economic growth has led to improved population health. Yet this link is now weakening, and attention is being focussed on assessing the effect of FTAs on health and the ability of government to mitigate against negative impact. Within this context, this study presents an assessment of the health impact of the proposed FTA between the United States and the European Union.”

Among other issues analysed, the report addresses the consequences of TTIP for alcohol policy and alcohol harm in Europe. And it provides a number of crucial findings. So, let me share four of them with you:

1) Concerning projected economic benefit versus already existing health burden of TTIP

The principal area of economic benefit from TTIP to the EU is predicted to emanate from non-tariff based regulatory reform. At around €120bn the magnitude of impact is not insignificant although the strength of recent empirically based challenges should not be underestimated. Equally, to help locate the discussion within the public health realm one can cite a 2012 Centre for Addition and Mental Health report by Jürgen Rehm and Kevin Shield that states that the social costs of alcohol consumption for the year 2010 could amount to €155.8 billion. Whilst the study does not directly consider the impact of regulatory public health intervention in this field, it is evident that the value magnitude of just one public health issue bears comparison with the potential direct economic gains that are projected to accrue from TTIP.”

2) Concerning trade and price of products promoting unhealthy lifestyle

The same issue could apply to alcohol, where there is again an expectation of reduced tariffs and increased imports. As a reference the CETA agreement will eliminate all import tariffs on spirit alcohols and wines. Indeed, both industry groups Spirits Canada and Spirits Europe see the potential for growth in Europe and Canada respectively. Spirits Canada have said that they expect to double their exports to Europe, targeting in particular Eastern Europe. Whilst the position regarding tariffs on alcohol between the US and Europe are different, TTIP clearly represents a potential challenge to alcohol control policies if its implementation results in reductions in price and increase in supply.

If this is the case, then public health bodies may seek to use a number of regulatory instruments to offset any detrimental health impact. Concern has been raised by a number of public health stakeholder groups that the TTIP could make such a regulatory response more difficult to achieve. This issue is discussed further in the Health Policy chapter of this paper.”

3) Concerning Health policy space, e.g. in alcohol policy-making

Health policy space is currently being expanded from an existing policy focus on prevention and harm reduction and regulatory domains such as tobacco control, to include alcohol, unhealthy foods and related lifestyle issues. Coinciding as this does with global trade that is consistently seeking new growth markets, there is evident risk of direct and indirect challenge to the right to regulate. FTAs such as TTIP are likely to form an important element of the legal basis for mediating this increasingly contested space and helping to determine the boundaries of future health policy scope and ambition.”

4) Concerning regulatory scope and regulatory snare

A second impact of legal action taken against governments under international law can be termed ‘regulatory snare’. This is a further aspect of the ‘regulatory chill’ hypothesis that focuses on the impact on governments that become involved in legal challenge to regulation brought about under international law.

The regulatory snare aspect of this case has two elements. Firstly, there is the physical legal process, which can stop the implementation of a policy. This is the current situation in relation to minimum alcohol pricing in Scotland. The second aspect of regulatory snare is the impact on public authorities and other stakeholder groups, with respect to the resource and cost impact of having to deal with often protracted legal proceedings.”

These four points clearly outline the dangers and threats posed by the current TTIP agenda to evidence-based, high-impact alcohol policy-making.

And I also want to to highlight a problem with the report, from our perspective. It is the chapter on “Trade compliant public health”. The researchers introduced the chapter this way:

In developing public health strategies that seek to utilise pricing or other regulatory levers, it appears to make sense for health policy officials to work closely with trade officials to ensure that flexibilities can be built into trade law and fully utilised. For example, if there are ways of regulating access to unhealthy foods, alcohol and tobacco in a manner that is consistent with the broader objectives of TTIP, then it makes sense to explore these.”

We in IOGT International would have wished for a different approach. We do not think that it is public health which ought to be compliant with trade.

It is the other way around: health is a human right and public health is a primary objective of any government. Therefore trade should always make sure to be compliant with public health goals. Trade policy must not undermine, threaten, jeopardise and/ or weaken public health policy making. In the case of alcohol it’s clear: alcohol is no ordinary commodity and trade should not lead to alcohol being more widely available, cheaper, and more heavily marketed.

For further reading:

Access the complete study on the IOGT Science Hub: “The Transatlantic Trade and Investment Partnership: International trade law, health systems and public health”

Everything You Need To Know About TTIP and Alcohol Harm, read my blog here…

Suggested citation for the report:

Khan, U., Pallot, R., Taylor, D. and Kanavos, P. (2015) ‘The Transatlantic Trade and Investment Partnership: international trade law, health systems and public health’ London School of Economics and Political Science and Modus Europe report.

A grant from the following organisations made the LSE and MODUS Europe research possible:

European Public Health Alliance (EPHA

European Alcohol Policy Alliance (Eurocare)

European Heart Network (EHN

Royal College of Physicians (RCP London

Wemos Foundation 

IOGT International 

International Diabetes Federation Europe (IDF Europe

European Federation of Public Service Unions (EPSU

Cancer Research UK 

European Association for the Study of the Liver (EASL