Scientific Article
Investigating TTIP: International Trade Law, Health Systems And Public Health

Usman Khan, Robert Pallot, David Taylor and Panos Kanavos
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
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    London School of Economics and Political Science and Modus Europe
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The Transatlantic Trade and Investment Partnership: International Trade Law, Health Systems and Public Health

Study Overview

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.

The proposed Transatlantic Trade and Investment Partnership (TTIP) between the US and the EU constitutes the largest ever FTA of its kind.

Although the TTIP mandate has recently been made public, access to negotiating texts remains limited and it is apparent that much detail on TTIP is still to be agreed.

Study Aims and Objectives

The research study provides an assessment of major trends in free trade policy. It traces the development of bi-lateral agreements and the expansion of the remits of FTAs to include policies on non-tariff and investment protection and arbitration issues. There is also an assessment of broader global trade governance matters as they relate to health policy.

The study aims and objectives were as follows:

  1. Understanding the historical evolution of free trade agreements and their potential impact upon health status and healthcare policies and practices;
  2. Critically examining the aims and objectives of TTIP;
  3. Categorising and quantifying the major health sector and public health impacts of FTAs to date;
  4. Assessing, on the basis of the information available, the potential health and healthcare policy and practice benefits from the implementation of a finalised TTIP agreement;
  5. Estimating the overall value of such benefits that could result;
  6. Identifying the areas of risk within the health domain that might be associated with the implementation of a finalised TTIP agreement;
  7. Giving particular consideration to the interface between health policy and public health, particularly in relation to foods as well as non-alcoholic sugar-sweetened beverages, alcohol and tobacco; and
  8. In the light of the above, developing a public health focused strategic response framework for EPHA and its members.

The study is based upon a structured and systematic rapid evidence assessment and a targeted stakeholder engagement process, commissioned to run over an eight-week time period during August and September 2014.

Study Recommendations

There remains a strong commitment to concluding the TTIP negotiations, and as such stakeholder groups should take a proactive, systematic, engaged and evidenced-based approach that is focussed on supporting a positive growth agenda, protecting the right to regulate and mitigating areas of potential risk.

The suggested response of civil society organisations should involve focus, engagement and challenge and should recognise that TTIP forms just one element of a wider platform of international trade law, which is increasingly focussed on non-tariff issues.

  • Focus – Should be put on those chapters of TTIP that are of the greatest importance to health such SPS, TBT, IP and Services, as well as to broader regulatory themes such as the precautionary principle.
  • Engagement – There is a need for the public health community to continue to seek to positively engage in the TTIP development process, so as to ensure the common understanding of regulatory boundaries.
  • Challenge – The researchers’ assessment has identified the absence of systematic assessment of the health impact of each of the relevant chapters within TTIP. Increased use of economic impact assessment tools and techniques could help to address this issue and provide a more robust evidence base.

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