What does good governance look like in international trade? Roundtable talks hosted by GPI

Trade and investment agreements are legal instruments that are designed to support national economic policies. However, trade and health are neither mutually exclusive nor incompatible policy arenas. In fact, the need to bring health and wealth together has been a consistent message for some time, underlined most recently by the former Bank of England Chief Economist, Andy Haldane, at a speech to The Health Foundation in November 2022.  

Non-communicable diseases, such as heart disease, diabetes and cancers, place an unsustainable burden on the UK’s health services. In 2017, 27% of emergency hospital admissions in England, Scotland and Wales were attributed directly to NCDs with patients increasingly presenting with co-morbidities. Unfortunately, the UK’s post-Brexit trade deals have yet to incorporate measures to address the commercial determinants of health that can lead to preventable and avoidable NCDs. In addition, international trade governance allows the multinational corporations who produce unhealthy commodities to wield extensive influence at the WTO; this results in member states weakening health protection measures through challenges of unfair trading practices.  

The Global Policy Institute (GPI) hosted and facilitated roundtable talks in July with 20 key leaders and experts from a variety of sectors and disciplines to agree some steps towards achieving a model of democratic governance that puts health at the heart of international trade policies. The talks benefitted hugely from input from Scotland and Wales where the devolved governments, especially in Wales, have often led the way in thinking about trade and health. 

These unique talks were organised jointly with the PETRA trade and health network at the University of Chester and held under strict Chatham House rules to preserve anonymity and encourage honest, open discussion. The talks were chaired by Emeritus Professor David Hunter, School of Government and International Affairs (SGIA) Durham University, and Senior Fellow at the GPI, and a PETRA Co-investigator, and organised by PETRA’s administrator, Heather Lodge, and Associate Professor in European Politics, SGIA and GPI, Dr Kyriaki Nanou. 

Over the course of two days of discussions, the workshop identified a set of PACE recommendations, covering: 

Position: not being anti-trade but coming from a desire to improve health and a wish to see trade deals be above party politics. 

Advocacy: speaking the language of trade, quantifying potential impacts and suggesting policy solutions with efforts focussed on the formative stage of trade negotiations; building advocacy around the recognition that health is wealth, and the principle of “do no harm.”  

Collaboration: linking with other groups to develop a brief for a UK trade strategy vision with three specific key asks; making an impact by informing the House of Lords International Agreements Committee on monitoring and scrutiny of public health impacts and mitigations; embedding legal training on trade issues for public health professionals; and using citizens’ juries and deliberative methods to articulate the public voice. 

Evidence: moving away from justifying public health as an exception by using evidence from tools such as health impact assessments and modelling of macro-economic, health and fiscal impacts; synthesising evidence for Ministers and Civil Servants and providing guidance on policy measures that would tweak impacts.  

The success of the event can be judged by the energy generated by the workshop discussions and the commitment made by participants at the close of the event to continue working together to build capacity in understanding how the negative impacts of trade policy on population health can best be addressed. In particular, the forthcoming UK general election opens up a space and window of opportunity to influence and shape policy. 

The workshop ended with an agreed action agenda of potential outputs and opportunities to be seized over the short, medium and long term. These included:  

• revisiting PETRA’s R&D Framework/Manifesto in the light of observations made during the workshop;  
• producing input into the political manifestos in the run-up to the forthcoming UK general election expected over the next year or so;  
• developing and strengthening training for trade and health specialists;  

• conducting a mapping exercise of trade policy/agreements processes and culture, and producing case studies to illustrate these;  
• horizon scanning to identify what is happening on trade over the next 5-10 years;  
• engaging with analysts in relevant government departments to increase understanding of trade and health concerns, and to help break down silos and encourage cross-government working.  

Finally, our intention is to publish articles to capture the learning from the workshop.  

July 2023