Trade, food, and chronic diseases

Professor Sharon Friel, National Centre for Epidemiology and Population Health, ANU

1. Liberalisation of international food trade

2. Increased foreign direct investment

3. Globalised advertising and marketing

3 drivers of dietary change

Trade Agreements

– Rules governing the flow of goods and services between countries

– Trade liberalization – reducing barriers to trade e.g. tariffs (import taxes), non-tariff barriers

Important multilateral WTO agreements

Goods • GATT

• Agreement on Agriculture

• Agreement of Application of Sanitary & Phytosanitary Measure

• Agreement on Technical Barriers to Trade

Services • General Agreement on Trade in Services (GATS)

Intellectual Property

• Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS)

The changing face of trade policy

Deep RTAs

21st Century Regional Trade Agreements

• More like “Investment” than Trade agreements

• Complex economic integration agreements including non-traditional trade issues

– intellectual property (IP)– investment protection– regulatory cooperation

• More favourable arrangements for wealthy countries and transnational corporations

• Inherent power imbalances

• New risks to health and health equity

Trans Pacific Partnership Agreement (TPP)

Currently negotiating: Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, United States, Vietnam

Trade-related pathways to nutrition and health

Pathways linking trade agreements, food and diet-related health

TRADE GOVERNANCE

Development processes:

Actors (negotiators,

ministers, industry, civil

society)

Sectors

TRADE AGREEMENTS

Chapters/Measurese.g.

• Market access• Intellectual property

rights• Investment protection• Technical barriers to

trade• Sanitary and

phytosanitary measures • Financial services• Government

procurement• Regulatory coherence• Cross-border services• State-owned enterprises

HEALTH OUTCOMES & THEIR SOCIAL DISTRIBUTION

UndernutritionOverweight & Obesity

Non-communicable diseases

TRADE GOVERNANCEImplementation processes:

RatificationLegislation

Dispute resolution procedures

AvailabilityAffordabilityAcceptability

Imports/Subsidies/

Tariffs;

Investments (marketing, labeling);

Regulatory/Policy space

FOOD ENVIRONMENT

•What food are produced

•Amount of food•Nutritional quality of food

•Food price

1. Nutritional quality and quantity of imports

2. Reduce tax-revenue base of governments to fund nutrition health and social programs

3. Foreign direct investment

4. Limitations on domestic policy instruments

• In 2004 mutton flap consumption was about 600 g per week per adult and comprised 18% of total meat consumption

• Draft legislation for import quota to any product that had >40% energy from fat• Under WTO trade rules quotas are perceived as highly trade distorting• WTO accession negotiations resulted in postponement of legislation

Quantity of mutton flaps imported into Tonga, 1980–2007

Thow et al 2010 Food Policy 35: 556–564

1. Nutritional quality and quantity of imports

2. Reduce tax-revenue base of governments to fund nutrition health and social programs

3. Foreign direct investment

4. Limitations on domestic policy instruments

Pacific Agreement of Closer Economic Relations (PACER PLUS)

Oxfam 2009

• Elimination of substantially all import tariffs between PICs and Australia and New Zealand

• Most of the increase will be in PIC imports not exports

Education Health PACER revenue loss

Cook Islands 14 11 6

Fiji 29 14 3

Kiribati 14 9 15

PNG 10 6 2

Samoa 22 17 12

Tonga 13 14 19

Vanuatu 23 11 18

Government Expend as % Total Budget

1. Nutritional quality and quantity of imports

2. Reduce tax-revenue base of governments to fund nutrition health and social programs

3. Foreign direct investment

4. Limitations on domestic policy instruments

4 agribusinesses control almost 90% of global grain trade

A: Archer Daniels Midland (ADM)B: BungeC: CargillD: Louis Dreyfus

Oxfam 2012. Cereal Secrets: the worlds largest grain traders and global agriculture

Convenience creep by TNCs in Asia?

Baker and Friel in press. Obesity Reviews.

High-income countries: Singapore, South Korea, Taiwan, and JapanUpper-middle income countries: China, Malaysia, and ThailandLower-middle income countries: India, Philippines, Vietnam, Indonesia, Pakistan

Stuckler et al (2012) Manufacturing Epidemics: The Role of Global Producers in Increased Consumption of Unhealthy Commodities Including Processed Foods, Alcohol, and Tobacco. PLoS Med 9(6): e1001235. doi:10.1371/journal.pmed.1001235

Soft Drink Consumption(volume per capita)

1% higher GDP per capita 0.90%***(0.19)

1 percentage point higher urban population (% of total)

0.018%*(0.0068)

Free Trade Agreement with the United States

55.4%*(24.2)

Number of Countries 35R2 0.74

FTAs, Soft Drink Consumption, 35 low- and middle-income countries, 2010

1. Nutritional quality and quantity of imports

2. Reduce tax-revenue base of governments to fund nutrition health and social programs

3. Foreign direct investment

4. Limitations on domestic policy instruments

Key Technical Barriers to Trade

www.foodindustry.asia

Thailand Snack Food Labelling

Technical Barriers to Trade Dispute

• 2006 Proposed Traffic Light System X

• Proposed Warning Label

“Should take less, and exercise for a better health”

Trans Pacific Partnership agreement: constraining public health regulation and policy space

• Addressing NCDs will require strong action to regulate the tobacco, alcohol, processed food industries

• But the TPP could tie the hands of governments:

– Investor-state dispute settlement– Increased opportunities for industry input into

policy making; complaint mechanisms

Friel et al. Globalization and Health 2013, 9:46. DI: 10.1186/10.1186/1744-8603-9-46

Tobacco companies deciding national health policy?

Challenged in three forums:• High Court (unsuccessful)• WTO (Ukraine, Honduras, Dominican Republic)• Hong-Kong Australia Bilateral Investment

Treaty (challenge by Philip Morris Asia using an ISDS clause)

TPP: Health advocacy in Australia

• PHAA’s policy on trade agreements and health• Advocacy

– Letters to PM, ministers– Stakeholder presentations; meetings with negotiators and politicians– Cross sectoral engagement (DoHA, AusAID)

• Awareness raising– Articles, media releases, interviews– Seminars, workshops

• Research and analysis• Submission writing• Working with other organisations; building coalitions• Advocacy at the World Federation of PHAs (WFPHA)

Send a letter to the Trade Minister: www.aftinet.org.au