On 18 February, the European Commission launched its long-awaited “Trade Policy Review” laying out their plans for “An Open, Sustainable and Assertive Trade Policy.” The document includes three core objectives:
- supporting recovery, green and digital transformations.
- shaping global rules for a more sustainable and fairer globalisation, and,
- increasing EU capacity to pursue its own interests and enforce rights.
This sounds positive, but public health advocates could be forgiven for being surprised – and a little concerned – about just how little attention in the review is paid to health, even amidst a global pandemic. Instead, the document is far more concerned with geopolitics and securing the EU’s place as one of the leaders of global free trade. The current pandemic should have made clear how dependent economic health is dependent on public health and well-being. Where is ‘health in all policies’ when you need it?
The review’s attention to health is limited to COVID-19. The pandemic is framed as having accelerated and focussed attention on the above-mentioned transitions, and highlighting the interconnections between economies. The relevance of the pandemic in the eyes of the Commission is primarily tied to questions of geopolitics, rather than a recognition of the importance of sound public health policies for economic prosperity: “It has exposed the risk of a breakdown of global cooperation and trust… raised questions regarding the right policy mix in terms of diversification of domestic and external sources of supply and the build-up of strategic production capacities and reserves.” COVID-19, in short, simply reinforces the EU’s wider geopolitical analysis of global uncertainty and growing unilateralism, leading to disruption and bypassing of multilateral institutions.
Health is also identified as a “sensitive industrial ecosystem” where a combination of a dramatic increase in demand for certain health related products (i.e. Personal Protective Equipment) and supply shortages due to restrictive measures (think lockdowns) exposed some vulnerabilities. The solutions identified by the Commission relate only to crisis planning: crisis preparedness, diversifying production and supply chains and ensuring strategic stockpiling. As such the bigger picture is missed.
The review’s analysis therefore boils down to questions around the production and supply of medical goods. This obscures the other ways in which trade can impact public health, instead framing the pandemic as illustrating the need for international cooperation and free trade. This may well be true, but it subordinates public health to the EU’s geopolitical strategy, arguing against the protectionism of China, and until recently the US. As EPHA’s Scientific advisor on trade wrote previously, current trade debates often focus on a binary opposition between securitisation and the EU’s preferred “open strategic autonomy” – neglecting the necessary “comprehensive consideration of the complex interactions that exist between trade, investment and public health.” The Commission’s trade policy review falls precisely into this trap.
Sustainability and social protections
On the other hand, much of the focus of the review concerns incorporating sustainability and social goals into the EU’s trade agenda, an ambition which is to be applauded and which will certainly also benefit public health. The European Green Deal is referred to as the EU’s new growth strategy, and the interdependence of the green transition and social equity – core labour standards, social protection in line with the European Pillar of Social Rights and gender equality – is stressed. However, health is still not covered explicitly under the heading of sustainable development.
Trade deals are in this context seen as levers by which “to promote the understanding among our partners that the green transformation is not only a necessity in the medium term, but already constitutes smart economic policy today,” which again sounds positive. However, other parts of the strategy seem to undermine, or at least mitigate this. As part of the process of strengthening focus on implementation and enforcement of trade agreements, and ensuring a level playing field, the review asserts that “It is therefore important to create the conditions for the ratification of agreements with Mercosur and Mexico” in order to take advantage of the significant economic opportunities there. EU policy-makers might argue that the additional commitments concerning deforestation and other environmental goals for the EU-Mercosur agreement, which are currently being negotiated, will mean that the agreement will be entirely consistent with the EU’s sustainability commitments. It is hard not to draw the conclusion however that this stubborn insistence on signing trade deals in order to increase geopolitical and economic influence globally trumps the EU’s green and social values. In any case, as long as public health is not explicitly addressed in the EU’s trade agreements, public health will suffer.
WTO health and trade initiative
One explicitly health and trade related action the EU is undertaking, is the pursuit of a trade and health initiative in the World Trade Organisation. This is mentioned briefly within the trade strategy, in the context of building resilience through stable, rules-based trading, opening of new markets, and “developing cooperative frameworks for fair and equitable access to critical supplies.”
This, and the concept paper released by the EU makes clear that, although this initiative is undoubtedly a positive step – insofar as it facilitates access to medical/pharmaceutical goods that might be undermined by export and import restrictions/barriers – it falls into a similar dichotomisation as the rest of the trade policy strategy, seeing trade and health in the binary terms of openness v securitisation.
Once again, this seems incredibly unambitious in the context of the COVID-19 pandemic. The WTO health and trade initiative doesn’t address the issue of waivers of WTO intellectual property rules for COVID vaccines (or in the context of potential future pandemics). Given that global inoculation is needed to tackle COVID effectively and prevent new variants from developing and undermining existing vaccines and treatments, this is very short-sighted.
Compulsory licensing under the WTO’s TRIPS Agreement is of course permissible and facilitated by the entry into force in 2017 of Article 31bis. But the existence of such mechanisms to facilitate compulsory licensing doesn’t prevent them from being difficult to navigate (especially for developing countries) and potentially superseded by more stringent IPR provisions in other trade agreements. They also do not necessarily address issues related to IPRs pertaining to production processes for pharmaceuticals as well as the regulatory approval of generics (which may be delayed). So both domestically and at WTO level, the EU seems to be trapped in binary thinking when it comes to trade and health.
“Open strategic autonomy” – joined up thinking?
The Trade Policy Review highlights that its new central strategy of “Open strategic autonomy” is dependent on “joined up internal and external action, across multiple policy areas, aligning and using all trade tools in support of EU interests and policy objectives.” If those policy areas exclude public health, even amidst a global pandemic, even under a Commission President who has highlighted the “need to build a stronger European Health Union” and even when polls are clear that a majority of Europeans want more action on health at the EU level, then the Commission risks fundamentally undermining the effectiveness of its trade strategy in delivering the benefits for citizens it claims is its aim.