Koivusalo Meri
National Institute for Health and Welfare, PO Box 30, Helsinki FI 00271, Finland.
Health Promot Int. 2014 Jun;29 Suppl 1:i29-47. doi: 10.1093/heapro/dau033.
New trade agreements affect how governments can regulate for health both within health systems and in addressing health protection, promotion and social determinants of health in other policies. It is essential that those responsible for health understand the impacts of these trade negotiations and agreements on policy space for health at a national and local level. While we know more about implications from negotiations concerning intellectual property rights and trade in goods, this paper provides a screening checklist for less-discussed areas of domestic regulation, services, investment and government procurement. As implications are likely to differ on the basis of the organization and structures of national health systems and policy priorities, the emphasis is on finding out key provisions as well as on how exemptions and exclusions can be used to ensure policy space for health.
新的贸易协定影响着政府在卫生系统内部以及在其他政策中解决卫生保护、促进和健康的社会决定因素方面进行卫生监管的方式。负责卫生工作的人员必须了解这些贸易谈判和协定对国家和地方层面卫生政策空间的影响。虽然我们对知识产权和货物贸易谈判的影响了解得更多,但本文为国内监管、服务、投资和政府采购等较少讨论的领域提供了一份筛查清单。由于影响可能因国家卫生系统的组织和结构以及政策重点而异,重点在于找出关键条款以及如何利用豁免和排除规定来确保卫生政策空间。