Walls Helen, Baker Phillip, Smith Richard
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H9SH, UK.
Leverhulme Centre for Integrative Research on Agriculture and Health, 30 Gordon Square, London WC1H0PD, UK.
J Public Health Policy. 2015 Nov;36(4):491-501. doi: 10.1057/jphp.2015.23. Epub 2015 Aug 6.
International trade has brought economic benefits to many countries, but the association of trade and investment liberalisation with poor health outcomes concerns the public health community. The need to secure more 'healthy' trade is a recognised priority, especially as countries move from global to regional/bilateral trade agreements - with greater public health risks. However, a transition towards 'healthier trade' may be hindered by worldview differences between the trade and health communities. There is a tendency for health actors to perceive trade as a threat to population health, and for trade actors to view health as a constraint to trade objectives of reducing barriers to cross-border commercial flows and economic growth. Unless such differing worldviews can be aligned, finding ways forward for addressing public health in trade policy is likely to be difficult. Moving forward will involve understanding the values and drivers of the respective groups, and developing solutions palatable to their various interests. Given the power imbalances between the two areas, it is likely that the health community will have to make the first moves in this respect. This article outlines the key issues involved and suggests areas where such moves have been, and may be made.
国际贸易给许多国家带来了经济利益,但贸易与投资自由化和不良健康结果之间的关联引发了公共卫生界的担忧。确保更“健康”的贸易是公认的优先事项,尤其是随着各国从全球贸易协定转向区域/双边贸易协定——这带来了更大的公共卫生风险。然而,向“更健康贸易”的转变可能会受到贸易界和卫生界世界观差异的阻碍。卫生行为体倾向于将贸易视为对民众健康的威胁,而贸易行为体则将卫生视为对降低跨境商业流动壁垒和经济增长等贸易目标的制约。除非能够弥合这种不同的世界观,否则在贸易政策中解决公共卫生问题的前进道路可能会很艰难。向前推进将涉及了解各自群体的价值观和驱动因素,并制定符合其不同利益的解决方案。鉴于这两个领域之间的权力失衡,卫生界很可能必须在这方面率先采取行动。本文概述了其中涉及的关键问题,并指出了已经和可能采取此类行动的领域。