1,721,051 research outputs found
WHO response to WTO member state challenges on tobacco, food and beverage policies.
Full text linkIn 2013, the World Health Assembly endorsed the World Health Organization’s (WHO) Global action plan for the prevention and control of noncommunicable diseases 2013–2020 to achieve a 25% reduction in mortality from noncommunicable diseases by 2025.1 Two years later, all of the world’s governments committed to reducing the global burden of noncommunicable diseases as part of the sustainable development goals. The rationale for these commitments is clear: in 2016, noncommunicable diseases caused almost threequarters of all deaths worldwide and this burden has significant economic costs.2 The World Economic Forum estimates that, without concerted action, cumulative economic losses from noncommunicable diseases will exceed 7 trillion United States dollars over the period 2011–2025 in low- and middleincome countries.3 WHO’s Global Action Plan is ambitious, as it aims to achieve a world free of the avoidable burden of noncommunicable diseases.1 The plan recognizes that this aim can only be achieved through determined action by Member States and international partners. The contribution of WHO is its ability to convene, set norms and standards, and offer technical support. For example, WHO has developed cost–effective interventions for preventing noncommunicable diseases that include labelling regulations for salt, fat and sugar, for soft drinks, for tobacco and for alcoholic beverages
Trade challenges at the World Trade Organization to national noncommunicable disease prevention policies: A thematic document analysis of trade and health policy space.
Full text linkBACKGROUND: It has long been contested that trade rules and agreements are used to dispute regulations aimed at preventing noncommunicable diseases (NCDs). Yet most analyses of trade rules and agreements focus on trade disputes, potentially overlooking how a challenge to a regulation's consistency with trade rules may lead to 'policy or regulatory chill' effects whereby countries delay, alter, or repeal regulations in order to avoid the costs of a dispute. Systematic empirical analysis of this pathway to impact was previously prevented by a dearth of systematically coded data. METHODS AND FINDINGS: Here, we analyse a newly created dataset of trade challenges about food, beverage, and tobacco regulations among 122 World Trade Organization (WTO) members from January 1, 1995 to December 31, 2016. We thematically describe the scope and frequency of trade challenges, analyse economic asymmetries between countries raising and defending them, and summarise 4 cases of their possible influence. Between 1995 and 2016, 93 food, beverage, and tobacco regulations were challenged at the WTO. 'Unnecessary' trade costs were the focus of 16.4% of the challenges. Only one (1.1%) challenge remained unresolved and escalated to a trade dispute. Thirty-nine (41.9%) challenges focussed on labelling regulations, and 18 (19.4%) focussed on quality standards and restrictions on certain products like processed meats and cigarette flavourings. High-income countries raised 77.4% (n = 72) of all challenges raised against low- and lower-middle-income countries. We further identified 4 cases in Indonesia, Chile, Colombia, and Saudi Arabia in which challenges were associated with changes to food and beverage regulations. Data limitations precluded a comprehensive evaluation of policy impact and challenge validity. CONCLUSIONS: Policy makers appear to face significant pressure to design food, beverage, and tobacco regulations that other countries will deem consistent with trade rules. Trade-related influence on public health policy is likely to be understated by analyses limited to formal trade disputes
The Impact of the 2008 Global Financial Crisis on the Health of Canadians
No full textDespite a clear impact on the Canadian economy, little is known about the subsequent health impacts of the 2008 Global Financial Crisis (GFC). This thesis aims to fill this gap in knowledge by conducting a secondary analysis of Canadian Community Health Survey (CCHS) data to assess the impact of the GFC on health in Canada – a country that has not yet been thoroughly studied from this angle. Based on when the respondent completed the survey, exposure to the GFC was categorized into four phases: pre-crisis, crisis, stimulus, and austerity. Outcomes investigated include measures of mental health, physical health, and health-related behaviours. Statistically significant associations were observed between several health outcomes and the austerity period as compared to the pre-crisis period. Austerity has been linked to worsening health in other studies and represents an example of how the policy response can have greater detrimental impact on health than the financial crisis itself
International Trade and Investment Agreements and Health: The Role of Transnational Corporations and International Investment Law
No full textAddressing complex global health challenges, including the burden of noncommunicable diseases (NCDs), will require change in sectors outside of traditional public health. Contemporary regional trade and investment agreements (RTAs) like the Trans-Pacific Partnership (TPP) continue to move further ‘behind-the-border’ into domestic policy space introducing new challenges in the regulation of health risk factors. This dissertation aimed to clarify the pathways through which RTAs influence NCDs, and to explore points along those pathways with the intent of improving the existing evidence base and supporting policy development. This work develops a critical theoretical framework exploring the ideas, institutions, and interests behind trade and investment policy; it also develops a conceptual framework specifying how trade and investment treaty provisions influence NCD rates through the effects of trade and investment on tobacco, alcohol, and ultra-processed food and beverage products, as well as access to medicines and the social determinants of health. Using health impact assessment methodology, three analytical components were designed to examine pathways of influence from RTAs to health outcomes as mediated by the interests of transnational corporations (TNCs). The first component explored the influence of industry during the TPP negotiations and how its health-related interests were reflected in the final TPP text. The second component examined the role of trade and investment liberalisation in health-harmful commodity markets, finding a rise in TNC sales after a period of liberalisation. The third component demonstrated how investor rights and investor-state dispute can challenge the state’s right to regulate if it damages the profits of TNCs, which may threaten effective health regulation, and provides opportunities to strengthen the right to regulate. The work in this dissertation provides support for the thesis that trade and investment policies are a fundamental structural determinant of health and well-being, which are highly influenced by TNCs that guide such policies in the interest of maximising their profits and protections, often to the detriment of public policy and population health. This work identifies the need for more robust health impact assessments of RTAs before future agreements are ratified, as well as an imperative to challenge vested interests that entrench neoliberal policy preferences that have hindered sustainable and equitable development
Global Health Diplomacy: Understanding How and Why Health is Integrated into Foreign Policy
No full textThis study explores the global health diplomacy phenomenon by focusing on how and why health is integrated into foreign policy. Over the last decade or so, precipitated primarily by a growing concern about the need to strengthen global health security and deliver on the Millennium Development Goals, foreign policymakers have been paying more attention to health as a foreign policy concern and several countries have adopted formal global health policy positions and/or strategies. To elucidate a deeper and clearer understanding of how and why health is integrated into foreign policy, this thesis used a case study research design that incorporated literature and document review and interviews with twenty informants to conduct an in-depth analysis of the United Kingdom’s (UK) Health is Global: A UK Government Strategy 2008-13. Health is Global represents the first example of a formal national global health strategy developed using a multi-stakeholder process. Briefer background case reviews of three nations that are leaders in global health diplomacy - Brazil, Norway and Switzerland, were also conducted to inform the analysis of the in-depth case. Policy analysis included categorizing data into five areas: context (why?), content (what?), actors (who?), process (how?) and impact (so what?). The Multiple Streams Model of Policymaking and Fidler’s health and foreign policy conceptualizations - revolution, remediation and regression - were used to analyze the findings. Based on this analysis, the primary reason that the countries examined have decided to focus more on global health is self-interest - to protect national and international security and their economic interests. Investing in global health was also seen as a way to enhance a state’s international reputation. In terms of self-interest, Brazil was an outlier, however. International solidarity and health as a human right have been the driving forces behind its long-term investment in development cooperation to date. Investing in health for normative reasons was also a prevalent through weaker theme in the UK, Swiss and Norwegian cases. The study highlighted the critical role that policy entrepreneurs who cross the domains of international relations and health play in the global health policymaking process. In regards to advancing a conceptual understanding of global health diplomacy, the findings propose that the whole-of-government global health policymaking process is a form of global health diplomacy. The thesis elucidated factors that underpin this process as well as lessons for other nations, in particular, Canada. While ascertaining the impact of national global health strategies was not the main objective of this thesis, the study provided an initial look at the impact of these policy instruments and processes. Such impacts include better collaboration across government actors leading to enhanced policy coherence and a more strategic focus on global health. Finally, some have argued of late that the global health revolution is over due to the current world economic crisis. Considering the level of interest in whole-of-government global health strategies and the ever growing and sophisticated world-wide global health policy community, based on this thesis, the global health revolution is alive and well
The Impact of the 2008 Global Financial Crisis on the Health of Canadians
No full textDespite a clear impact on the Canadian economy, little is known about the subsequent health impacts of the 2008 Global Financial Crisis (GFC). This thesis aims to fill this gap in knowledge by conducting a secondary analysis of Canadian Community Health Survey (CCHS) data to assess the impact of the GFC on health in Canada – a country that has not yet been thoroughly studied from this angle. Based on when the respondent completed the survey, exposure to the GFC was categorized into four phases: pre-crisis, crisis, stimulus, and austerity. Outcomes investigated include measures of mental health, physical health, and health-related behaviours. Statistically significant associations were observed between several health outcomes and the austerity period as compared to the pre-crisis period. Austerity has been linked to worsening health in other studies and represents an example of how the policy response can have greater detrimental impact on health than the financial crisis itself
The role of trade and investment liberalization in the sugar-sweetened carbonated beverages market: a natural experiment contrasting Vietnam and the Philippines
Full text linkAbstract
Background
Trade and investment liberalization may facilitate the spread of sugar-sweetened carbonated beverages (SSCBs), products associated with increased risk factors for obesity, type II diabetes, and cardiovascular diseases (Circulation 121:1356–1364, 2010). Apart from a limited set of comparative cross-national studies, the majority of analyses linking liberalization and the food environment have drawn on case studies and descriptive accounts. The current failure of many countries to reverse the obesity epidemic calls for investigation into both individual and systemic factors, including trade and investment policies.
Methods
Using a natural experimental design we tested whether Vietnam’s removal of restrictions on foreign direct investment (FDI) subsequent to its accession to the World Trade Organization in 2007 increased sales of SSCBs compared with a matched country, the Philippines, which acceded in 1995. Difference-in-difference (DID) models were used to test pre/post differences in total SSCB sales and foreign company penetration covering the years 1999–2013.
Results
Following Vietnam’s removal of restrictions on FDI, the growth rate of SSCB sales increased to 12.1 % per capita per year from a prior growth rate of 3.3 %. SSCB sales per capita rose significantly faster pre- and post-intervention in Vietnam compared with the control country the Philippines (DID: 4.6 L per annum, 95 % CI: 3.8 to 5.4 L, p < 0.008). Vietnam’s increase in SSCBs was primarily attributable to products manufactured by foreign companies, whose annual sales growth rates rose from 6.7 to 23.1 %, again unmatched within the Philippines over this period (DID: 12.3 %, 95 % CI: 8.6 to 16.0 %, p < 0.049).
Conclusions
Growth of SSCB sales in Vietnam, led by foreign-owned companies, significantly accelerated after trade and investment liberalization
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Globalism, social insecurity and health outcomes in Australia
Full text linkAs the dominant ideology of the most recent wave of globalization, globalism promotes `marketfriendly policy as a global panacea. Resulting social inequalities, both within and between countries, generate deeper health divides. Focusing on boom-time Australia from the mid-1990s to the mid- 2000s, this chapter identifies a range of policy initiatives and structural shifts linked to globalist pressures. Policy measures include
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