1. Trade and Health National Assessment The World Health Organisations Diagnostic Tool on Trade and Health Presented by: Corinna Hawkes, Consultant corinnahawkes@aliceadsl.fr

2. Why a diagnostic tool and workbook on trade and health? Increasingly, health issues cross national boundaries Health is moving out of its traditional arena & becoming a more important component of foreign policy New skills & capacity needed to negotiate these global regimes, including trade, to ensure good health outcomes Previous experience of IP & health services suggests a need to develop more systematic approach to analyze cross- border trade and health issues

3. WHO Mandate on trade and health WHA Resolution 59.26 (May 2006) on international trade and health to build the capacity to understand the implications of international trade and trade agreements for health and to address relevant issues through policies and legislation that take advantage of the potential opportunities, and address the potential challenges, that trade and trade agreements may have for health

4. Objective of the diagnostic tool To help countries develop a national assessment / strategy on impact of trade on health: Assess opportunities and risks associated with international trade rules and greater cross- border flows of goods, services and capital Identify the strategies needed to harness benefits and prevent/mitigate negative impacts Identify capacity building needs and help structure requests for capacity building Create mechanism to facilitate participation of health authorities in trade policymaking process

5. Who is involved? WHO Secretariat: Department of Ethics, Equity, Trade and Human Rights, Dr Nick Drager WHO regional offices (SEARO, WPRO, EMRO) Coordination: Chantal Blouin, WHO Consultant Country input: Thailand, Malaysia, Vietnam prepared case studies based on preliminary matrix Lead experts and reviewers (WTO, World Bank, UNCTAD): Content and background analysis of tool

6. What does it comprise? Matrix of questions, a menu of five components Indirect impacts of trade on population health and health systems Trade in health-related products Trade in harmful products Trade in health services Trade in foodstuffs Workbook Review of evidence on linkages Documents best practices, data sources, international norms & standards

7. How is it being prepared? Draft tools prepared by lead experts for each five themes Regional meeting in Delhi March 2007 National meeting in KL, April 2007 Scientific Resource Group meeting, August 2007 Technical Meeting, Ottawa Oct 2007 Additional external reviewers providing written comments Publication of the tool at the end of 2008 (World Bank as publisher)

8. How will it be implemented? Preparation of national assessments on trade & health by countries in cooperation with WHO Working Group featuring a range of experts to guide the development, administration and analysis of the tool (representatives from health ministry, trade ministry, public & private health providers, medical licensing bodies, NGOs active in the health field, etc.). Adapted to country specific contexts and needs of the different actors

9. Example. Trade in foodstuffs and health Core health concerns around food Undernutrition Over-nutrition: obesity & diet-related chronic diseases (heart disease, diabetes) Foodborne disease Links with trade Food availability, prices Food marketing Food safety

10. Relevant Trade Agreements & rules WTO Agreement on Agriculture WTO Agreement on Sanitary and Phytosanitary Measures WTO Technical Barriers to Trade Agreement WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) Related rules in regional & bilateral trade agreements Any measure designed to facilitate business by transnational companies

11. Diagnostic tool questions for trade & foodborne disease I Health What is the burden of foodborne diseases? What are the risk factors? Impact of trade on health Are the risk factors associated with traded foods? What is the volume and value of trade of foods with high risks? Trade rules What existing trade agreements affect trade in high risk foods? How have trade agreements affected food safety risks?

12. Diagnostic tool questions for trade & foodborne disease II Impact of health on trade Have concerns about food safety risks affected food trade? Have trade agreements concerning food safety affected food trade? National regulations What is the national regulatory environment on food safety? Is this environment consistent with international standards and best practices? Policy coherence What measures are in place to promote coherence between trade rules and strategies to reduce foodborne disease ?

13. How diagnosis supports national assessment & capacity building for trade and health Opportunities/risks for health SPS Agreement/food imports Participation of health authorities in the trade policymaking Focus on domestic as well as exported foods Capacity building needs Using international food safety regulation to build food safety capacity for national food supply

14. Thank you