1. TransAtlantic Dialogue on Underage Drinking Royal College of Surgeons London, England June 28, 2011 “Global Trade Issues Related to Addressing Underage Drinking” Donald Zeigler, PhD, Rush University Medical Center

2. Trade Agreements: global, regional & bilateral Goals Goals Removal of regulations Removal of regulations Ending regulations shall process toward freer trade Ending regulations shall process toward freer trade Process of trade liberalization shall be irreversible Process of trade liberalization shall be irreversible

3. Fundamental Conflict of Interest Aim of trade liberalization: Aim of trade liberalization: reduce tariffs and regulations reduce tariffs and regulations increase marketing, sales and consumption increase marketing, sales and consumption Aim of alcohol control policies: Aim of alcohol control policies: reduce the overall consumption and the harmful consequences reduce the overall consumption and the harmful consequences

4. Operating assumption of trade Treat alcoholic beverages as ordinary commodities – like bread, milk, coffee or tea. Treat alcoholic beverages as ordinary commodities – like bread, milk, coffee or tea. Alcohol is no ordinary commodity Alcohol is no ordinary commodity

5. Agreements liberalize trade More competition for market share More competition for market share More aggressive advertising More aggressive advertising Aspirational goods – “sexy” international brands, and easier to smoke; alcopops for girls & young women Aspirational goods – “sexy” international brands, and easier to smoke; alcopops for girls & young women Lower prices Lower prices

6. Trade agreements negotiated primarily in secret by government negotiated primarily in secret by government often in consultation with business interests often in consultation with business interests

7. TAs, particularly GATS, can affect the ability to regulate alcohol under terms of “restriction of retail trade”

8. Potential targets Laws concerning distribution of alcohol Laws concerning distribution of alcohol Licensing restrictions Licensing restrictions Governent alcohol monopolies Governent alcohol monopolies

9. Information, education and prevention Information, education and prevention Laws on alcohol advertising and sponsorships Laws on alcohol advertising and sponsorships

10. 2005 World Medical Association statement consideration of alcohol as an extra-ordinary commodity consideration of alcohol as an extra-ordinary commodity measures affecting the supply, distribution, sale, advertising, promotion or investment in alcoholic beverages be excluded from international trade agreements measures affecting the supply, distribution, sale, advertising, promotion or investment in alcoholic beverages be excluded from international trade agreements.

11. Recent issues Thailand & Brazil – alcohol labeling Thailand & Brazil – alcohol labeling Thailand seeking to remove tobacco and alcohol as normal commodities from trade agreements Thailand seeking to remove tobacco and alcohol as normal commodities from trade agreements Philippines alcohol tax Philippines alcohol tax EU pressing US on control states EU pressing US on control states WTO Doha Round stalled but… WTO Doha Round stalled but… Special session UN General Assembly on Noncommunicable Diseases Special session UN General Assembly on Noncommunicable Diseases

12. Counter measures Adopt “precautionary principle” Adopt “precautionary principle” Introduce strong evidence-based policies Introduce strong evidence-based policies Make no more alcohol commitments in new TAs Make no more alcohol commitments in new TAs Require alcohol – no ordinary commodity Require alcohol – no ordinary commodity Counter alcohol “experts” Counter alcohol “experts” Demand public health voice in trade committees Demand public health voice in trade committees

13. Donald W. Zeigler, Ph.D. Community & Social Medicine, Dept of Preventive Medicine Rush University Medical Center, Chicago, IL USA zeiglerdw@aol.com

14. AMA and World Medical Association urged WHO to assist nations to frame trade policy to protect health