Abstract
BackgroundThere is an extensive body of research demonstrating that trade and globalisation can have wide-ranging implications for health. Robust governance is key to ensuring that health, social justice and sustainability are key considerations within trade policy, and that health risks from trade are effectively mitigated and benefits are maximised. The UK’s departure from the EU provides a rare opportunity to examine a context where trade governance arrangements are being created anew, and to explore the consequences of governance choices and structures for health and social justice. Despite its importance to public health, there has been no systematic analysis of the implications of UK trade policy governance. We therefore conducted an analysis of the governance of the UK’s trade policy from a public health and social justice perspective.ResultsSeveral arrangements required for good governance appear to have been implemented – information provision, public consultation, accountability to Parliament, and strengthening of civil service capacity. However, our detailed analyses of these pillars of governance identified significant weaknesses in each of these areas.ConclusionThe establishment of a new trade policy agenda calls for robust systems of governance. However, our analysis demonstrates that, despite decades of mounting evidence on the health and equity impacts of trade and the importance of strong systems of governance, the UK government has largely ignored this evidence and failed to galvanise the opportunity to include public health and equity considerations and strengthen democratic involvement in trade policy. This underscores the point that the evidence alone will not guarantee that health and justice are prioritised. Rather, we need strong systems of governance everywhere that can help seize the health benefits of international trade and minimise its detrimental impacts. A failure to strengthen governance risks poor policy design and implementation, with unintended and inequitable distribution of harms, and ‘on-paper’ commitments to health, social justice, and democracy unfulfilled in practice. Although the detailed findings relate to the situation in the UK, the issues raised are, we believe, of wider relevance for those with an interest of governing for health in the area of international trade.
Highlights
There is an extensive body of research demonstrating that trade and globalisation can have wideranging implications for health
Our analysis identified a number of important considerations relevant to UK trade policy governance, using publicly available data generated by the Department for International Trade (DIT) and International Trade Committee (ITC)
In the UK context, transparency between central government and the devolved nations/administrations is critical to facilitating the involvement of the latter, which is key to the establishment and implementation of inclusive and coherent trade policy [37]
Summary
There is an extensive body of research demonstrating that trade and globalisation can have wideranging implications for health. Research on trade policy lies at the intersection of these two fields, and a growing body of research has identified its implications for health and social justice [4, 5]. Much of this has focused on how trade liberalisation and transnational commerce has increased consumption of harmful products, in particular energy-dense food and beverages [6, 7]. Literature has focused on the constraints imposed by trade and investment agreements on countries’ policy flexibility in the area of public health [13,14,15]. These examples, and others, have led some to question why public health is, too often, excluded from these discussions, and to advocate for reforms to trade policy governance, the conduct of trade negotiations [16,17,18,19]
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