The international context of Alcohol policy—health may yet trump trade. Comment on Chapter 14: The international context of alcohol policy

Abstract

As the title of this volume implies and its individual chapters demonstrate (Babor et al. 2003), the range of health, economic and social consequences resulting from alcohol use make alcoholic beverages unlike the vast majority of consumer goods. The economic, social and cultural role of alcohol in many countries, however, poses challenges to policymakers trying to control alcohol effectively. Recent trends towards globalization have complicated these efforts, as international trade agreements have been viewed as a threat to existing control policies and the strengthening of these policies. As the authors of Chapter 14 describe, there are several alcohol policy domains—often those with the greatest demonstrated effects in curbing alcohol use and abuse—that can be impacted by trade treaties. Multi-national producers trying to gain a footing in new markets might challenge local monopolization of alcoholic beverages as anticompetitive. Similarly, some could interpret trade agreements as a threat to local bans on alcohol advertising and promotion, in that they could create an uneven playing field favoring entrenched domestic producers over newly entering multi-nationals. Alcoholic beverage taxes can be impacted by regional agreements that attempt to harmonize these taxes. While creating the potential to increase taxes to the levels set in countries where high taxes are being used to control alcohol use and abuse, too often the opposite happens and harmonization occurs at the low end of the range. At first glance, the application to alcohol of international trade agreements that aim to open markets and increase competition—often resulting in lower prices, more extensive marketing and increased availability—appear at odds with the public health goals of reducing the harms that result from alcohol use and abuse. As noted in Chapter 14, recent experiences with tobacco—also ‘no ordinary commodity’—are illustrative. The tobacco control community also debates the threat posed by international trade agreements for tobacco control efforts (Bettcher & Shapiro 2001; Callard et al. 2001). However, recent experiences with tobacco demonstrate how public health concerns can be used to support strong control policies that appear to violate international trade agreements and provide an effective model for strong international efforts to curb the damage caused by alcohol (Chaloupka & Nair 2000; Taylor et al. 2000). While many speculate that trade concerns trump public health in international disputes, the opposite was concluded in a 1990 US challenge to the Thai Tobacco Control Act under the General Agreement on Tariffs and Trade. While some provisions of the Thai act were struck down (those significantly restricting imports of tobacco products), the GATT panel upheld key components (including a strong ban on cigarette advertising and promotion), stating that Thailand could give priority to public health over trade liberalization and that these measures were necessary to achieve this goal. This principle is formalized in Article XX of the 1994 GATT, which states that ‘nothing in this Agreement shall be construed to prevent the adoption or enforcement by any contracting party of measures…necessary to protect…human health’. While some commentators suggest that amendments to the GATT and other subsequent trade agreements (including the General Agreement on Trade in Services and the Trade-Related Aspects of Intellectual Property) could lead the World Trade Organization to decide differently today (for tobacco, alcohol or other products that harm public health), the precedent established by the decision in the US/Thai dispute remains in place. More promising, as described in Chapter 14, is the Framework Convention on Tobacco Control (FCTC)—a treaty that addresses directly tobacco control policies with international implications. After several years of negotiation, the FCTC was adopted unanimously by the 192 members of the World Health Organization in May 2003, and 40 countries and the European Community signed the treaty within the first week possible. The treaty covers a wide range of policies with international implications, including taxation, restrictions on advertising and promotion, package design and labeling guidelines, product regulation, smuggling controls, duty-free sales bans and more (WHO 2003). While not yet having the force of law, the FCTC has mobilized tobacco control efforts globally and has spurred the adoption of strong tobacco control policies in many countries. The success of the FCTC provides a model for a similar comprehensive, international effort to control alcohol. While the implications of international trade agreements for national and international alcohol control efforts remain murky, the recent experiences with tobacco suggest more optimism than expressed by the authors. Because of the public health damage it causes, alcohol is clearly not an ordinary commodity. Precisely for this reason, international trade agreements allow the application of strong national alcohol control policies that apply evenly to domestic and foreign firms. Moreover, concerted action addressing transnational issues around pricing, advertising and promotion, labeling and other alcohol control efforts are feasible. Alcohol: No Ordinary Commodity should prove invaluable in guiding these efforts, both nationally and internationally.