Zoltán Massay-Kosubek

(author – Adolfo Costantini) Rome, 2 May 2016.The recent leak of confidential Transatlantic Trade and Investment Partnership (TTIP) documents by Greenpeace did not cover the planned Sustainable Chapter and it is worth to reflect upon if increased transparency will help making Trade agreements sustainable. The adoption of Sustainable Development Goals in New York in September 2015 was a significant step forward by establishing a legal framework to ensure sustainable development. TTIP and the Trans-Pacific Partnership (TPP) are trade agreements which represent a more efficient vehicle by which to promote the SDGs. While the EU Commission proposed a chapter on Sustainable Development and trade in the TTIP were discussed during TTIP negotiations rounds, it is unfortunate that although many SDGs are directly relevant for public health, Sustainable Development chapters in Trade agreements only cover environment and social aspects and fail to address public health sustainability.

What is the relevance of trade for health?

Trade negotiations are taking place in a context of the high and growing burden of chronic non-communicable diseases (NCDs) including cancers, cardiovascular and respiratory diseases (COPD), diabetes and obesity.

In that regard, increased trade of health harmful goods – tobacco, alcohol, unhealthy foods – will be detrimental to public health.

Giving the example of alcohol: alcohol-abuse is the leading risk factor for ill-health and premature death for the working age population (25-59 years) in Europe [1] . The societal costs of alcohol use in Europe are in excess of €155 billion per year across the EU [2]. Alcohol-related diseases across Europe claim 120,000 lives every year in the EU .

These are unusual goods that illustrate the limits to the benefits of free trade – in that making them cheaper for consumers may become dramatically more expensive for society and governments in the longer term costs of illness and treatment.

Missing link betweed Trade Agreements and existing international instruments on public health

The goals of the EU’s Trade Policy should pay attention to health as Article 168 of the Treaty on the Functioning of the European Union (TFEU) requires in a legally binding manner that health should be included in all EU policies.

Sustainable Development chapter should make reference to existing international public health instruments in the field of public health.

Such instruments include
Global Action Plan for the Prevention and Control of NCDs 2013-2020
the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) which is legally binding, as ratified by all the 28 EU Member States and by the EU itself;
the Rome Framework for Action on Nutrition of 2014
the WHO European Food and Nutrition Action Plan (2015-2020).

The main demands to a sustainable European Trade policy

Sustainable development chapters in Trade agreements should have a strong public health dimension in the future. Horizontal policy instruments in trade agreement – especially Regulatory Cooperation and different Investment protection mechanisms – could fundamentally compromise public health legislation and policies. A regulatory chill would be particularly disastrous in terms of health policy if it halts policy action on antibiotic resistance, access to medicines, alcohol, tobacco and unhealthy foods. The EU should maintain the unquestionable right to set policies to affect with the price, availability, or accessibility of goods which are harmful to health – which should be treated differently to other products.


Article performed by Adolfo Costantini, law student at the LUISS University. For questions or more information contact at costantiniadolfo@gmail.com

Note: The author was an intern at the European Public Health Alliance (EPHA) for the time of the article.


[1] Scientific Opinion of the Science Group of the European Alcohol and Health Forum (2011) Alcohol, Work and Productivity

[2] Rehm, J. et al (2012) Interventions for alcohol dependence in Europe: A missed opportunity to improve public health.

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