This article is part of our special report Resilient and innovative EU health systems.
SPECIAL REPORT / While EU-US trade talks are expected to generate great economic benefits on both sides of the Atlantic, the impact of a trade agreement on the EU's healthcare systems will surely be negative, experts warn.
The second round of talks over the Transatlantic Trade and Investment Partnership (TTIP) had been supposed to start in Brussels today (7 October), but were postponed due to the government shutdown in the United States.
Although a free trade pact is expected to generate new economic opportunities on both sides of the Atlantic, healthcare professionals are worried over the impact that deregulation and free market economics would have on their sector.
Speaking at a panel debate at the European Health Forum in Gastein, Austria, on Thursday (3 October), Detlev Ganten, the president of the World Health Summit, said the key question was whether free-trade agreements restrict local government's ability to choose their own political, social and cultural systems – including the capacity to implement policies that promote and protect public health.
According to Ganten, the EU-US trade negotiations will align the legal systems of the European Union and the United States with respect to infectious diseases, food safety and tobacco policies. This, he said, would limit EU countries' ability to regulate these areas, including access to drugs, health services and nutrition. Health communities would have to follow up and adapt to changes, he warned.
To preserve its protective healthcare and social model, Ganten said the EU should push to maintain a high-level of safety during the negotiations – both on food and chemicals, especially the endocrine disruptor Bisphenol A, used in some plastics and resins.
Negotiators should also take into account national drug regulations when approving new medicines and pricing them on the market, the expert added.
Economic benefits and commercial interests
The notion that the economic benefits of liberalisation would compensate for the potential negative impacts was also challenged at the EU health forum.
"There will be economic gains, but they will be distributed differently. There are groups who have been working on this and concluded that even within Europe, the gains will be different. So it's not just one Europe, but various nations. Not everybody will gain from it. Some will have problems," Ganten said.
Els Torreele, the director of the Open Society Public Health Program’s Access to Essential Medicines Initiative, said that the trade agreement was not about public health or driven by people with an interest in the area.
"This is about trade and commercial interests. What we should do is damage control and safeguard what we care about so that they are not getting worse through the negotiation of the trade agreement," she said.
Ganten added that the negotiations currently are behind held behind close doors, partially, but would have to be open and transparent, in order not to avoid public criticism that could derail the talks.
'Defend what we have'
Bernie Merkel, a policy analyst at the European Commission's health and consumers directorate (DG Sanco), said that the EU would be weaker in negotiations with the United States as there were enormous differences among EU countries in healthcare and health services. Health competences were weak under the Lisbon Treaty, he added.
"This is the main issue. You can't change the treaty via trade negotiations. Because of this we're are going to take a rather defensive line, while the Americans will be very aggressive. They don't like our approach to public health protection. They will use this opportunity to attack it," Merkel said.
"The best way to go about this is defend what we have, while negotiate deals in one or two areas. But really, if you think we can use TTIP to raise the standards in healthcare, access to medicines and whatever, you have to remember that America works well for those with money, but not so well for those without," the policy analyst continued.
Petru Luhan, a Romanian MEP from the centre-right European People's Party (EPP), advocated for a more incisive approach. "We should focus on which advantages we could get by signing such an agreement and it should include health as a new chapter," Luhan said.
Ganten concluded that even though the Americans are experiencing a government shutdown and problems with their never-ending healthcare reform, they are "getting their acts together" in negotiations.
Although the European Commission, member states and stakeholders have a fragmented view of the trade agreement, the EU has to stick together if it wants to negotiate on an equal footing, he said.
The president of the European Health Forum Gastein, professor Helmut Brand, said in a statement: "I see the agreement as a historical chance for constructively working through some issues currently burdening relations between Europe and the US, for instance, the differing positions on genetic engineering or on security standards.
"A key issue in negotiations is the role the independent national testing and supervisory authorities will play in the future. The question arises whether the US Food and Drug Administration (FDA) will accept European approvals and vice versa," Brand added.
The Gastein Health Forum meeting in Austria is Europe's largest gathering of health policymakers.
This year’s conference discusses how to secure the EU's healthcare systems for the future after years of budget cuts due to the financial crisis.
The eurozone debt crisis has forced some governments to drastically cut their public health budgets in an effort to contain deficits.
Between 2008 and 2011, 17 out of the EU’s 28 member states have slashed their public spending on healthcare due to austerity policies.
>> Read our LinksDossier: Austerity: Healthcare in hardship
- Autumn: Second negotiating round
- December 2013: Third negotiations round
- January 2014: Stock-taking exercise with EU Commissioner Karel de Gucht and US Trade representative, Michael B. Froman