“Great benefits can be made by opening health sectors to trade and investment integration, but very few countries have undertaken such reforms,” write Lucy Davis and Fredrik Erixon in a policy brief for the European Centre for International Political Economy (ECIPE).
They argue that the fiscally untenable situation of national health services as well as recent technological and medical innovations are now making trade in healthcare services both feasible and desirable. Yet, they add, the potential for trade in health care has so far been under-exploited due to continuous opposition.
As Davis and Erixon point out, two international policy dialogues exist regarding the liberalisation of healthcare trade. One takes place in the World Health Organisation (WHO) and is “sceptical if not hostile” to increased trade integration when it comes to North-South relations, according to the authors. The other occurs in the World Trade Organisation (WTO) and is tilted in favour of free trade, they say.
Nevertheless, while health care is part of the General Agreement on Trade in Services (GATS) in the WTO, few countries have made strong commitments, and most bilateral and regional agreements neglect the area. The authors argue that current trade agreements have weak provisions for trade in health care.
Despite this lack of liberalisation in health care services, the fact that the area is included in trade negotiations at all is a source of criticism. A large group of organisations and opinion-formers consider liberalisation either irrelevant or are fervently against it.
The opposition often argues that health care is a “fundamental human right” and sees the inclusion of related services in WTO agreements in particular as a reflection of the spread of globalisation motivated by profit-making concerns.
But the authors insist that this negative view is contrasted by concrete examples in several developing countries, where export strategies for health care have been successful.
“Countries as diverse as Brazil, China, Cuba, India, and South Africa are already significant exporters of health care,” Davis and Erixon write, saying this goes to show that there are tangible benefits to be found in the sector for North and South alike.