USMCA (NAFTA 2.0): tightening the constraints on the right to regulate for public health.


Journal

Globalization and health
ISSN: 1744-8603
Titre abrégé: Global Health
Pays: England
ID NLM: 101245734

Informations de publication

Date de publication:
14 05 2019
Historique:
received: 06 03 2019
accepted: 06 05 2019
entrez: 16 5 2019
pubmed: 16 5 2019
medline: 4 7 2019
Statut: epublish

Résumé

In late 2018 the United States, Canada, and Mexico signed a new trade agreement (most commonly referred to by its US-centric acronym, the United States-Mexico-Canada Agreement, or USMCA) to replace the 1994 North American Free Trade Agreement (NAFTA). The new agreement is the first major trade treaty negotiated under the shadow of the Trump Administration's unilateral imposition of tariffs to pressure other countries to accept provisions more favourable to protectionist US economic interests. Although not yet ratified, the agreement is widely seen as indicative of how the US will engage in future international trade negotiations. Drawing from methods used in earlier health impact assessments of the Trans-Pacific Partnership agreement, we undertook a detailed analysis of USMCA chapters that have direct or indirect implications for health. We began with an initial reading of the entire agreement, followed by multiple line-by-line readings of key chapters. Secondary sources and inter-rater (comparative) analyses by the four authors were used to ensure rigour in our assessments. The USMCA expands intellectual property rights and regulatory constraints that will lead to increased drug costs, particularly in Canada and Mexico. It opens up markets in both Canada and Mexico for US food exports without reducing the subsidies the US provides to its own producers, and introduces a number of new regulatory reforms that weaken public health oversight of food safety. It reduces regulatory policy space through new provisions on 'technical barriers to trade' and requirements for greater regulatory coherence and harmonization across the three countries. It puts some limitations on contentious investor-state dispute provisions between the US and Mexico, provisions often used to challenge or chill health and environmental measures, and eliminates them completely in disputes between the US and Canada; but it allows for new 'legacy claims' for 3 years after the agreement enters into force. Its labour and environmental chapters contain a few improvements but overall do little to ensure either workers' rights or environmental protection. Rather than enhancing public health protection the USMCA places new, extended, and enforceable obligations on public regulators that increase the power (voice) of corporate (investor) interests during the development of new regulations. It is not a health-enhancing template for future trade agreements that governments should emulate.

Sections du résumé

BACKGROUND
In late 2018 the United States, Canada, and Mexico signed a new trade agreement (most commonly referred to by its US-centric acronym, the United States-Mexico-Canada Agreement, or USMCA) to replace the 1994 North American Free Trade Agreement (NAFTA). The new agreement is the first major trade treaty negotiated under the shadow of the Trump Administration's unilateral imposition of tariffs to pressure other countries to accept provisions more favourable to protectionist US economic interests. Although not yet ratified, the agreement is widely seen as indicative of how the US will engage in future international trade negotiations.
METHODS
Drawing from methods used in earlier health impact assessments of the Trans-Pacific Partnership agreement, we undertook a detailed analysis of USMCA chapters that have direct or indirect implications for health. We began with an initial reading of the entire agreement, followed by multiple line-by-line readings of key chapters. Secondary sources and inter-rater (comparative) analyses by the four authors were used to ensure rigour in our assessments.
RESULTS
The USMCA expands intellectual property rights and regulatory constraints that will lead to increased drug costs, particularly in Canada and Mexico. It opens up markets in both Canada and Mexico for US food exports without reducing the subsidies the US provides to its own producers, and introduces a number of new regulatory reforms that weaken public health oversight of food safety. It reduces regulatory policy space through new provisions on 'technical barriers to trade' and requirements for greater regulatory coherence and harmonization across the three countries. It puts some limitations on contentious investor-state dispute provisions between the US and Mexico, provisions often used to challenge or chill health and environmental measures, and eliminates them completely in disputes between the US and Canada; but it allows for new 'legacy claims' for 3 years after the agreement enters into force. Its labour and environmental chapters contain a few improvements but overall do little to ensure either workers' rights or environmental protection.
CONCLUSION
Rather than enhancing public health protection the USMCA places new, extended, and enforceable obligations on public regulators that increase the power (voice) of corporate (investor) interests during the development of new regulations. It is not a health-enhancing template for future trade agreements that governments should emulate.

Identifiants

pubmed: 31088499
doi: 10.1186/s12992-019-0476-8
pii: 10.1186/s12992-019-0476-8
pmc: PMC6518719
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

35

Commentaires et corrections

Type : ErratumIn
Type : CommentIn

Références

Int J Health Serv. 2017 Apr;47(2):277-297
pubmed: 28013576
Environ Health Perspect. 2013 Jun;121(6):705-10
pubmed: 23674482
Health Promot Int. 2018 Aug 1;33(4):561-571
pubmed: 28082373
BMJ Open. 2016 Apr 04;6(4):e010339
pubmed: 27044579
Bull World Health Organ. 2018 Mar 1;96(3):185-193
pubmed: 29531417
Global Health. 2016 Jun 06;12(1):25
pubmed: 27265351
CMAJ. 2017 Jul 4;189(26):E881-E887
pubmed: 28676578
J Law Med Ethics. 2013 Spring;41(1):199-223
pubmed: 23581666
Am J Clin Nutr. 2015 Jun;101(6):1144-54
pubmed: 25904601
Int J Health Policy Manag. 2016 Apr 17;5(8):487-496
pubmed: 27694662
Global Health. 2015 Oct 12;11:42
pubmed: 26455360
Glob Public Health. 2013;8(1):55-64
pubmed: 23181629
Am J Clin Nutr. 2008 Dec;88(6):1722S-1732S
pubmed: 19064537
PLoS Med. 2012 Jan;9(1):e1001154
pubmed: 22253577
Occup Environ Med. 2007 Sep;64(9):569-70
pubmed: 17704198
Int J Health Serv. 2016 Oct;46(4):597-613
pubmed: 27516183
Curr Opin Pediatr. 2013 Apr;25(2):247-54
pubmed: 23429708

Auteurs

Ronald Labonté (R)

School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, Ontario, K1G 5Z3, Canada. rlabonte@uottawa.ca.

Eric Crosbie (E)

School of Community Health Sciences, Ozmen Institute for Global Studies, University of Nevada Reno, 1664 N. Virginia Street, Reno, NV, 89557-0274, USA.

Deborah Gleeson (D)

School of Psychology and Public Health, La Trobe University, Bundoora, VIC, 3086, Australia.

Courtney McNamara (C)

Department of Sociology and Political Science, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway.

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Classifications MeSH