Democratic participation in trade policy: Creating a Public Health Advisory Committee on Trade (PHACT)

There is presently no formal mechanism for the public health community to present information and guidance to Congress and the U.S. Trade Representative (USTR) regarding trade negotiations that affect the public's health. A Public Health Advisory Committee on Trade (PHACT) is needed to achieve a transparent public debate.

The U.S. international trade advisory system was created by Congress in 1974 to institutionalize domestic input into trade negotiations from interested parties outside the federal government. The trade advisory committee system has not kept pace with the expansion of trade policy to cover wide realms of economic and social activity, including public health, and inadequately represents the public's interests. In 2002, the U.S. Government Accountability Office (GAO) found that “new stake holders in the trade process, such as public health…have limited or no participation in the formal committee system, even though topics such as intellectual property are of interest to them.”

Proposed legislation would create a public health advisory committee to bring an effective voice from public health to trade policy, and create transparent and accountable procedures for all trade advisory committees. There is strong representation in the advisory committee structure by industries which have a direct financial stake in trade including: pharmaceuticals; tobacco; alcohol; the processed food industry; and health services and health insurance. Industry proposes to dilute the proposed public health committee with additional industry representatives. This would contradict the express need for this committee, and risks compromising a much needed and straightforward expression of public health's interests.