Collaboration or consultation? Deliberating the health consequences of trade policy in the European Union and United States

Since the late 1980s, public health and social justice advocates have demanded that policymakers address the growing equity and quality concerns associated with the health consequences of globalization. Governments in turn, have tried to manage these demands- to various degrees of success. This research assesses comparatively the range of government responses to public health advocacy on trade in the last decade: the successes and failures of the various deliberation mechanisms employed by the European Union and United States to legitimate, and sometimes modify, their respective trade policies. The evidence presented includes interviews with policymakers and public health advocates in Brussels and Washington DC, combined with an analysis of key documents and attendance records, revealing the degree of access to trade policymakers provided by these different approaches. While some of these mechanisms have raised awareness surrounding trade and health issues, reflecting an overall tendency for trade policy-making to become more transparent, the research also raises some important concerns. Policy deliberation forums risk gravitating towards information sharing without providing meaningful input into decision-making: towards consultation with advocates, rather than collaboration. Methods used by advocates to counter this tendency will be discussed, including the importance of coalition building, utilizing multiple lobbying arenas, and employing pressure from elected representatives.