Trade and the political economy of non-communicable diseases

The increasingly broad reach of international trade in tobacco products, unhealthy food and beverages, and alcohol ensures that one’s risk of developing a non-communicable disease (NCD) is increasing regardless of global location. In spite of the importance of trade in promoting global NCD burden, the World Health Organization Action Global Action Plan for the Prevention and Control of NCDs 2013-2020 does not include trade restrictions as an explicit strategy to reduce the global burden of NCDs, subsumed instead into a call for “multi-sectoral action” on NCDs. A political economy of health is adopted to analyze ongoing, global NCD prevention and control efforts and assess their implication for trade and health. Using Brown’s (2003) notion of “neoliberal political rationality” – defined as an extension of market values into non-economic spheres and to all institutions and social action – it is asserted that the problem of NCDs is fundamentally one of the neoliberal global economic structure that privileges corporate interests over those of individuals. NCDs are thus treated as market externalities of the globalized neoliberal economic system which go unregulated by states. The Trans-Pacific Partnership (TPP) is examined to demonstrate how a neoliberal political rationality is employed to prevent a tobacco trade carve out in the TPP and why a political economy of health approach will be required to reduce the global NCD burden.