A Trade and Health General Framework for Country Analysis: Product to Process A. Didar Singh Nick Drager
agenda why country studies, research & plans to operationalize the guidelines and findings of the blue book initiate country analysis studies & process dual purpose of assessing the ground position as well as build capacity in the process establish a network and forum for trade and health
why trade and health importance of trade and health in globalized context need for policy coherence example of the services sector and of FDI
Trade in services has grown faster than trade in goods (Compound growth, 1985=1) 3.5 3 Services 2.5 2 1.5 Goods 1 1985 1987 1989 1991 1993 1995 1997 1999 * Population estimate from a sample of 100 countries for period 1985-98. Figure for 1999 is estimate from 69 countries. World trade defined as (X+ M )/2 Source: IMF BoP Rev. 5, through SIMA. DECPG staff calculations
a growing comparative advantage in services 5 4 3 2 1 0 Growth (1991 values are indexed to 1; Unit: US$) Services (exports) Services GDP Growth Rate (CAGR) GDP 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 17.3 % 9.2% 7.5% 30 25 20 15 10 5 0 FDI 40 Growth Rate (CAGR) 35 (1992/93 values are indexed to 1; Unit: US$ ) FDI in Services* FDI in Non-services 36% 20%
and developing countries share in world exports increasing (percent) 25.0 22.5 20.0 17.5 Goods 18.0 18.3 20.6 17.5 22.0 18.0 15.0 Services 14.0 13.7 12.5 10.0 1986 1990 1995 1998 * Population estimate from a sample of 100 countries. Source: IMF BoP Rev. 5, through SIMA. DECPG staff calculations, 1985-99
new composition of FDI flows FDI flows are being redirected to developing economies: for the first time since 1998, the majority of top ten destinations are developing economies China, Mexico, Poland, India, Russia and Brazil. These have displaced France, Italy, Canada, and Australia Global market share of developing countries of front and back office operations (BPO: call centres, technical support centres, shared service centres) is increasing by 10% annually Expected to go to 60% in next two years
country strategies understand implications of globalization, FDI and trade in so far as they impact health Impact of increasing cross border flows on health Impact from opening of national economy on health Impact of international institutions and rules on health (WTO) Countries thus need a process towards strategy To do this they need country studies and analysis To do which they need data
country focus for trade and health Trade in Health Services and GATS Access to Drugs and TRIPS Food Safety and SPS Any other trade related issue that member countries may wish to identify.
objectives and methodology Monitor and evaluate awareness and status of existing WTO agreements that impact on health Use qualitative analysis where data not compiled Develop a general, non-country relatively simple framework and questionnaire Key categories and issues be included Involve stakeholders, especially strategy-makers
criteria/categories for snap-shot framework The Infrastructural framework The Policy framework The Legal and regulatory framework The Human Resource or capacity framework The Health related Trade data & issues
three levels The study should bring in key elements and data at - the macro-economic level the sectoral level and the agreement-specific level.
TRADE AND HEALTH ENVIRONMENT MACRO SECTORAL HEALTH SECTOR AGREEMENT GATS SPS TRIPS OTHER Infrastructure Policy Legal HRD
The Trade and Health Environment Framework Macro-economic level Sectoral level Domestic Health Sector Agreement-specific level Infrastructural Framework The country level institutional and infrastructure status State of the health facilities in the country Institutional structures as they relate to GATS, TRIPS and SPS etc. Policy framework A comment on the overall economic policies including trade policy Health policy especially in relation to trade issues Policy analysis of the existing strategies in place Legal framework The status of the rule of law Rules and regulations governing trade and health. Legal and regulatory issues Human Resource framework The levels of education and literacy. The existing availability of health professionals Capacity available for handling agreement specific concerns. Health-related Trade data and practices Overall trade and investment data Data and examples of health related trade Data and illustrations of health services, drugs, SPS issues etc.
the product Based on the framework for each of the areas and levels questionnaires have been developed for administering to health professionals, managers, policy makers and private sector practioners These can be first used for countries in accession discussions with WTO Can be used for developing countries in general as a step towards policy coherence This workshop is a step in this direction
the ten-step process 1. Confirm the Framework for Country Studies 2.Nominate focal points Regional and national (WHO and Member State) 3.Set up Expert Group 4. Select/Appoint National Consultant 5. Carry out Research based on Framework 6. Monitor, review and finalise study 7. Identify gaps 8. Build capacity 9. Devise strategies 10.Establish Task Group to carry forward initiative