International trade and investment agreements: opportunities and challenges for noncommunicable diseases

Four behavioural risk factors for noncommunicable diseases (NCDs) are tobacco use, physical inactivity, harmful use of alcohol, and unhealthy diet. In general, the liberalisation of trade increases the availability and lowers the cost of goods, which may create concerns with respect to harmful products such as tobacco and alcohol. Governments can address NCD risk factors through a range of regulatory responses, but as these regulations may lower or restrict trade in the relevant goods, they must be designed in accordance with international trade agreements. In this article, we argue that although poorly-designed regulatory responses to NCD risk factors may be inconsistent with international trade agreements, they include sufficient flexibility to accommodate evidence-backed measures that are well-adapted to their public health purposes. Specifically, in shaping regulatory responses to NCD risk factors, governments should bear in mind international trade rules, which include obligations not to discriminate against imported like products, and not to restrict trade, intellectual property rights or foreign investment more than necessary for public health purposes.