This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.
The vast sums of money ploughed into efforts to fight diseases such as Aids, TB and malaria in the last 10 years have saved many lives but have also sometimes undermined health systems in poor countries, according to a survey by the World Health Organisation and others published today. A worldwide outcry around the turn of the millennium over the plight of people in Africa dying of Aids, a disease kept in check with drugs in rich countries, triggered a rush to fund big disease-fighting programmes on the part of western governments, aid organisations and philanthropic donors such as the Bill and Melinda Gates Foundation. But until now, there has been little attempt to find out how well the money has been spent and what impact the focus on high-profile diseases has had on the everyday business of hospitals, clinics and overworked healthcare staff in the poorer countries.
For many in the field of public health, the eradication of smallpox was one of the greatest triumphs of 20th-century medicine. This astounding achievement has influenced national and international organisations to mount or consider efforts to eradicate many other infectious diseases, including measles, Guinea worm disease, Chagas' disease, polio, and malaria. Eradication may well be public health's greatest rhetorical weapon in the battle against dread diseases. Indeed, the ability to command funding, popular support, the attention of politicians, and positive media coverage by talk of disease eradication is unparalleled. ... It may seem churlish to wonder in the face of a public health triumph that saved untold numbers from death and disability if disease eradication is ethical. Nevertheless, there are sound reasons for wondering whether the pursuit of eradication—as opposed to aggressive and effective disease management—is the right thing to do for other infectious diseases.
Medical tourism - the travel of patients from one (the “home”) country to another (the “destination”) country for medical treatment - represents a growing business. A number of authors have raised the concern that medical tourism reduces access to health care for the destination country’s poor and suggested that home country governments or international bodies have obligations to curb medical tourism or mitigate its negative effects when they occur. This Article is the first to comprehensively examine both the question of whether this negative effect on access to health care occurs for the destination country’s poor, and the normative question of the home country and international bodies’ obligations if it does occur. I draw on the work of leading theorists from the Statist, Cosmopolitan, and Intermediate camps on Global Justice and apply it to medical tourism. ...
In this Article I examine “medical tourism” — the travel of patients who are residents of one country to another country for medical treatment — which is fast becoming a multi-billion dollar industry. To date, the primary U.S. medical tourists appear to have been uninsured or underinsured Americans seeking substantial cost savings by traveling to less developed countries for care. More recently, state governments, self-insured firms, Fortune 500 companies, and domestic insurers have begun attempts to get their insured populations to use medical tourism as well by requiring it or giving incentives for its use (what I call “insurer-prompted medical tourism”).