The Potential of Regional Trade Agreements for Extending Social Protection in Health: Lessons Learned and Emerging Challenges

Globalisation induces nation states to build marketplaces that span various countries with the objective of facilitating trade and improving economic competitiveness. International experiences gained from three common markets, the European Union (EU), North American Free Trade Agreement (NAFTA) and Common Southern Market (MERCOSUR) allow for drawing some general conclusions that might be helpful for guiding similar processes in other regions and preparing them better for the challenges of human and social rights in open economies. Analysis of existing trade agreements shows that even relevant differences in design, structure, financing, coverage and regulation of health systems in member states do not necessarily prevent them from implementing common block-wide social protection and health service arrangements. Public health activities, epidemiologic surveillance and disease prevention have the potential of being starting points for shared activities of member states in the health field. Bior multi-national enterprises are eligible to become focal points of cross-border arrangements and regulations, especially if they are public or publicly administered. In general, coordination and cooperation between countries can be tried out or applied first in border regions where there is a high flow of goods, services and persons. When it comes to implementing the social dimension in the policy and priority setting of trade agreements, motivating spirit, driving forces and the concordance of value-sets in member states are crucial conditions. National governments planning to set up or join regional trade agreements have a broad decision margin regarding the extent to which they include social and human rights in regional trade arrangements. International organisations that are promoting regional economic blocks such as the World Bank, the World Trade Organisation and others should inspire political and economic decision-makers to consider health and social protection as crucial points for international trade. There is a broad array of political options between either strengthening the social dimension of common markets or dissolving the existing regional cohesion in favour of entering strictly market-driven blocks.