The American Public Health Association,
Recognizing that the American Public Health Association supports access to health services as a human right; and
Aware that the American Public Health Association has called for international trade agreements to include provisions that elevate the standards of health care, environmental health, workers safety, the training of health care providers, and overall health status, referred to as upward harmonization,1 and supports the protection of children in the workforce2; and further
Aware that a ministerial level meeting is scheduled in Qatar in November, 2001, to further develop provisions of the General Agreement in Trade in Services (GATS), originally accepted by the World Trade Organization (WTO) in 1994, and to make coverage by GATS mandatory for all 140 WTO nations; and
Noting that GATS would extend existing rules and trade sanctions to the provision of services that now apply to products through the General Agreement on Tariffs and Trade (GATT),3,4 that the provisions under consideration would require the 140 WTO nations to take affirmative action to prevent international competition from private corporations for broadly defined public services if even one private provider presently exists, in areas including health care services, health insurance, water, education, child care, social services, and corrections; and
Recognizing that provisions of GATS could also limit and possibly eliminate the ability of any U.S. state or region to enact and enforce regulations over health care services including nursing homes, hospitals, or health maintenance organizations;5–7 and
Noting that GATS also addresses the standards of training and conditions of employment for health care and other service workers,5,8,9 which could be harmonized with standards in other countries to assure that elevated standards do not present a barrier to commercial trade, and that the basic rights of such workers, including the right to organize, are not ensured; and
Recognizing that negotiators plan to extend to GATS the regressive rules on government procurement of goods currently included in GATT, and that these rules prohibit the imposition of human rights, labor and environmental standards on contractors and prohibit the adoption of any procurement policies based on a corporation’s record of compliance with human and labor rights, public health, and environmental safeguards domestically and abroad; and
Aware that the for-profit U.S. hospital,5 nursing home, and health insurance10,11 industries have already begun to expand in Europe and Latin America,8 and that this expansion is associated with a diminution in equitable access to services5,10,12 and
Noting that the pharmaceutical industry has exercised its intellectual property rights in violation of the limited protections afforded under the WTO’s TRIPS agreement to prevent poor countries from making life-saving medications affordable for people with AIDS, with devastating consequences for human life in Africa, India and elsewhere,13 and taken action to stop the manufacture and dispensing of lifesaving AIDS drugs by the government of Brazil,14 thereby posing a dire threat to the survival of the nation; and
Aware that countries with unified systems of care through the public sector have a far higher percentage of coverage for health care than countries with more privatized and fragmented systems,15 and that countries with a more equitable distribution of wealth also enjoy better health outcomes; and
Noting that the Free Trade Area of the Americas (FTAA) is simultaneously being negotiated to apply to the countries of North and South America with the exception of Cuba, and is intended to be completed no later than 2005; and
Aware that the FTAA would apply to all governmental measures including laws and regulations as well as all measures affecting trade in services taken by non-governmental institutions at all levels of government when acting under powers conferred on them by government authorities, including religious institutions,6 and aware that in this respect FTAA gives even greater rein to private corporations than the North American Free Trade Agreement (NAFTA), which has been associated with further emiseration of the Mexican indigenous population, including indigenous Mexicans, and caused the Canadian government to rescind bans on toxic substances including MME and PCBs in response to law suits from private corporations,6 and to abandon programs providing access to generic drugs;5 and
Noting that FTAA would extend private rights of action against countries, now included in NAFTA, to all other nations covered by FTAA, and that prohibiting any company from competing for public services could subject the country both to international trade sanctions and costly lawsuits for present and future losses to private companies, similar to those levied by manufacturers under the auspices of the GATT and NAFTA;5 and
Recognizing that both GATS and the FTAA provide broad rights to corporations and diminish the decision-making role not only of the public sector but of democratic bodies at all levels of civil society, referring to all individuals and institutions other than corporations; and
Noting that neither GATS nor the FTAA identifies social equity or democracy as a goal,5 but are dedicated solely to strengthening the ability of the private enterprise system to generate wealth, and could in fact prevent governments from holding service providers accountable for key social and public health objectives like affordable access to medical treatment, education and utilities, as well as to affirmative action goals; and
Recognizing that international trade can be one element of economic development, but that an important criterion of the success of such development is the benefit to all segments of the population;16 and
Aware that additional bilateral trade agreements are being negotiated between WTO member nations that pose similar threats; therefore
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