Center for Policy Analysis on Trade and Health - CPATH

Campaign: Public Health Voice in Trade Policy

TPP and Public Health 2016
Public Health on Fast Track: to House W&M 4-22-15
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Campaign: Public Health Voice in Trade Policy
Tobacco Control and the TPP
CPATH on Leaked TPP IP Text
Mexico, Chile on TPP-Tobacco
Tobacco & Trade Consortium 2013
2012: Health Advocates Assert Carve-Out; U.S. Weak TPP/Tobacco Proposal
TPP Forums Jan 2012
Trans Pacific Partnership
Tobacco and Trade Publications
Trade Advisory Committees December 2010
Key Trade Agreements - CPATH Analysis and Commentary
Special 301 Hearings: Change Course!
CPATH at APHA 2009 Trade Advisory Committees
CPATH EVENT Aug. 26 2009: CAFTA and Access to Meds
Trade and Health Forum Program APHA Nov. 2009
About CPATH - Overview
CPATH Article: CAFTA Impact on Meds, Prices
Press Release: CPATH on CAFTA in Health Affairs
CAFTA aumenta los precios de medicamentos
Congressional Hearing on Trade Advisory Committees
Towards Change: Korea; Peru; Public Health Objectives
Trade & Health at APHA 2008
Global Trade Events at APHA November 2007
Thailand's Compulsory Licenses for Medicines
Globalization and Health Resource Center - Overview
Key Issues
CPATH Publications
Related Resources
CPATH Presentations
CPATH at US Social Forum 2007
Monterey Forum 2005
FTAA Forum
Public Health Summary Statements on Free Trade Agreements
Sign-On Statements
Terms of Use
More About CPATH

New ITAC Charters Call for Nominations from Unions and NGOs


The Department of Commerce has called for nominations to Tier 3 Industry Trade Advisory Committees, including representatives of labor unions and NGOs.  Feb. 24, 2014, pp. 10099 - 10101.  Nominations are open through Feb., 2018.

Click here to download ITAC Notice






MARCH 25, 2014

Ellen R. Shaffer, PhD MPH, and Joseph E. Brenner, MA, Co-Directors



The Center for Policy Analysis on Trade and Health (CPATH) has played a leading role in documenting and seeking redress for the illegal capture of trade advisory committees by commercial interests, that has insulated the Administration from public discourse and the public interest. We have brought these issues to the attention of policy-makers and the public, through publications,[1], [2] advocacy, litigation,[3]  proposed legislation,[4] and testimony to Congress[5] and to the Administration,[6] including the USTR and the Department of Commerce. The Washington Post[7] recently updated and corroborated CPATH’s observations.


In addition, the public and policy makers are demanding transparency in trade negotiations, and taking action to achieve it. The constraints imposed by requiring absolute confidentiality from committee members are now a matter of national policy and concern. 


However, this proposal arises as the trade policy agenda is at a genuine crossroads. The theoretical foundation for global trade policy is glaringly inadequate to address 21st century imperatives for sustainable economic development: to generate economic growth, innovation, fulfilling and remunerative employment, and stable markets, while expanding wealth and redressing persistent inequalities in economic, social and political resources and power within and between countries; to protect the environment and climate in developing energy sources; and to promote systems of agriculture that guarantee food security. Neither sober analysis nor credible economic forecasting supports assertions that trade agreements will significantly advance employment, while lowering prices, and improving the global standard of living.


The objective set out at Bretton Woods in 1948 to reduce or eliminate tariffs in order to stimulate cross-border commerce has been substantially accomplished. Trade negotiations presently focus on reducing the permissible parameters for government regulations, and limiting government involvement generally in a wide range of arenas.  The framework of deregulation and privatization was set during the Uruguay Round of global trade negotiations that concluded with the establishment of the World Trade Organization (WTO) in 1994. It has proven to be a spectacular failure at creating trade agreements. The WTO Doha Round has limped along since 2002 without appreciable progress towards an agreement. There is popular opposition to two major regional trade agreements that the U.S. is negotiating, one with Pacific Rim nations, the other with Europe.


Further, global trade rules are demonstrably vehicles for destabilizing entire economic sectors, such as Mexican agriculture; blocking access to affordable life-saving medications, propping up prices and discouraging innovation by pharmaceutical companies; and protecting the tobacco industry from government plain-packaging regulations, well-established to play a significant role in curbing the global epidemic of tobacco-related deaths and disease.


Policy must address the imperative to revitalize the public sector as an essential partner in economic development; to recognize the legitimate role of government measures and the sovereignty of democratic decision-making over commercial incentives, and the value of public enterprises; and to include the public as creative and entitled participants rather than disruptive adversaries.


We propose that public health and public interest participants in the PITAC are in a position to generate constructive democratic discussion, analysis and critique of the trade agenda, its processes and its results. The PITAC should promote dialogue and debate with other trade committees and with broad sectors of the interested public and with policy-makers, on every level of trade policy.


The U.S. must take concrete steps to align our global economic power with our capability and responsibility to direct trade policy purposefully towards democracy, sustainability and equality. We have the opportunity and imperative to integrate public health's perspective and participation as the U.S. Administration confronts today's challenges in trade negotiations.  In the context of the creation and implementation of a Tier 2 Public Interest Trade Advisory Committee (PITAC), public health’s perspective will prove invaluable in determining trade objectives, and in drafting, analyzing and advancing trade proposals that foster these foundational goals.


Unilever CEO Paul Polman, who disbanded quarterly reporting in the interest of longer term planning, has said that capitalism "is an enormous force to lift people out of poverty. But at the same time, we haven't figured out how to do that without incurring enormous levels of…overconsumption; and frankly, leaving too many people behind. You cannot say that the system properly works if there are over a billion people going to bed hungry."[8]


[Click below for complete CPATH Comments]

Click here to download CPATH PITAC Comments

Corporate Domination of Trade Advisory Committees Violates Federal Law
New Public Interest Advisory Committee on Trade ~ A Small Step Forward

 March 1, 2014 - CPATH’s campaign to end the illegal domination of influential federal trade advisory committees by corporate interests was fueled this week by graphic illustrations in the Washington Post on the committees’ current members.  

CPATH Reports first called public attention to the secretive committees in 2005.  Pressure from public health and tobacco control groups led to the appointment of a public interest tobacco control representative to the Agricultural Committee on Tobacco, Cotton, and Peanuts in 2005, and subsequent Congressional action in 2009.

Congress and the public are increasingly demanding democratic participation in setting global trade policy, including openly disclosing the terms of pending trade agreements.

The United States Trade Representative (USTR) has announced it will solicit applications in the near future through the Federal Register for a Public Interest Trade Advisory Committee (PITAC) to advise the Administration on trade negotiations.  The PITAC, to include public health and other public interest representatives, would be a nod towards compliance with the Federal Advisory Act, which requires all such committees to be fairly balanced in terms of points of view represented, and the Trade Act of 1974, which specifies interests that should be included on trade committees.

“Trade agreements are now a key weapon for corporations like tobacco to eliminate laws that prevent more kids from getting addicted to their deadly product. The original economic goals of trade deals, like eliminating tariffs to encourage cross-border trade, were substantially accomplished long ago. But trade rules have a direct impact on public health and domestic policy, including access to affordable medicines and health care, the right and ability of government laws and regulations to protect the public’s health from the epidemic of tobacco-related deaths and diseases, internet freedom, industrial farms, preventable climate change, labor rights, and economic instability related to unregulated capital flows,” said Dr. Ellen R. Shaffer, Co-Director of CPATH. 

“The U.S is now negotiating major multi-party agreements, including the Trans-Pacific Partnership Agreement (TPP) with 11 Pacific Rim nations, and another with the European Union, affecting a significant percentage of the U.S. and the global economy,” said Joe Brenner, CPATH Co-Director.  

“These massive and controversial new trade agreements call for intensified transparency and involvement by the public and our elected representatives in Congress at every stage of trade negotiations," according to Brenner. "Until now, the TPP has been negotiated without meaningful, informed public input or debate, yet the finance, pharmaceutical, tobacco, energy, communications, processed foods and health insurance industries have had highly privileged access to government trade negotiators.”
[clip - see complete statement below]

Click here to download complete CPATH Statement

Please Support Our Work!

Campaign for a Public Health Advisory Committee on Trade (PHACT)

Reframing global trade policy.  The global economy is at a crossroads.  Financial instability, emerging economies, and environmental change present challenges to business as usual. Over the past decade public health has become a countervailing force in trade policy.  We had the opportunity and imperative to integrate public health’s perspective and participation as a new U.S. administration confronts today’s challenges. In response to a campaign by the CPATH network and legislation proposed by allies in Congress (HR 2293/Van Hollen and S.1664/Stabenow), the Administration reported it was revamping the membership of trade advisory committees, and adding public health members to existing committees. These committees should look at the nexus between trade and other international agreements, such as environmental and health agreements, as well as institutions such as the World Health Organization. The Campaign for a Public Health Advisory Committee on Trade (PHACT) offers renewed opportunities to reverse policies with a negative impact on public health, and implement policies that promote and protect health.

CPATH and the APHA Trade and Health Forum solicited resumes from individuals who would like to serve on trade advisory committees.    

We identified at least 9 Committees in Tier 3 that address trade and health issues:

Chemical, Pharmaceuticals, Health Science Products (ITAC 3)     

Consumer Goods (ITAC 4)   

Distribution Services (ITAC 5)         

Information and Communications Technologies, Services, and Electronic Commerce (ITAC 8)  

Services and Finance (ITAC 10)       

Customs and Trade Facilitation (ITAC 14)

Intellectual Property Rights (ITAC 15)
Standards and Technical Trade Barriers (ITAC 16)
Agricultural Technical Advisory Committee for Trade in Tobacco, Cotton, Peanuts (ATAC)

CPATH conducted an analysis of representation by industry on U.S. Trade Advisory Committees on May 1, 2009.

Click here for full report

CPATH at Ways & Means Hearing on Trade Advisory Committees, HR 2293

On Tuesday, July 21, 2009, at 10 a.m., the Trade Subcommittee of the House Committee on Way and Means held a hearing on how the U.S. trade advisory committee system is functioning, and on how to increase transparency and public participation in the development of U.S. trade policy. 


The hearing examined the development of trade policy from several perspectives.  CPATH Co-Director Ellen R. Shaffer, PhD MPH, was an invited witness and discussed the importance of public health representation on U.S. trade advisory committees.  Her testimony, and the testimony of other witnesses, can be found under 'Congressional Hearing on Trade Advisory Commitees.' 


Reps. Chris Van Hollen (D-MD) and Lloyd Doggett (D-TX) have introduced HR 2293 to  add a Public Health Advisory Committee on Trade (PHACT) to the influential Second Tier of the Federal Trade Advisory Committee System.


The hearing took place at Room 1100, Longworth House Office Building, beginning at 10:00 a.m. Committee Advisory Note:

Click here for Hearing Advisory Notice

Click here for CPATH Notification of Hearing


To Members of Congress:

Please Co-Sponsor HR 2293/S. 1644, The Public Health Trade Advisory Committee Act    [Introduction]

We're writing to ask you to co-sponsor H.R. 2293/S. 1644, the Public Health Trade Advisory Committee Act. 


Global trade agreements increasingly affect the public's health, from the price of medicines to regulations that protect the safety of food and water supplies.


The Government Accountability Office and the Center for Policy Analysis on Trade and Health (CPATH) have documented the absence of public health representation on U.S. trade advisory committees.  Advisors from health-related industries including pharmaceuticals, tobacco, processed foods, alcohol beverage and health insurance have had exclusive access to government trade negotiators....   [See full Letter of Support:]

Click here to download full Letter of Support

 Bill Summary: H. R. 2293 – The Public Health Trade Advisory Committee Act




Establishes a Public Health Advisory Committee on Trade (PHACT) as a Tier 2 committee. It states that members shall be appointed from nominations submitted by organizations with an interest in improving and protecting public health.  They should have expertise in one or more of 5 areas: trade and sustainable development; public health’s right to regulate in areas including tobacco control, alcohol control, and standards to ensure safe food, air and water; vital human services; occupational safety and health; or access to affordable prescription drugs. Members cannot represent for-profit entities, or receive significant financial support for a for-profit entity represented on any other trade advisory committee.




Requires the appointment of a public health NGO representative to the Tier 1 ACTPN.  An eligible NGO cannot receive 20% or more of its total funding from a single commercial, for-profit entity, or 30% of its total funding from commercial for-profit entities.




Includes Health and Human Services as an Agency to receive information from trade advisory committees. Requires Agencies including USTR, Secretaries of Agriculture, Commerce, HHS, Labor and Defense, to consult with the advisory committees before, during and after negotiations, and to respond in writing to their concerns. Written advisory committee opinions should include  any dissenting views. 




Advisory committees shall submit a report on the expected effects of proposed trade agreements no later than the date that the President notifies Congress of the intent to negotiate.  Reports shall include the extent to which the trade agreement promotes: the economic interests of the U.S.; public health and the environment; and equity and reciprocity in particular sectors.  It shall also include a summary of any dissenting opinions by committee members.  The reports shall be available on the USTR’s website unless the President determines a particular report should not, according to specified criteria.

click here to download Summary of HR 2993

Public Health Officials Applaud HR 2293 (Van Hollen/Doggett) -
Would Create a Public Health Advisory Committee on Trade (PHACT), 
Open USTR Committees to Public

Rep. Chris Van Hollen (D-MD) has joined Rep. Lloyd Doggett (D-TX) to introduce HR 2293,  the Public Health Trade Advisory Committee Act.  The legislation amends the Trade Act of 1974  to require that a Public Health Advisory Committee on Trade (PHACT) be added to the influential Second Tier of the Federal Trade Advisory Committee System. 


The Trade Advisory Committee System was created to help the president develop U.S. trade policy.  The new committee will give public health concerns greater consideration at the onset of trade agreement formation and ultimately make America safer and healthier. 


Additionally, the bill requires greater openness and transparency in how all of the trade advisory committees operate. The changes would involve more timely communications among committees, Congress and the Administration, and hold the Administration accountable for responding to committees’ concerns.

Click here for public health leaders' comments on HR 2293

CPATH Responds to NY Times: Health Key to Trade and Properity

12/27/07 NY Times, CPATH response to "Trade and Prosperity" editorial:


To the Editor:

Current trade agreements preclude and sometimes reverse the very safety net you propose to ameliorate their damage, as new Congressional leaders recognize. Trade pacts undermine access to affordable medicines and offer new levers of power to the drug, tobacco, alcohol, health care and processed food industries. These industries dominate United States federal trade advisory committees and influence trade policy to promote the bottom line over health.


The public, the candidates and The Times are right to call for affordable health care. We also need a new, sustainable trade model that does not destabilize public health benefits where they exist or are emerging among our trading partners. These are the genuine keys to prosperity.


Ellen R. Shaffer
San Francisco, Dec. 23, 2007
The writer is co-director of the Center for Policy Analysis on Trade and Health.

To see the original editorial and responses:

Click here to download Letter

Campaign for Public Health Representation in Trade Policy


CPATH is coordinating the call by U.S. health organizations to include advocates for the public’s health on the U.S. Trade Representative's Advisory Committees, and to open Committee meetings to public scrutiny. Committee members enjoy significant influence on trade policy, according to a report by the Government Accountability Office.  Committees currently include representatives of the pharmaceutical, tobacco, health insurance, alcohol and processed food industries.  The Committees are legally required to present fairly balanced views on trade negotiations. There are no representatives of organizations concerned with the effects of international trade on health.


Many members of Congress strongly support the goal of public health representation in trade policy. 


GAO: U.S. Trade Policy Neglects Public Health

On 10/30/07, Rep. Henry A. Waxman and Sen. Edward M. Kennedy released a GAO report which finds that U.S. trade policy under the Bush Administration has neglected public health and the Doha Declaration, which affirms the right of WTO members to “promote access to medicines for all.”
Formal public health input into trade policy from the public health community has been limited, according to the GAO.  U.S.T.R. receives counsel on specific sectors and issues from fourteen “trade advisory committees.”  Most have no public health representation.

Click here for GAO Report

Van Hollen/Waxman Bill Called for Public Health Trade Advisors - Aug. 2007
Rep. Chris Van Hollen (D-MD) introduced HR 3204 in 2007, to expand public health representation on trade advisory committees, and assure an active role for Congress and the public in setting trade policy.  Rep. Henry Waxman was an original co-sponsor. In the current Congress, Rep. Van Hollen has introduced HR 2293, co-sponsored by Rep. Lloyd Doggett (D-TX) - see above on this page.

Click here for Summary of HR 3204

Click here for Full Text of HR 3204

Why USTR Must Take Action to Represent Public Health on U.S. Trade Advisory Committees:   A Brief Trade and Health Timeline, 1948-2006       June 16, 2006

Click here for Timetable June 2006

Six key Senators and 9 Congressional Representatives urge the USTR to represent public health in trade negotiations.

Notes from Meeting of Public Health Organizations and Office of the US Trade Representative (USTR)
June 12, 2006

Summary: Public health organizations and members of Congress have asserted public health’s strong interest in serving on trade advisory committees that influence US trade policies. The USTR’s office has agreed that public health has a legitimate claim to be represented. On December 16, 2005, the Department of Commerce and USTR posted a Federal Register announcement seeking public health nominees to Industry Trade Advisory Committees (ITACs) 3 (Chemicals, Pharmaceuticals, Health/Science Products & Services) and 15 (Intellectual Property).

To date, no nominees have been selected. The USTR has not responded to reasonable requests from public health groups for deadlines on appointments. During that time, ITAC 3 has established a subcommittee on pharmaceuticals and intellectual property, which continues to meet without public health representation.

Read a report of the meeting

Nine national health organizations called on the U.S. Trade Representative and Secretary of Commerce to include advocates for the public's health on its Advisory Committees, and to open Committee meetings to public scrutiny.

The organizations are: CPATH, American College of Preventive Medicine, American Public Health Association, American Nurses Association, California Conference of Local Health Officers, Doctors for Global Health, National Association of Community Health Centers, Physicians for Human Rights, and Physicians for Social Responsibility.

Click here for Letter Requesting Public Health Representation, May 2, 2005

Click here for Press Release May 2, 2005


CPATH analyzes United States trade advisory committees which currently lack and warrant public health and health care and health care representation. Statements from advisory committee reports demonstrate that they are of interest to and directly affect the work of the Public Health and Health Care community.

Click here for full report

USTR Response to Request for Public Health Representation, June 2005

CPATH Briefing Paper: International Trade Advisory Committee System Should Include Public Health Representation, 2005.

Click here for full report

On December 14, 2005, US health groups announce a federal suit against the US Government calling for representation on trade policy advisory committees.

Click here for Press Release, December 14, 2005

Click here for BNA Article on Lawsuit

  BIG BUSINESS:             42
  PUBLIC HEALTH:            0

Public Health
Public Health
Public Health
Public Health
Health Insurance
Public Health





The U. S. Trade Advisory Committees are legally required to represent a fair balance of interests.  The table above shows the reported breakdown of members prior to CPATH's work to promote public health representation.


Since 2005, as a result of CPATH’s Campaign for Public Health Accountability, the USTR has appointed a tobacco control representative to a key Advisory Committee, on Tobacco, Cotton and Peanuts, and a public health professional to the Advisoy Committee on Pharmaceuticals, reflected in the table below. 

  BIG BUSINESS:             42
  PUBLIC HEALTH:           3

Public Health
Public Health
Public Health
Public Health
Health Insurance
Public Health
Public Health

To sign up or volunteer for an event, see our "Contact Us" page.

Bringing a Public Health Voice to Global Trade and Sustainable Development
Ellen R. Shaffer and Joe Brenner, Co-Directors
P.O. Box 29586, San Francisco, CA 94129
phone 415-922-6204