Center for Policy Analysis on Trade and Health - CPATH

Key Issues
TPP and Public Health 2016
Public Health on Fast Track: to House W&M 4-22-15
Support Our Work!
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


Policy Analysis & Alternatives: Public Health and Trade

CPATH Analysis

Global Trade and Public Health, Ellen R. Shaffer, PhD, MPH, Howard Waitzkin, MD, PhD, Joseph Brenner, MA, and Rebeca Jasso-Aguilar, MA.

American Journal of Public Health, Jan. 2005. Global trade and international trade agreements have transformed the capacity of governments to monitor and to protect public health, to regulate occupational and environmental health conditions and food products, and to ensure affordable access to medications. Proposals under negotiation for the World Trade Organization’s General Agreement on Trade in Services (GATS) and the regional Free Trade Area of the Americas (FTAA) agreement cover a wide range of health services, health facilities, clinician licensing, water and sanitation services, and tobacco and alcohol distribution services. Public health professionals and organizations rarely participate in trade negotiations or in resolution of trade disputes. The linkages among global trade, international trade agreements, and public health deserve more attention than they have received to date. (Am J Public Health. 2005;95:23–34. doi: 10.2105/AJPH.2004.038091)

Click here for full article.

International Trade Agreements: Hazardous to Health? Ellen R. Shaffer, Joseph E. Brenner.

International Journal of Health Services. Volume 34, Number 3, Pages 467–481, 2004.

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Democracy & Global Governance

1. Public Health Representation in Trade Policy

Health Services

CPATH Analysis

"U.S. Public Health-Related Services Committed under the 'Bottom Up' Rules of the General Agreement on Trade in Services (GATS), and Concerns" - "Major GATS Provisions and 'Top Down' Rules: Health Implications."

Cick here to download "Bottom-Up" Rules

Click here to download "Top-Down" Rules

Intellectual Property & Access to Medicines

CPATH Analysis

DR-CAFTA Undermines Affordable Medicines; Pharmaceutical Industry’s Role on USTR Advisory Committees. Testimony by the Center for Policy Analysis on Trade and Health to the Ways and Means Committee, U.S. House of Representatives. Hearing on Implementation of the Dominican Republic-Central America Free Trade Agreement (DR-CAFTA), Thursday, April 21, 2005

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CAFTA Side Letter Does Not Protect Access to Medicines – CPATH briefing note requested by Citizens Trade Campaign. Posted online, distributed by Citizens Trade Campaign nationally, and to Congress. September 30, 2004

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California Can Choose to Provide Affordable Prescription Drugs: A Public Health Approach to Trade Agreements. CPATH Testimony to California Legislature hearing: Offshoring California’s Democracy and Capital: NAFTA, CAFTA, and the Tradeoffs of Free Trade. A Decade of NAFTA, Looking Forward to CAFTA: The Impact on State Sovereignty. October, 2004.

US-Australia Free Trade Agreement: Implications for Prescription Drug Prices in the US and Australia, June 2004.

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Public Health Protections

Tobacco and Alcohol Control


Universal Access to Water.

A billion people in the developing world lack access to safe drinking water, and 2.4 billion lack sanitation. Water is becoming scarcer and more costly in the United States in response to environmental factors, development, and maintenance. Major transnational corporations are vying to privatize water systems, supported by the GATS and international financial institutions. CPATH reports and analyzes the public health consequences of the water crisis, and offers democratic and sustainable alternatives for expanding access to safe water. Sister Cities projects bring together water system experts and union leaders from the developed and developing world to exchange skills and strategies, to create solidarity among communities facing privatized water systems, and to develop an effective advocacy response for providing policy alternatives in international trade negotiations.


International Fact-Finding
Mission on Water Sector Reform in Ghana - Report on the impact of proposed privatization of water in Ghana, issued in August, 2002. CPATH Directors Ellen R. Shaffer and Joe Brenner served as delegates representing the health care and labor communities, respectively.

Click here for Fact-Finding Mission Report

Educational Presentation:

Slide Show: "$ on Tap"

This power point slide presentation presents background on water privatization, and key findings of the International Fact-Finding Mission report on proposed privatization of water in Ghana.

Click here for Power Point Slide Show presentation

Click here for Slide Show (PDF)

Let us know if there are any events or updates you would like to share with fellow members.

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