Chapter 9 Notes
DepartmentInternational Development Studies
ProfessorAnne- Emanuelle Birn
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Chapter 9: Globalization, Trade, Work, and Health
-Focusing on neoliberal globalization
-Trade in goods, services, people, and capital is a key component of globalization
Globalization and its key features
-Generally speaking, globalization is the process whereby people are becoming
more interconnected and interdependent via particular political-economic
relations that work to compress time, space, and cognition. The process of greater
integration w/in the world economy through movements of goods and services,
capital, technology, and labour, which lead increasingly to economic decisions
being influences by global conditions.
--New globalization: pace at which it occurs is faster - combined w/ the hegemonic
(i.e dominant & largely unquestioned) ideology underwriting this process
**Globalization good or bad?
-how globalization affects the health of ppl around the world depends on who controls the
flow of capital, labor, & knowledge around the world, & who benefits from it .
Historical character and definitions of neoliberal globalization
-Globalization can be divided into several eras… 1870s, 1914, present time
-In the 19th century, global economic expansion was promoted as the key to
progress, shepherded by big businesses, trusts, and investors, especially in
Europe and North America.
-Main Tenets of the neoliberal economic model are that
-a) Unfettered free markets begin growth in annual per GDP
-b) Growth is synonymous w/ development
-c) growth is necessary and sufficient to reduce poverty
-Neoliberal economists also accept that financial crises are an expected norm in
between periods of growth, and that the state should do little to interfere. Also
assume that the state already plays too large a role in the economy and social
policy, and that state interference prevents markets from acting efficiently
-Neoliberal globalization’s key elements are the promotion of “free markets” and
the relaxation of trade barriers. Often the results are: 1) reduction of subsidies for
the poor, 2) cost recovery/user fees for essential services, 3) privatization of
public assets, 4) weakened role of government, 5) growing dominance of western
based transnational capital, and 6) high military expenditures.
-Neoliberal globalization has accelerated the growth of free trade zoned in
developing countries, “outsourcing” production that previously took place in
-Free trade zones also shift employment patterns w/in developing countries
-Neoliberal globalization… the political order is dominated by the logic of the
market, and the benefits of a “shrinking” world haven’t been equally shared
The global trade regime and the WTO
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-WTO covers all forms of trade… intellectual property, services, and goods.
-Main principles underpinning all WTO agreements: national treatment (foreign
goods, investments or services all treated the same as domestic goods); most
favoured nation (whatever special preferences are given to one trading partner
must be given to all WTO member nations); least trade restrictive practices
(whatever environmental or social regulations a country adopts domestically must
be those that least impede trade)
-All WTO decisions to date have prioritized economic growth over social policies,
and have ruled against labour and child labour rights when they have appeared to
be in conflict w/ competition = rules only appear to treat all members equally.
-In low income nations, free trade agreements grant more rights to investing
corporations than to local populations and authorities.
-According to proponents of globalizations, its effects on health are: a) economic
integration and globalization rises income in poor countries, b) globalization
improves the health of the poor (assuming a) is true)
-To the contrary, neoliberal globalization has been shown to negatively affect the
economies of most poorer countries, in turn jeopardizing health
-The surge in global economic activity, especially trade in commodities, has led
economic performance in some countries to improve in recent years.
-Wealth has not been equally distributed across nations as a result of increased
trade and foreign investment.
-Opponents of neoliberal globalization= many unions, small farmers, social
activist. These people decry globalization and as an undemocratic process
-Counties who have long whose govnt’s have been long time adherents to the
neoliberal model (central America), poverty and inequality have increased w/
consequent negative health effects on rural pop, marginalized and women.
-Most evidence suggests that the negative effects outweigh the positive for the vast
majority of the world’s population. Health problems linked to globalization.
Health effects of globalization.
-Health is profoundly shaped by national and international economic and political
factors – interacting w/ community level and individual conditions – that have
long lasting repercussions.
-Globalization influences health and generated health inequalities in 5 ways:
-1) trade liberalization and the world trade regime
-2) global reorganization of production and labour markets
-3) Dept crisis and structural adjustment of developing country economies
-4) environmental damage
-5) Financial liberalization
-Trade liberalization disproportionately affects agricultural workers and small
scale entrepreneurs who have no safety net, women, and children. Jobs for these
workers are usually in the informal economy and thus poorly regulated.
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-At same time, greater labour mobility of professionals has led to emigration from
developing countries of needed professionals.
-Global reorganization of production and labour markets resulted in the
exportation of jobs and entire industries to areas where regulation is lax.
-Due to debt crisis and imposition of structural adjustment policies on many
economies of the developing world, the ability of governments to invest in public
health, education, water and sanitation, nutrition, and neighbourhood
improvement has been constrained.
Trade liberalization, the world trade regime, and transnational corporations
-The increased fluidity of global production has facilitated the transfer of obsolete
production technologies to poorer countries, posing hazards to both the newly
unprotected employed population and to the overall population.
-Increased movement of people and goods can lead to increased exposure to
infectious diseases through rapid cross border contamination, disruption of animal
habitats through rapid urban growth, and unregulated food production & markets.
-Trade can raise probability of developing chronic disease through the marketing
of unhealthy products (alcohol/tobacco)
-Trade can affect health by reducing the provision and distribution of health related
goods, services, and personnel
Health implications of WTO agreements
-Several WTO agreements directly influence the health of the poor. Most
prominent = TRIPS (protecting a patent for 20 years, and whoever wants to
produce the drug has to pay the patent holder (usually very expensive)).
-Because of this, people in poorer countries cannot afford the patented drugs
-Countries that declare public health emergencies can overcome patent barriers by
granting compulsory licenses (for production of generic medicines), or through
parallel imports of medicine if they don’t have manufacturing capacity
-Yet, TRIPS remains highly prejudicial against developing countries and all people
of limited means. TRIPS, like other WTO measures, enables profits to be
prioritized over human well being.
-The SPS (sanitary and phytosanitary measures) places free trade above human
health and safety. SPS = requires scientific risk assessment even though foreign
goods cannot be treated differently from domestic goods.
-The General Agreement of Trade in Services (GATS) = most insidious of all
WTO agreements. It treats human services that are key social determinants of
health as commodities subject to trade rules.
-This includes the opening to commercialization of health care, the education
sector, and even water and sanitation services.
(*2 trade treaties that influence health? TBT & TRIPs)
TBT Technical Barriers to trade agreement
All ‘like-products’ be treated alike, all domestic regulations be ‘least-trade restrictive,’
and exceed international standards only in case of specific health grounds.
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