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1 Asian Journal of the WTO and International Health Law and Policy 53 (2006)


One of the most important themes to emerge from the relationship between trade and health in the first ten year's of the WTO's existence is the challenge of achieving policy coherence. This task is a foreign policy challenge for WTO Members, which requires looking at the relationship between trade and health against the backdrop of the making and implementing of foreign policy. Policy coherence has generally become a major concern for foreign policymakers because post-Cold War trends, such as accelerating globalization, seriously challenge traditional foreign policy assumptions, practices, and institutions. Part of this new context for foreign policy involves the rise of health as a foreign policy issue. The trade-health relationship in the WTO is embedded, thus, in a broader range ofpolicy coherency questions affecting all the governance functions served by foreign policy.

Considered against these broader frameworks, policy coherence concerning trade and health breaks down into external and internal contexts. External policy coherency considers the extent to which States balance their national interests in trade and health in their anarchical interactions. This balancing analysis focuses attention on rules of international law, such as WTO agreements, which States have devised to calibrate their national interests in trade and health. Internal policy coherency examines whether States have domestically organized their policymaking to ensure that both trade and health sectors contribute synergistically to the formulation of the national interest. As between external and internal policy coherency, more effort by States is required internally; and the article proposes an approach called "trade epidemiology" to foster better internal policy coherency. Improving policy coherency for trade and health externally and internally faces, however, significant obstacles, including the possibility that more pressing foreign policy, trade, and health problems subordinate the trade-health coherence objective on the foreign policy agendas of States.