Concerns about health are not new aspects of trade policies, but have long been part of trade negotiations. It is also known that failures in public health policies can substantially and adversely affect trade. The economic costs of global epidemics have been rising sharply, but more important is the point that prevention of epidemics requires not only functional public health measures at national borders, but in essence functional health systems. Health policies and trade policies have mutually compatible and strengthening aspects, but there are also crucial and important conflicts of interests. In this chapter I outline ethical issues and questions that relate to these conflicts and the importance of considering trade policies not merely as transnational policies, but also as representing a form of global legal development and governance in relation to rights, redistribution and regulatory measures. These have consequences not only across countries and amongst international organizations and actors, but also for the balance between public policies and interests and those of national and increasingly global corporate actors and interest groups.

In assessing the implications of trade on health policies we can distinguish two different components. The first is the impacts of trade upon determinants of health and health outcomes. The main and core interest here relates to the magnitude of flows of goods, services, people or capital with positive and negative implications being assessed in relation to these flows and their influence both on health outcomes and on how national health systems function.