## Session 5 #to-read Absolute advantage / comparative advantage. What the? [[Gross Domestic Product (GDP)]] measures income (not wealth) Free trade refers to unrestricted exchange of goods [[World Trade Organization (WTO)]] - Consensus-based decision making and power imbalances (US cotton and the C4 countries VS. Chinese textiles) - Dispute settlement mechanism - Health exceptions - The Doha round and stalling negotiations since 2001 - The rising importance of regional and bilateral agreements - Behind-the-border measures and the Investor-State Dispute Settlement (IDS) system The theory supporting trade liberalisation and health: 1. Classical economics: free trade results in more efficient allocation of goods in the absence of market failures (Smith, 1776; Ricardo, 1817) 2. Ricardian [[comparative advantage]]: output is maximised by free trade, even for countries with no absolute advantage in any sector. Thus, incomes increase and more resources can be dedicated to improving health The other side of the story: 1. Free trade allows access to foreign markets, but also allows access by foreign competitors 2. Emerging industries may be outcompeted - moves towards higher-value-adding industries become harder (1980s SAPs) 3. Often locked into producing primary commodities, whose relative value tends to fall over time (Prebisch, 1950; Singer, 1950) 4. The resulting dynamic perpetuates colonial production relations - the Global South exporting low-value raw commodities to the Global North / Imperial Core 5. Every wealthy country today has protected their infant industries from foreign competition and flaunted the intellectual property of other countries (Chang, 2016) 6. Less economic autonomy, less scope for industrial policy to improve quality of life 7. While the WTO is "one country, one vote" in theory, the consensus-based decision making process allows bullying 8. The Investor-State Dispute Settlement (ISDS) system gives power to private capital - can advocate for weakened regulations which harm health outcomes (e.g. British-American tobacco) ## Session 6 #to-read [[Preston Curve]] and its implication. The lack of causality. The lack of detail as of how inequality is captured in the curve. The inequality within countries could affect global health outcomes because of the safety net. Income also affects how state could finance their health programs. Main points: 1. Income vs. wealth 2. Many ways to measure material wellbeing 3. Whether income -> health is very relevant to a politics that justifies prioritisation of economic growth The [[Preston Curve]]: - The Preston Curve (Preston, 1975) tracks the apparent association between health and income between countries - There appears to be a logarithmic relationship which has shifted upwards over time - Many assert that this relationship is causal, although the direction of (and reasons for) this causality is the subject of intense debate [[Open Question]] "[[Focus on economic growth, and health will follow. Focus on health without economic development, and poverty will limit progress - is it true?]]" - how valid is this approach? Critiques: 1. Reverse causality 2. [[decolonization]] Countries that are rich today have better health outcomes, but this is due to colonial power relations, not 'focusing on growth' 3. Healthcare system design is important, not just income (health outcomes in Cuba vs. USA) 4. The level of income is important to health, but so is its distribution 5. Need to go beyond income inequality and talk about relationship to structural violence