Trade is an integral part of our agrifood systems. It promotes the availability and diversity of foods in a country and, therefore, plays a crucial role in influencing diets and affecting nutritional outcomes. The impact of trade can be positive for foods essential for healthy diets; however, trade can also increase access to energy-dense foods of low nutritional value, particularly ultra-processed foods, which could worsen nutritional outcomes. This mixed scenario emphasizes the importance of developing trade policies coherent with nutrition measures and improving diet quality while considering potential adverse effects.274
To address all forms of malnutrition with an agrifood-system approach, policies should provide a set of incentives that target producers, traders, food processors, retailers and consumers. These incentives range from domestic support and trade policies to taxes for sugar or fat content, labelling requirements and measures to protect children from the harmful effects of food marketing, most of which overlap with trade. Therefore, it is critical for policymakers to consider policy coherence when designing and implementing trade policies and nutrition measures, taking into account all stakeholders, especially the most vulnerable in low- and middle-income countries.
World Trade Organization rules-compliant policies
From a trade policy perspective, WTO agreements recognize non-economic objectives under Article XX of GATT, allowing members to protect human health and provide countries with the flexibility to pursue nutrition objectives, as long as measures do not discriminate between imported and domestically produced foods. In the context of the Pacific Small Island Developing States, WTO rules have led to the evolution of policy instruments, from import quantitative restrictions to tariffs and to taxes or food standards to comply with the principle of non-discrimination.
The Samoa and Ghana examples offer significant insights for policymakers aiming to develop trade-compliant policies that support healthy diets. In both cases, transparent and scientific processes were utilized to ensure the necessity of policy interventions. A comprehensive approach was also applied to incorporate both imported and domestically produced foods, ensuring non-discriminatory policy measures.
More specifically, in Ghana, the introduction of food standards mandating maximum percentages for fat in meat cuts, which were reported as SPS and TBT measures in the country’s WTO Trade Policy Reviews, is an approach that has potential in enhancing coherence between trade and nutrition measures. From the nutrition point of view, such food standards result in a ban on fatty meat cuts, thus improving nutritional outcomes. From the trade point of view and based on Part 4 findings, SPS and TBT measures, on average, facilitate food trade between trade partners. For example, joining an RTA with the highest coverage of TBT provisions would increase imports of unprocessed and minimally processed foods, which include meat cuts, by 140 percent. Although this is an average result across countries, foods and provisions, it highlights the potential of using TBT measures such as nutrition labelling for increasing the coherence between trade and nutrition policies.
Understanding the interface between trade and nutrition policies can inform the design of policies that are effective and consistent with WTO rules. In addition to Ghana’s food standards, Chile has navigated WTO agreements on nutritional information to develop the mandatory front-of-package nutrition labelling for NCD prevention.
Regional trade agreements increase awareness and understanding between trade and health sectors
In the context of regional trade agreements, it is important to consider the impact of increased trade on nutrition during the negotiation process. As trade can have heterogeneous impacts on nutrition, depending on the position of a country on the development path, the structure of its economy and agricultural sector and its demographic characteristics, nutrition impact assessments based on international dietary guidance can inform the negotiation process. Indeed, evidence suggests that a health impact assessment carried out in Australia in the context of the Trans-Pacific Partnership Agreement was useful in engaging the public and informing the negotiations.275
At the same time, the trade–nutrition policy nexus must be strengthened; specifically, there is an opportunity for nutrition to be included in the set of objectives of a trade agreement. Countries need to identify the level of coherence between trade policies and health and nutrition goals within their specific national settings. For example, in Samoa, the inclusion of a key government nutritionist in the WTO accession committee enabled consideration of the nutritional implications of removing the ban on turkey tails and supported the decision to commit to undertaking a study to replace the ban.276
To date, studies indicate there is scope to strengthen policy coherence between trade and nutrition. At the national level, establishing mechanisms to enable engagement between the health and trade actors in the negotiation and implementation of trade agreements and the design of nutrition measures further supports and fosters policy coherence between trade and nutrition.
In Thailand, efforts to support policy coherence between trade and health has highlighted the importance of building capacities among trade policymakers over time, to strengthen an understanding of the interface between trade and health. For example, in 1998, the Ministry of Public Health established the Ministerial Committee on Health Impact from International Trade, with subcommittees on SPS, TBT and other agreements, to focus on health issues arising from trade negotiations and to increase coordination with the Ministry of Commerce and Ministry of Industry. Transparency was strengthened through the National Health Assembly, established in 2008, as a forum for government, non-government stakeholders, civil society and the knowledge community to discuss health issues arising from wider policies, including trade policies.277
In Australia, recent research highlighted an opportunity to increase awareness and understanding of trade and nutrition linkages among trade policymakers, negotiators and politicians by framing nutrition effectively in an economic context, to increase consideration and priority.278 Similarly, with reference to the Common Agricultural Policy in the European Union, clear communication of nutrition guidelines and a mandate to address nutrition-related health concerns were found to aid policy action for nutrition in the agricultural trade space.279
For deep trade agreements, policy coherence between trade and nutrition objectives, stakeholder engagement and transparency are critical. In general, there is little evidence of the welfare impacts of deeper trade agreements in food and agriculture globally. However, when deep trade agreements promote the convergence of standards and regulations, the results could depend on whether special interests in signatory countries are aligned or in conflict. For example, while trade agreements that focus on market access tend to dilute the influence of special interests, as lobbies for exporters act as counterweights to import-competing lobbies, in deeper agreements, industry interests may be aligned across countries as firms would benefit from lower trade costs.280, 281
International guidance
A major challenge faced by the Government of Ghana when establishing agrifood standards for fat content in meat cuts was the lack of international guidance.282 Although WHO provides guidelines on healthy diets, and on fat, carbohydrate and sugar intake, these are difficult to translate into SPS or TBT provisions to apply to single foods.283, 284 There is not only a need for scientific evidence linking the intake to NDCs, but also information on NDC trends in the country, specific food consumption patterns and diets that would provide the necessary justification for applying the measure. International guidance and advice on how to set up and manage this process will be important. Experts believe there is already potential to develop nutrition-related TBT provisions for ultra-processed foods.285
More broadly, there is an opportunity for guidance relevant to agrifood systems and nutrition based on the policy space as this is shaped by WTO rules, with the objective of presenting good practices and innovative solutions for the trade–nutrition policy nexus.286 This would strengthen the interface between trade and nutrition and contribute to building agrifood-system approaches towards healthy diets. In this context, the FAO elearning Academy capacity development initiatives and elearning courses can contribute towards building capacity in the trade–nutrition policy nexus, ensuring that new competencies are transferred to policymakers, embedded in national institutions and tailored to country-specific development and nutrition needs.
