在双边投资条约中保障健康:乌拉圭的经验。

IF 5.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Gastón Ares, Gerónimo Brunet, Dori Patay, Anne-Marie Thow
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引用次数: 0

摘要

背景:作为全球化的结果,国际投资协定(IIAs)的激增已被确定为导致政策惰性或对有意义的公共卫生政策行动冷淡的因素之一。卫生保障措施,即保护国家管制权的具体条款,已越来越多地列入国际投资协定,以保护卫生政策。然而,对国际投资协定在全球范围内推广卫生保障措施所涉及的进程以及阻碍和促进这些措施的因素仍然缺乏深入的了解。在这方面,本研究打算通过分析乌拉圭这个拉丁美洲发展中国家采取保健保障措施的情况来填补这一研究空白。目标是:(一)审查乌拉圭在2024年前签署的双边投资条约中纳入卫生保障措施的演变情况,(二)分析乌拉圭在菲利普莫里斯ISDS案之后如何处理双边投资条约,(三)探讨乌拉圭利益攸关方对将卫生保障措施纳入双边投资条约的看法,(四)确定在双边投资条约中纳入卫生保障措施的障碍和促进因素。结果:对乌拉圭签署的双边投资协议的文献分析显示,卫生保障纳入的趋势呈上升趋势,自2010年以来达到100%。对主要利益攸关方的访谈表明,卫生保障措施通过跨国转移网络从国外扩散开来。虽然乌拉圭在将卫生保障纳入最近的双边投资协定方面没有遇到挑战,但事实证明,与发达国家重新谈判老一代双边投资协定是困难的。确定了促进和阻碍将卫生保障纳入双边投资协定的各种因素,这些因素涉及国家和政府间两级。结论:通过分析双边投资协定中卫生保障措施的采用情况,研究结果有助于了解影响投资协定与公共卫生政策之间界面演变的因素。国际组织关于重新谈判老一代双边投资协定的强烈建议可能有助于克服现有的权力动态,并支持发展中国家保护其监管空间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safeguarding health in bilateral investment treaties: the Uruguayan experience.

Background: The proliferation of International Investment Agreements (IIAs), as the result of globalization, has been identified as one of the factors contributing to policy inertia or chill on meaningful public health policy action. Health safeguards, i.e., specific clauses to protect the State's right to regulate, have been increasingly included in IIAs to protect health policy. However, an in-depth understanding of the processes involved in the diffusion of health safeguards in IIAs globally and the factors acting as barriers and facilitators for their uptake is still lacking. In this context, the present study intends to fill this research gap by analysing the uptake of health safeguards in the context of Uruguay, a developing Latin American country. The objectives were to: (i) examine the evolution of the inclusion of health safeguards in the Bilateral Investment Treaties (BITs) signed by Uruguay until 2024, (ii) analyse how Uruguay has approached BITs after the Philip Morris ISDS case, (iii) explore Uruguayan stakeholders' perspectives on the inclusion of health safeguards in BITs, (iv) identify barriers and facilitators for the uptake of health safeguards in the BITs.

Results: Documentary analysis of the BITs signed by Uruguay showed an ascending trend in the inclusion of health safeguards, reaching 100% since 2010. Interviews with key stakeholders suggested that health safeguards diffused from abroad through transnational transfer networks. While Uruguay has not faced challenges in including health safeguards in recent BITs, the renegotiation of old generation BIT agreements with developed countries has proven to be difficult. A wide range of factors that act as facilitators and barriers for the inclusion for health safeguards in the BITs were identified, which were related to both the national and intergovernmental levels.

Conclusions: Results contribute to the understanding of the factors that influence the evolution of the interface between investment agreements and public health policy by analysing the adoption of health safeguards in BITs. Strong recommendations from international organizations to renegotiate old generation BITs may contribute to overcoming the existing power dynamics and support developing countries in the protection of their regulatory space.

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来源期刊
Globalization and Health
Globalization and Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
18.40
自引率
1.90%
发文量
93
期刊介绍: "Globalization and Health" is a pioneering transdisciplinary journal dedicated to situating public health and well-being within the dynamic forces of global development. The journal is committed to publishing high-quality, original research that explores the impact of globalization processes on global public health. This includes examining how globalization influences health systems and the social, economic, commercial, and political determinants of health. The journal welcomes contributions from various disciplines, including policy, health systems, political economy, international relations, and community perspectives. While single-country studies are accepted, they must emphasize global/globalization mechanisms and their relevance to global-level policy discourse and decision-making.
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