Peter Sainsbury


This Case Study examines, with particular reference to the Australian Pharmaceutical Benefits Scheme (PBS), the events that occurred during the negotiation of the Australia-United States Free Trade Agreement (FTA) in 2003 and early 2004. The inclusion of the PBS in the FTA was a source of considerable concern in Australia due to its potential impact on health, and was a sticking point in negotiations.

Following brief descriptions of the PBS and the relationship between drug companies and the PBS, I outline in roughly chronological order some of the significant developments in the negotiations from a public health viewpoint. I also analyze the framing of the negotiations by the United States and Australian governments and the lack of transparency and public accountability with which the negotiations took place. I argue that trade negotiations, like the FTA, can have important health consequences; as such, public health advocates must become more active participants in the negotiations process.

This Case Study tells a story of process, not outcomes. In the telling I wish to stimulate consideration of the role public health workers can play in international trade negotiations, an arena in which they have not traditionally been much involved, but one that will assume increasing importance for the health of both individuals and nations.