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PLANETARY HEALTH

The AfCFTA agreement should be radical in prioritizing Africa’s health

Parked trucks wait in a 10km queue to cross the Kenyan-Ugandan border from the town of Busia, Kenya November 14, 2020.
Reuters/Baz Ratner
The African Continental Free Trade Area provides a historic opportunity to link trade with health.
  • Ebele Mogo
By Ebele Mogo

Researcher, MRC Epidemiology Unit of the University of Cambridge.

Published

There is a lot to be hopeful about with the dawn of the historic African Continental Free Trade Area (AfCFTA) and its promise to diversify economies, reduce reliance on exported goods, and boost regional trade. However, its success in boosting sustainable development will depend on the priority it gives to “planetary health.”

It was often assumed that planetary health—a concept and field covering the health of humans and the environments they depend on—could be an afterthought of development. In a world currently beset by a pandemic, this assumption has fallen apart. The pandemic has been blamed for the first major setback in poverty reduction in Africa in two decades. It has also led to a diversion of funds toward crisis responses, thus compromising regional development assets.

“AfCFTA’s success in boosting sustainable development will depend on the priority it gives to ‘planetary health.'”

With these challenges in mind, it is easy to make the connection between thriving pan-African trade and the need for equitable access to vaccines, therapeutics, and life-saving medications, particularly with this pandemic. Indeed, the global economic cost of not vaccinating developing countries from the pandemic has been placed at $9 trillion. However, what remains overlooked is just how much trade in non-healthcare sectors still impacts health.

The relationship between trade and health

Africa is a young continent filled with potential, but also the region of the world with the shortest life expectancy, due to a synergy between infections, injuries, and non-communicable diseases. Changing environments and socioeconomic pressures make it harder to access fresh foods, live in sanitary conditions, commute without risks such as crime, injury, and pollution, and exercise safely. This increases risks for non-communicable diseases such as diabetes, cancer, and heart diseases, which in turn worsen the risk for infections such as tuberculosis and of dying due to the current pandemic, and vice versa.

Trade has a significant role to play in this deadly synergy. Without adequate accountability mechanisms, trade environments encourage sales and marketing in commodities that contribute greatly to GDP while overlooking their impacts on planetary health. For example, while tobacco cultivation is often counted as a source of income and tax revenues, the economic losses it causes in the form of illness, death, and injury due to smoking, fire hazards, and environmental damage and deforestation go uncounted.

“Trade must be used to create healthier and more sustainable development.”

This omission compromises the health of the same population that is expected to drive sustainable development. Currently, close to half of the sub-Saharan African population is estimated to be hypertensive. Many of these people will leave the workforce prematurely due to illness and death, which will in turn compromise the welfare of their families. Additionally, communities face unchecked health risks from industrial activities including business externalities such as harmful exposure to soot, marketing practices such as the advertisement of tobacco and ultra-processed fast foods to children, and deadly workforce conditions such as those in mining the raw materials used for consumer products.

The role of trade in sustainable development

The proof of the AfCFTA will be in its implementation. Trade must be used to create healthier and more sustainable development. Currently, the AfCFTA agreement does well to note that exceptions to tariff reliefs will be applied to activities that contravene anti-dumping laws. It also affirms countries’ rights to protect human, animal, and plant life or health. The interpretation of these stipulations will depend on its governing body which includes an Assembly, a Council of Ministers, a Committee of Senior Trade Officials and the Secretariat. This governing body will need to firmly keep planetary health a priority amongst a host of well-funded competing pressures.

The AfCFTA also plans to start by prioritizing the transport, tourism, and communication sectors. These goals could be advantageous through investments in sustainable multi-modal transport systems for example. To do so, implementing parties will need to spell out products and services in each of these sectors with damaging planetary health impacts for which tariff reliefs will not apply, while prioritizing market creation for those that provide value.

Proactive industry standards and financing tools have been used to create incentives in areas of the economy where growth is desired, for instance, encouraging the creation and distribution of coronavirus vaccines. Such tools can be used in shaping markets in the direction of healthy and sustainable infrastructure, goods and services.

There is also a role for investors, who will no doubt be taking advantage of the opportunity for more liberal trade. It would be prudent of them to do due diligence on their portfolio companies, so as to determine the impact of their investment monies. This should involve assessing not just the profitability of their investments, but the broader impacts of their portfolio companies on the health of their workforces throughout the supply-chain, the health of the public and the environment.

The technical support given to industries, particularly micro- and medium-scale industries, should prioritize pan-African research and innovation, as user-led solutions tend to not only be more effective at solving challenges, but often to intersect sustainability concerns with economic concerns. This can lead to much-needed system shifts.

We can take a cue from the pan-African visionary and former president of Burkina Faso, Thomas Sankara. His vision of self-sufficiency via local production is evident in him saying that the revolution would “be measured by something else, it will be measured by the level of production. We must produce, we must produce.”

Sankara tied this vision not only to local trade, but to securing the health of the whole population and of the ecosystems they relied on. He concurrently invested in strengthening healthcare systems, particularly vaccination rates, championing physical activity, tackling desertification and deforestation, strengthening local food production, and conserving water resources.

Such deliberate prioritization of planetary health is what will ensure that trade via the AfCFTA agreement is indeed a tool for sustainable development.

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