Navigating Trade Challenges at the WTO to Prevent NCDs and Promote Better Health for All
The World Trade Organization (WTO) is the international organisation responsible for regulating international trade. It includes a comprehensive set of rules to avoid discriminatory or unnecessary barriers to trade, supplemented by a large institutional framework of councils, committees, and bodies to resolve legal disputes. An important set of these rules determine what governments can – and cannot – do when they introduce new national goods regulation that could have a significant impact on trade. These rules on so-called technical barriers to trade (TBTs) are discussed extensively at the TBT Committee where WTO members (including the UK) notify their regulations and respond to questions or challenges from other WTO members.
The UK government is considering a range of policies to address non-communicable diseases (NCDs) such as obesity, diabetes, heart disease and strokes, in line with international efforts to prevent NCDs. These policies involve regulating the food, tobacco and alcohol industries. As these policies, and specifically labelling and packaging requirements, may have a significant impact on trade, they will have to be notified – and, therefore, potentially questioned – by representatives from other governments at the TBT Committee.
While WTO rules allow governments to regulate to protect public health, this is not an unconditional right, and where there is a real or perceived lack of clarity, legitimate policies may be challenged by other governments. Existing research has demonstrated the influence that TBT Committee discussions can have: encouraging governments to weaken, abandon, or delay the implementation of public health policies.
This three-year project has examined how governments have defended policies to prevent NCDs at the TBT Committee over the past 30 years, using mixed qualitative and quantitative methods, with a view to identifying key learnings for governments that are considering the implementation of NCD prevention policies.
We thank the NIHR for the generous support it has provided (AwardNIHR204663), which has made this project possible.
Research Team
Amandine Garde (Project Chief Investigator)
Amandine Garde is Professor of Law at the University of Liverpool. By combining expertise in consumer, trade, health, food, advertising and human rights law and policy, she aims to bridge the traditional boundaries between various sub-disciplines of law to facilitate a better understanding of the complex and cross-cutting legal issues pertaining to the prevention of NCDs. In 2015, she established the Law & Non-Communicable Diseases Research Unit, which advises international organisations, civil society, public health agencies and governments. She is an honorary member of the UK Faculty of Public Health and a qualified solicitor.
Gregory Messenger (Project Co-Lead)
Greg Messenger is Professor of Trade Law and Policy at the University of Bristol Law School. He is a specialist in trade law and policy, with a particular focus on the use of trade policy instruments to pursue public policy aims, including the protection of public health. He is co-founder and co-director of the Trade & Public Policy (TaPP) Network, the largest network of academic experts on UK trade policy.
Marcelo Campbell (Project Co-Investigator)
Marcelo Campbell is a doctoral researcher at the School of Law and Social Justice, University of Liverpool, where his research examines how litigation brought against states by civil society and industry actors shapes food environments in Latin America. He has worked with the World Health Organization and the Food and Agriculture Organization of the United Nations and has published on food regulation and international economic law. Marcelo has also contributed to research projects on food environment regulation and to capacity-building initiatives aimed at strengthening understanding of the relationship between public health law, food policy and international trade.
May Van Schalkwyk (Project Co-Investigator)
May Van Schalkwyk is a senior clinical research fellow at the University of Edinburgh. Her research seeks to describe and explain how commercial practices shape ideas, knowledge, science, and policymaking. May's work spans a wide range of industries and commercial practices, including the activities of industry-funded organisations, industry influence on youth education and safety programmes, and the use of metaphor as a form of corporate political activity. She focuses particularly on building greater understanding of the commercial determinants of health through cross-industry comparative analysis. She also has a special interest in the role of film in advancing health policy and public health and was co-executive producer of the documentary film Unmasking Influence.
Gabriel Siles-Brügge (Project Co-Investigator)
Gabriel Siles-Brügge is Professor in Global Governance & Public Policy in the School for Policy Studies at the University of Bristol and a Fellow of the Academy of Social Sciences. Gabriel works at the intersection of public policy, EU Studies and International Political Economy. He has established an international reputation for his research on the (de)legitimation of economic policy through ideas, evidence, and expertise, with a particular focus on the politics of trade. His policy expertise and commitment to social justice in the area of international trade has seen him work with a wide range of NGOs, trade unions, and parliamentary bodies on trade policy matters.
We have worked closely with the NIHR and the Department of Health and Social Care (DHSC) throughout the Project. We are also most grateful for the support and guidance we have received from the members of our Project External Advisory Board:
- Alison Cox, NCD Alliance
- Barbara Crowther, Sustain and Children’s Food Campaign
- Sue Davies, Which?
- Alison Douglas, Alcohol Focus Scotland (AFS)
- Ian Gilmore, Alcohol Health Alliance (AHA)
- Katherine Jenner, Obesity Health Alliance (OHA)
- Monika Kosinska, World Health Organization (WHO)
- Paul Lincoln, previously at UK Health Forum
- Mzwandile Mabhala, Association of Schools of Public Health in the European Region (ASPHER)
- Benn McGrady, World Health Organization (WHO)
- Katherine Severi, Institute of Alcohol Studies (IAS)
- Alison Tedstone, previously at Public Health England (PHE)
- Theresa Marteau, University of Cambridge
- Erik Wijkström, World Trade Organization (WTO)
Project video
As part of the Project, we worked with John Kelly from Wildfire Collective to produce a short video intended to demystify the impact that the WTO has on the right of governments to regulate the tobacco, alcohol and food industries to prevent NCDs and promote better health for all.
'Navigating Trade Challenges to Promote Public Health: The Right to Regulate'
Resources
This Project was primarily policy-facing and led to the production of policy reports and training material for the NIHR and government colleagues. However, we have also produced some public-facing, freely accessible resources that we will continue to post on this page as they are published.
Providing a clear and succinct analysis of the relevant trade and investment regimes and the obligations they impose, this book identifies the key principles that must be considered when formulating and implementing NCD prevention strategies that are both effective and able to withstand legal challenges. Published in June 2025, it is available in Open Access from Bristol University Press.
The WTO-NCD Database
The WTO-NCD Database analyses 904 Specific Trade Concerns (STCs) raised at the WTO TBT Committee over 31 years (from 1 January 1995 to 4 March 2026).
Building on data from the ePing SPS & TBT Platform, the WTO-NCD Database identifies and analyses those STCs identified as relevant for NCDs.
Each NCD-relevant STC is broken down into objectives of measures (e.g., consumer protection or human health and safety…), NCD relevant keywords (e.g., tobacco, labelling, food standards…). For each, the Database catalogues the WTO members raising STCs, those responding, and the number of times an STC was raised.
This novel Database provides a rich set of data to support the analysis of the practice of committees such as the TBT Committee, and the treatment of public health in trade institutions.
- WTO NCD Database v1 (Excel spreadsheet)
End-of-Project Conference
On Thursday 2nd and Friday 3rd July 2026, the University of Liverpool hosted the end-of-project conference (SLSJ events space and online). This conference presented and contextualised the Project research findings, offering an opportunity for participants to explore and analyse the relationship between public health and the world trade regime. By bringing together speakers from across the trade and health communities, it allowed those working on these issues to dive into the new evidence base and reflect on future work. We were delighted that so many colleagues from different walks of life could join us in Liverpool or online for this two-day event to share their expertise and insights.
The Research Team also organised a public lecture that Professor Mark Petticrew from the London School of Hygiene and Tropical Medicine delivered on 2nd July, concluding the first day of the conference proceedings.
We are now working with John Kelly from Wildfire Collective to produce a video capturing the highlights of the conference and will be posted here shortly.
The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.