Increasing Protection of GIS at the WTO: Clawbacks, Greenfields and Monopoly Rents

Currently there are proposals and negotiations regarding the strengthening of protection for geographic indicators (GIs) in the WTO. A major proponent of stronger protection for GIs has been the European Union. One of the arguments it has put forward for stronger protection has been that it will provide an avenue for economic development for agricultural producers in developing countries – a way to capture rents in the markets of developed countries. This paper first outlines the proposed changes to the international protection of geographic indicators. Second, the potential for groups of producers to generate and capture rents in foreign markets is assessed under differing assumptions pertaining to industry structure, product differentiation in the short and long run, barriers to entry reputation and the form of legal protection in importing countries. A discussion of the resource requirements to establish and maintain a GI is also provided.Agricultural and Food Policy, International Development, International Relations/Trade, WTO, GIS,

Post-Moratorium EU Regulation of Generically Modified Products: Trade Concerns

EU, GMO, trade, Agribusiness, Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety, International Relations/Trade,

Post-Moratorium EU Regulation of Genetically Modified Products: Triffid Flax

The regulatory regime for contamination permits the imposition of import bans with neither a scientific justification nor a risk assessment. No scientific assessment of Triffid flax was done prior to the import ban. The import regime put in place to deal with the contamination of flax with the GM-flax CDC Triffid provides no rationale for the thresholds of safety established for the testing regime. The EU is consistently pushing for commercial, economic and social considerations to be included, along with science, in decision-making. Such considerations are often perceived as avenues for economic protection to creep into EU decision-making. Such considerations can, however, cut both ways. The Canada-EU testing regime for Triffid makes provision for, but does not necessarily require, the testing of cargoes when they reach European ports (Western Producer, 2010). The risks associated with inspection upon arrival made exports to Europe too risky. By only requiring the passing of the tests prior to product leaving Canada, flexibility to find alternative markets for contaminated cargoes has been gained. Thus, while costly, the testing regime for flax exports to the EU has allowed for the resumption of Canadian flax exports to the EU. Of course, the import Protocol negotiated between the EU and Canada was a one off. In a future case, economic and commercial considerations could be used to bolster economic protection. This is why science was agreed upon as the arbitrator of SPS-based trade barriers by the Member States of the WTO, including the EU. Thus, the EU regulatory regime for GM-products would seem open to a new challenge at the WTO. Of course, the political consequences of such a challenge would have to be carefully weighed.GMO, food, EU, Triffid Flax, Agribusiness, Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety, International Relations/Trade,

Post-Moratorium EU Regulation of Genetically Modified Products: Trade Concerns

Trade in genetically modified (GM) products remains a major issue in agricultural trade policy. In particular, the European Union has sought to deny market access to GM-products. In the wake of a WTO case brought by Canada and the US, among others, against an import ban imposed on genetically modified agricultural products by the European Union (EU) – which the EU lost – the import ban was dropped and the EU put in place a new regulatory regime for GM-products. The EU suggests that the post-moratorium regulatory regime is compliant with its WTO obligations. As of June 2011, the operation of this new import regime has not been formally assessed. The first GM-crops are just now working their way through the post-moratorium regulatory system and an assessment of the operation of the regime is timely. The results of this assessment suggest that the EU’s approval system is only partially based in science and thus is not in conformity with its SPS obligations under the WTO. Hence, the new EU regulatory regime could be challenged through a WTO Disputes panel.EU regulatory regime, Genetically Modified (GM) products, Science, SPS, Agribusiness, Agricultural and Food Policy, Food Consumption/Nutrition/Food Safety, International Relations/Trade,

Guide to Geographical Indications: Linking Products and Their Origins (Summary)

Geographical Indications present significant opportunities for differentiating products or services that are uniquely related to their geographic origin. While they can offer many positive economic, social, cultural, and even environmental benefits, they can also be problematic and therefore caution is warranted when pursuing them. The publication distills the relevant lessons that could apply, particularly to developing countries, from a review of more than 200 documents and a number of original Case Studies. It presents a groundwork to better understand the costs and the benefits of undertaking Geographical Indications by outlining the basic processes, covering the pros and cons of different legal instruments, and offering insights into the important factors of success. It reviews and presents current data on the key issues of global GIs such as: economic results, public and private benefits; and market relevance.Geographical Indications, developing country, marketing, local, traditional, culture, appellation, legal protection, Denomination of Origin

Guide to Geographical Indications: Linking Products and Their Origins (Summary)

Geographical Indications present significant opportunities for differentiating products or services that are uniquely related to their geographic origin. While they can offer many positive economic, social, cultural, and even environmental benefits, they can also be problematic and therefore caution is warranted when pursuing them. The publication distills the relevant lessons that could apply, particularly to developing countries, from a review of more than 200 documents and a number of original Case Studies. It presents a groundwork to better understand the costs and the benefits of undertaking Geographical Indications by outlining the basic processes, covering the pros and cons of different legal instruments, and offering insights into the important factors of success. It reviews and presents current data on the key issues of global GIs such as: economic results, public and private benefits; and market relevance

Raw and Cooked Vegetable Consumption and Risk of Cardiovascular Disease:a Study of 400,000 Adults in UK Biobank

OBJECTIVES: Higher levels of vegetable consumption have been associated with a lower risk of cardiovascular disease (CVD), but the independent effect of raw and cooked vegetable consumption remains unclear. METHODS: From the UK Biobank cohort, 399,586 participants without prior CVD were included in the analysis. Raw and cooked vegetable intakes were measured with a validated dietary questionnaire at baseline. Multivariable Cox regression was used to estimate the associations between vegetable intake and CVD incidence and mortality, adjusted for socioeconomic status, health status, and lifestyle factors. The potential effect of residual confounding was assessed by calculating the percentage reduction in the likelihood ratio (LR) statistics after adjustment for the confounders. RESULTS: The mean age was 56 years and 55% were women. Mean intakes of raw and cooked vegetables were 2.3 and 2.8 tablespoons/day, respectively. During 12 years of follow-up, 18,052 major CVD events and 4,406 CVD deaths occurred. Raw vegetable intake was inversely associated with both CVD incidence (adjusted hazard ratio (HR) [95% CI] for the highest vs. lowest intake: 0.89 [0.83–0.95]) and CVD mortality (0.85 [0.74–0.97]), while cooked vegetable intake was not (1.00 [0.91–1.09] and 0.96 [0.80–1.13], respectively). Adjustment for potential confounders reduced the LR statistics for the associations of raw vegetables with CVD incidence and mortality by 82 and 87%, respectively. CONCLUSIONS: Higher intakes of raw, but not cooked, vegetables were associated with lower CVD risk. Residual confounding is likely to account for much, if not all, of the observed associations. This study suggests the need to reappraise the evidence on the burden of CVD disease attributable to low vegetable intake in the high-income populations

Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research

<b>Background</b> Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.<p></p> <b>Methods and findings</b> The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.<p></p> <b>Conclusions</b> Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems

Current and future economic burden of diabetes among working-age adults in Asia: conservative estimates for Singapore from 2010-2050

Abstract Background Diabetes not only imposes a huge health burden but also a large economic burden worldwide. In the working-age population, cost of lost productivity can far exceed diabetes-related medical cost. In this study, we aimed to estimate the current and future indirect and excess direct costs of diagnosed type 2 diabetes among the working-age population in Singapore. Methods A previously-published epidemiological model of diabetes was adapted to forecast prevalence among working-age patients with diagnosed type 2 diabetes in the absence of interventions. The current methodology of the American Diabetes Association was adopted to estimate the costs of diabetes for this population. Diabetes-related excess direct medical costs were obtained from a local cost study while indirect costs were calculated using the human capital approach applied to local labor force statistics. These cost were estimated conservatively from a societal perspective on a per patient basis and projected to the overall Singapore population from 2010 to 2050. Results In 2010, total economic costs per working-age patient were estimated to be US$5,646 (US$4,432-US$10,612), of which 42$7,791 (US$5,741-US$12,756) in 2050, with the share of indirect costs rising to 65 %. Simultaneous increases in prevalence imply that the total economic costs of diabetes for the entire working-age population will increase by 2.4 fold from US$787 million in 2010 to US$1,867 million in 2050. Conclusions By current projections, diabetes in Singapore represents a growing economic burden. Among the working-age population, the impact of productivity loss will become increasingly significant. Prevention efforts to reduce overall prevalence should also engage stakeholders outside the health sector who ultimately bear the indirect burden of disease

Unmet needs of patients with chronic obstructive pulmonary disease (COPD): A qualitative study on patients and doctors

Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease with repeated exacerbations resulting in gradual debilitation. The quality of life has been shown to be poor in patients with COPD despite efforts to improve self-management. However, the evidence on the benefit of self-management in COPD is conflicting. Whether this could be due to other unmet needs of patients have not been investigated. Therefore, we aimed to explore unmet needs of patients from both patients and doctors managing COPD. Methods: We conducted a qualitative study with doctors and patients in Malaysia. We used convenience sampling to recruit patients until data saturation. Eighteen patients and eighteen doctors consented and were interviewed using a semi-structured interview guide. The interviews were audio-recorded, transcribed verbatim and checked by the interviewers. Data were analysed using a thematic approach. Results: The themes were similar for both the patients and doctors. Three main themes emerged: knowledge and awareness of COPD, psychosocial and physical impact of COPD and the utility of self-management. Knowledge about COPD was generally poor. Patients were not familiar with the term chronic obstructive pulmonary disease or COPD. The word ‘asthma’ was used synonymously with COPD by both patients and doctors. Most patients experienced difficulties in their psychosocial and physical functions such as breathlessness, fear and helplessness. Most patients were not confident in self-managing their illness and prefer a more passive role with doctors directing their care. Conclusions: In conclusion, our study showed that knowledge of COPD is generally poor. There was mislabelling of COPD as asthma by both patients and physicians. This could have resulted in the lack of understanding of treatment options, outcomes, and prognosis of COPD. The misconception that cough due to COPD was contagious, and breathlessness that resulted from COPD, had important physical and psychosocial impact, and could lead to social isolation. Most patients and physicians did not favour self-management approaches, suggesting innovations based on self-management may be of limited benefit