보건 관련 국제규범과 미국의 글로벌 보건의료정책 변화에 따른 통상규범적 검토

A Review of International Health Rules and Trade Rules in an Era of U.S. Global Health Policy Shifts

This study examines the evolution of international health rules and changes in U.S. global healthcare policy, analyzing their implications for international trade rules. Specifically, it investigates how health-related provisions within the World Trade Organization (WTO) framework have been interpreted and implemented between two competing objectives - national policy discretion and trade liberalization - with particular focus on the Agreement on Technical Barriers to Trade (TBT) and the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Central to this analysis is the transformation of U.S. global health policy. Since World War II, U.S. health policy has shown distinct variations based on administrative partisan characteristics. While Democratic administrations have favored multilateral cooperation through international organizations, Republican administrations have generally preferred bilateral cooperation or disease-specific programs. This policy divergence has intensified recently, as exemplified by the stark contrast between the Trump administration's 'America First' approach and the Biden administration's attempts to balance multilateral engagement with domestic policy autonomy. These policy shifts have directly influenced how international trade rules are utilized. Through examination of WTO dispute cases and specific trade concerns (STCs), this study demonstrates how the United States has strategically leveraged ambiguous provisions within international trade agreements. Particularly in pharmaceutical and medical device regulations, the U.S. has simultaneously advocated for trade liberalization while selectively employing trade rules to maintain regulatory discretion in healthcare. The recent announcement of withdrawal from WHO suggests this domestically-focused approach will be likely to further intensify. Based on these analyses, this study concludes that future international health rules must carefully balance the fundamental value of public health promotion with the practical goal of trade facilitation. To achieve this, it recommends establishing clearer interpretative standards for WTO provisions and strengthening international regulatory cooperation in medical products. These measures aim to create a predictable and equitable international health regulatory system while preserving national sovereignty in health policy decisions.