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Table 1 The TAPIC framework elements (adapted from Greer 2016, 2017, Jarman 2017)

From: Brexit and trade policy: an analysis of the governance of UK trade policy and what it means for health and social justice

TAPIC element Definition Relevance to health and health equity Example mechanism Example challenges
Transparency An institution is said to be transparent when decisions, and the processes and grounds on which decisions are made, can be observed and the public and other relevant actors are informed about them. Transparency is more than simply recording activities but requires that the information about them is readily accessible, accurate, timely, and comprehensive, and is presented in a way that is comprehensible, taking account of the technical issues that might arise. Transparency is central to empowering members of health, environmental and social justice communities including health professionals, civil society and researchers, for example, to understand how decisions are being made, what is being considered and why, and to identity potential impacts Information provision and open document publication,
Transparency / lobbying / interests registers,
Freedom of information requests,
External audit
Countering concerns that transparency will translate to increased public criticism, weakening of negotiating positions, or failed trade agreements
Conflicts between national transparency agenda and level of transparency required by trading partners
Accountability Accountability exists when one actor must explain their decisions and actions to specified others with the ability to mandate remedial actions and/or impose sanctions when necessary. Clear lines of accountability are key to establishing systems and actors within them who are responsible for identifying, and acting upon, health and equity impacts of trade policy, and to ensure that individuals and institutions are held to account regarding their actions in these areas. Scrutiny committees,
Legislative mandates,
Trade impact assessments,
Transnational arbitration/dispute settlement mechanism
Legislative scrutiny may be reduced when decision-making power is delegated to executive agencies
Large scale and rapid institutional change can make lines of accountability less clear
Trade impact assessments may not include health and equity considerations
Dispute settlement prioritise economic norms
Participation Participation requires that affected parties are empowered with meaningful opportunities to access decision-makers in shaping policy. While transparency may allow various policy actors such as health or social justice advocates and the public to ‘see’ who is taking decisions, how and about what, participation, when conducted well, can facilitate more active involvement within the processes of deliberation and decision-making. It may therefore be seen as supporting a more democratic form of decision-making, facilitating critical and contrasting voices to be heard and for health and equity aspects of trade to be taken in consideration and acted upon in a timely manner. Public consultation,
Public forums / webinars,
Trade advisory committees
Overcoming knowledge barriers to participation. Restrictive membership of advisory committees.
Public consultations and dialogues may not be routinized or inclusive enough
Integrity An organisation is said to have integrity when it has strong internal systems and rules, underpinned by missions and cultures that also promote integrity. Integrity is about good management and has connotations with trust, which in turn can influence the degree and nature of stakeholder participation with important implications for inclusion of diverse groups and interests, including in relation to health and equity. Risk registries,
Internal career path,
International laws, treaties, commitments (e.g. Framework Convention on Tobacco Control, Doha Declaration, Sustainable Development Goals)
Codes of conduct are often advisory in nature
Revolving doors for policy-makers exist between government and industry
Capacity Policy capacity often refers to the ability to develop policy that supports the achievement of desired goals with the resources at hand. Of particular concern from a health and social justice perspective, is the capacity to identify, anticipate, mitigate and act upon trade aspects that hold implications for health and the interests of vulnerable groups. Trade-specific capacity building,
Training of health staff and vice versa in trade policy (e.g. WTO online training modules)
Exit from EU and loss of capacity
Complexity of trade deals and their impacts
Difficulty of inter-departmental working
Trade staff are not health specialists