The GATS and South Africa's National Health Act

A Cautionary Tale
November 23, 2005
341.76 KB40 pages

This new study shows how South Africa’s flagship health legislation conflicts with binding commitments the former apartheid regime negotiated under the World Trade Organization’s General Agreement on Trade in Services (GATS).  This trade treaty conflict threatens to undermine the much-needed legislation and, if left unresolved, would make meeting the health needs of the majority of the population far more difficult.  The study explores several options that South Africa has for resolving this conflict in favour of its health policy imperatives, but each entails risk.  South Africa’s dilemma should serve as a world-wide warning that health policy-makers, governments and citizens need to be far more attentive to negotiations that are now underway in Geneva to expand the reach of the GATS.

The current WTO talks are now entering the final  phase of negotiations. If the deadlock in agriculture is broken, there will be massive pressure on governments, especially developing country governments, to make substantial new GATS commitments.  Lost in all this brinksmanship is careful consideration of the actual impacts of trade-in-services commitments on development policies.

The study provides concrete evidence of the problems WTO services commitments can cause for redistributive health policies worldwide.  It also explores options for South Africa to resolve the conflict between its GATS treaty commitments and its health policies. The study includes an executive summary and a foreword by David Sanders,  Professor and Director, School of Public Health, University of the Western Cape.

The document can be  downloaded free of charge from

Note: A hard-copy version of this study will be published in South Africa by the South African Municipal Workers Union and the Municipal Services Project in March 2006.

“Sinclair shows how the outgoing apartheid regime, cynically or carelessly, sold South Africa’s sovereignty and the right of its citizens to a more equitable health dispensation by signing up to the GATS. By laying bare the maze of bewildering legalese embedded in the articles of the GATS he shows how this trade treaty both threatens to further commercialize South Africa’s already highly skewed health care system and also to undermine the redistributional thrust of the long-awaited National Health Act passed in 2004.”
—From the foreword by David Sanders.