This analysis examines the impact of trade agreements on global health governance amid rising multilateralism challenges.
The current trend of growing state disengagement from global governance institutions—seen as a threat to the World Health Organization—is not unfamiliar to the World Trade Organization (WTO). Over the past two decades, multilateral trade negotiation channels have increasingly given way to more selective partnerships, built around preferential alliances and strategic markets outside established global platforms. These alliances have taken shape through Regional Trade Agreements (RTAs)—treaties negotiated outside the WTO umbrella between two or more countries that facilitate trade and economic integration between them. 1 Between 2015 and 2022, the number of RTAs in force rose from 290 to 385, both through major blocs—already formalized in large-scale regional trade integration, such as the European Union—and through bilateral arrangements between individual states or regional markets. 2 Examples include, among others, the Comprehensive and Progressive Agreement for Trans-Pacific Partnership, recently expanded to twelve countries with the accession of the UK, and the new UK-India free trade agreement.
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Filho et al. (2026) studied this question.
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