International investment liberalization, transnational corporations and NCD prevention policy non-decisions: a realist review on the political economy of tobacco, alcohol and ultra-processed food Milsom, P, Smith, R, Baker, Phillip and Walls, H 2021, International investment liberalization, transnational corporations and NCD prevention policy non-decisions: a realist review on the political economy of tobacco, alcohol and ultra-processed food, Globalization and Health, vol. 17, no. 1, pp. 1-19, doi: 10.1186/s12992-021-00784-3. Attached Files Name Description MIMEType Size Downloads Title International investment liberalization, transnational corporations and NCD prevention policy non-decisions: a realist review on the political economy of tobacco, alcohol and ultra-processed food Author(s) Milsom, P Smith, R Baker, Phillip orcid.org/0000-0002-0802-2349 Walls, H Journal name Globalization and Health Volume number 17 Issue number 1 Article ID ARTN 134 Start page 1 End page 19 Total pages 19 Publisher BMC Place of publication London, Eng. Publication date 2021 ISSN 1744-8603 1744-8603 Keyword(s) AGREEMENTS AUSTRALIA CHALLENGES Foreign investment FRAMEWORK Investment liberalization Life Sciences & Biomedicine Non-communicable diseases NONCOMMUNICABLE DISEASES NUTRITION Political economy of health Public, Environmental & Occupational Health PUBLIC-HEALTH Regulatory chill Science & Technology STATE DISPUTE SETTLEMENT TRADE-POLICY TRANS-PACIFIC PARTNERSHIP Summary Abstract Background Public health concerns relating to international investment liberalization have centred on the potential for investor-state dispute settlement (ISDS)-related regulatory chill. However, the broader political and economic dimensions that shape the relationship between the international investment regime and non-communicable disease (NCD) policy development have been less well explored. This review aimed to synthesise the available evidence using a political economy approach, to understand why, how and under what conditions transnational corporations may use the international investment regime to promote NCD prevention policy non-decisions. Main body Methods: Mechanisms explaining why/how the international investment regime may be used by transnational health-harmful commodity corporations (THCCs) to encourage NCD prevention policy non-decisions, including regulatory chill, were iteratively developed. Six databases and relevant grey literature was searched, and evidence was extracted, synthesized and mapped against the various proposed explanatory mechanisms. Findings: Eighty-nine sources were included. THCCs may be incentivised to use the ISDS mechanism since the costs may be outweighed by the benefits of even just delaying regulatory adoption, particularly since the chilling effect tends to ripple out across jurisdictions. Drivers of regulatory chill may include ambiguity in treaty terms, inconsistency in arbitral rulings, potential arbitrator bias and the high cost of arbitration. Evidence indicates ISDS can delay policy adoption both within the country directly involved but also in other jurisdictions. Additionally, governments are adopting standard assessments of public health regulatory proposals for trade and ISDS risk. Various economic, political and industry-related factors likely interact to increase (or decrease) the ultimate risk of regulatory chill. Some evidence indicates that THCCs take advantage of governments’ prioritization of foreign investment over NCD prevention objectives to influence the NCD prevention regulatory environment. Conclusions While ISDS-related regulatory chill is a real risk under certain conditions, international investment-related NCD prevention policy non-decisions driven by broader political economy dynamics may well be more widespread and impactful on NCD regulatory environments. There is therefore a clear need to expand the research agenda on investment liberalization and NCD policy beyond regulatory chill and engage with theories and approaches from international relations and political science, including political economy and power analyses. Language eng DOI 10.1186/s12992-021-00784-3 Indigenous content off Field of Research 1117 Public Health and Health Services HERDC Research category C1 Refereed article in a scholarly journal Free to Read? 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