TRADE, INVESTMENT AND COMPETITIVENESS TRADE, INVESTMENT AND COMPETITIVENESS EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT COVID-19-Era Trade Policy Interventions Affecting Medical Goods: Form, Frequency, Duration, and Scale. March 2022 Author: Simon J. Evenett © 2022 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. 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Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2625; e-mail: pubrights@worldbank.org. Cover design and layout: Diego Catto / www.diegocatto.com >>> Abstract Drawing upon the findings of several trade policy surveillance initiatives, an account is presented here of government resort to trade restrictions and reforms affecting medical goods during the COVID-19 pandemic. Some nations mustered effective public health responses early in the pandemic without resorting to trade restrictions. Some other governments quickly reversed export restrictions once their adverse side effects became evident. However, another group of nations have removed COVID-19 trade restrictions very slowly, if at all. These findings challenge the assumption that existing multilateral rules effectively regulate the crisis-era application of general exceptions to non-discrimination norms for goods trade. While the logic of those exceptions is to prevent multilateral trade obligations impeding public health responses, the COVID-19 pandemic has shown that these flawed rules on exceptions have attenuated the contribution of cross-border trade to pandemic response, in particular in those developing countries that source much medical goods from abroad. Simon J. Evenett: Professor of International Trade and Economic Development, University of St. Gallen, Switzerland, and Founder of the St. Gallen Endowment for Prosperity Through Trade, the institutional home of the Essential Goods monitoring initiative (EGI), the Global Trade Alert (GTA), and the Digital Policy Alert (DPA). Thanks to Fernando Martin Espejo, Apolline Duclaux, and André Brotto Reigado for assembling the charts and statistics found in this paper. Thanks are also due to Simon Neumueller for supplying the latest World Trade Organization (WTO) information on export restrictions and to his colleagues for their cooperation. Comments from Jen Brant, Michele Ruta, Bob Wolfe, and Alan Wolff on an earlier draft were gratefully received. Further comments are welcome and can be sent to the author at simon.evenett@sgept.org. Contents I. Introduction 5 II. Monitoring of trade policy choice affecting medical goods 7 Resort to trade policy measures on medical goods: Findings from five III. 11 approaches to monitoring IV. Subsidy and local preference policies affecting the medical goods sector 14 V. Policy implications 16 References 19 Annex A: Structured comparisons of the quantum of trade policy intervention in force reported by five different approaches to COVID-19 pandemic-era monitoring 28 on medical goods. I. Introduction Although first and foremost a public health calamity, in a highly integrated world trading system that the COVID-19 pandemic had implications for unilateral trade policy and trade relations between governments was, in retrospect, unsurprising. The uncertain scale, severity, and duration of this pandemic plus the imperative of sourcing needed medical supplies to overcome short-lived domestic shortages played their part in shaping government resort to trade restrictions and reforms on medical goods. It appears that dozens of members of the World Trade Organization (WTO) availed themselves of general exceptions to non-discrimination principles1 found in multilateral trade accords.2 For some trade diplomats, COVID-19 was a public health crisis and the best the way for the world trading system to serve humanity was to get out of the way of national policymakers. This view aligns with the traditional view of general exceptions to the General Agreement on Tariffs and Trade (GATT), namely, that non-discrimination principles can be abandoned when some compelling societal imperative arises (Jackson 1989). Advocates of this perspective soon received a brutal tutorial on the consequences of unilateral trade restrictions in an era of extensive cross-border supply chains (Evenett 2021a, Forini et al. 2020, Gereffi 2020, Mirodout 2020). The very flexibility allowed for under the general exceptions to the GATT became a threat to public health at home and abroad, in particular to those developing countries heavily dependent on sourcing medical goods from trading partners (Bown 2020). Rather than taking trade policy out of contention, resort to GATT general exceptions exacerbated trade tensions among governments. These tensions were to worsen when export curbs were applied to shipments of COVID-19 vaccines and accusations of “vaccine nationalism” arose. The fallout from the unilateral free-for-all in trade policy is that a major debate has arisen at the WTO over the legitimacy and application of its rules on intellectual property. A set of rules allowing for exceptions to multilateral trade norms faced a system-wide stress test. The COVID-19 pandemic presented another challenge to the world trading system, this time in the monitoring of trade policy responses. While two years into the pandemic it is possible to write the previous paragraph with a good sense of trade policy choices of governments, in the 1 The principal departure documented in the monitoring exercises reported in this paper are those from the long-established principle of National Treatment. 2 This is not the only interpretation of the facts presented here. As one reviewer of an earlier draft of this paper noted “I do not think that WTO Members availed themselves of exceptions so much as ignored the WTO entirely.” EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 5 first quarter of 2020, official monitoring of resort to commercial The remainder of this background note is organized as policies affecting medical goods was limited, at best. The follows. Since getting the facts on the table is the first order absence of high-quality information about the trade policy of business, the next section describes three initiatives—two choices made by trading partners may have added to fears official and one undertaken independently of governments— and reinforced the rush towards export curbs on personal that sought to monitor trade policy responses affecting medical protective equipment (PPE), other medical consumables, and goods during the COVID-19 pandemic. Relevant similarities medical equipment such as ventilators. and differences across these initiatives are highlighted as they may have a bearing upon how readers interpret the results In these circumstances, it is appropriate to take stock of the that follow. trade reforms and restrictions governments put in place from the first quarter of 2020, when the horror of COVID-19 was The third section of this paper is devoted to reporting what recognized, and the World Health Organization declared a actually happened to trade policy towards medical products pandemic. Drawing on several initiatives to track trade policy from the start of 2020. The form, frequency, duration, and scale responses relating to COVID-19-related medical goods of four broad classes of trade policy intervention are described (including relevant vaccines and ingredients), the purpose of in some detail. In this section can be found the answers to the this background paper is to present an account of the form, questions posed two paragraphs above. frequency, duration, and scale of such policy intervention. Given the interest in government measures to support current This analysis seeks to answer the following questions: How and future production of medical goods, the fourth section many governments resorted to trade policy changes on provides global statistics on the resort to subsidy awards in this COVID-19 medical goods? What was the balance between sector as well as measures taken to increase local sourcing of resort to trade reforms and trade restrictions? Did any of medical goods, whether by the private or public sectors. the governments considered to have mustered an effective public health response to COVID-19 manage to do so without The last section of the paper returns to the fundamental resorting to export curbs? What value of cross-border trade question of whether multilateral trade norms should shape in medical goods was potentially covered by trade reforms national responses to systemic crises and whether the and by trade restrictions? How did the trade policy response postwar formulation that emphasizes flexibilities (a much-used change over time? How “temporary” were trade restrictions euphemism) is still fit for purpose. Has the web of cross-border imposed under the general exceptions of the GATT? Is there commercial linkages reached the stage where flexibility does likely to be permanent or at long-lasting scarring of cross- more harm than good? Some thoughts are offered, then, on border trade in medical goods? the potential reform of relevant multilateral trade rules. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 6 II. Monitoring of trade policy choice affecting medical goods High quality information is a public good and typically there are weak incentives to provide such goods. Those incentives are further attenuated in the case of trade policy since the parties being tracked—governments—are, at best, of two minds on the wisdom of being monitored. Many WTO members recognize the systemic value of transparency but are all too aware of the advantages of designing and executing trade policy intervention in ways to avoid the attention of domestic actors and trading partners (Kono 2006). States can slow down the publication, sharing/notification, and verification of relevant documentation, frustrating attempts to track policy intervention. Self-censorship by officials at international organizations cannot be ruled out either. Multi-year budgetary support for sustained information collection may be difficult to secure. Academics and researchers are under such pressure to publish that, by and large, they contend that they cannot afford to spend the time collecting information; instead, they prefer to download data. The upshot is that few are ready to bear the high entry and recurring fixed costs of sustained information collection and some of the initiatives start fizzle out. Another consequence of limited information collection is that few understand the competencies required and the scale of the investments needed to undertake effective trade policy surveillance—making it even harder to sell such projects to senior management of organizations (be they national governments, international organizations, foundations or, for that matter, universities.) Consequently, there are compelling incentives-based arguments as why the world trading system is systematically starved of relevant trade policy information. Moreover, many officials have developed coping mechanisms for operating with limited trade policy intelligence. Agnotology is too prevalent. It should be no surprise then that, at the time the COVID-19 pandemic hit, no international organization had the core competencies in place that could be deployed quickly and effectively to monitor the pandemic-related trade policy responses of governments. Given the salience of COVID-19, this situation could not stand. At first, the World Customs Organization (WCO) began publishing lists of customs territories imposing trade policy changes—mainly export curbs—on medical consumables and on medical equipment. The WCO’s monitoring was soon wound up and attention shifted to trade policy information collected by the International Trade Centre (ITC) and made available by the WTO Secretariat. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 7 As part of its MACMAP initiative, ITC began tracking what it contains a total of 288 current and lapsed export restrictions referred to as the temporary imposition of COVID-19-related on medical goods. The two files were combined and trade measures. Changes in import and export policies were duplicates of measures were removed yielding a database of documented and posted online in the form of a table. As of 513 COVID-19 era trade policy interventions affecting medical 11 February 2022, that table included 398 entries, each goods, of which 335 were implemented on or after 1 January representing a policy intervention affecting cross-border trade 2020.5 in either food or medical goods. Measures are classified as either trade “restrictive” or trade “liberalizing.” Moreover, The international public sector did not monopolize information measures are deemed “active” or “terminated.” To the best collection on trade policy intervention at this critical juncture. of our knowledge, during the COVID-19 era the ITC has not A third initiative, undertaken by the independent St. Gallen issued periodic reports specifically addressing trade policy Endowment for Prosperity Through Trade, was initiated in the changes affecting so-called essential goods. first quarter of 2020 and then, in cooperation with the European University Institute and the World Bank, became known as the For its part, the WTO initiated several COVID-19-related Essential Goods monitoring initiative (EGI).6 The EGI releases surveillance initiatives, one of which covered trade in goods monthly information gathered on trade policy steps affecting and is relevant to this discussion.3 The WTO Secretariat COVID-19-related medical goods,7 food, and fertilizer. produces periodic reports on trade policy measures affecting medical goods (the latest being published in October 2021). In what follows, the discussion focuses on the set of medical These reports are based on information on relevant trade goods monitored. Unlike the ITC and WTO initiatives, the policy changes notified by WTO member governments or EGI defined the set of goods that it would track, identified the where a WTO member has verified information found by the relevant HS codes, and published that list in a methodology Secretariat. On the relevant webpage, the Secretariat states: document at its inception.8 “The below list has been compiled by the The EGI uses web crawling tools to systematically check and WTO Secretariat from official sources. identify potentially relevant policy interventions mentioned It is not exhaustive. The list and the on government websites, the websites of international information contained therein is an informal organizations, and in major media outlets. In this manner, situation report and an attempt to provide “leads” are identified and then processed, whereby pertinent transparency with respect to trade and information on the trade policy intervention is documented. trade-related measures taken in the context That information included the implementing jurisdiction; of the COVID-19 crisis. The list of measures the type of policy intervention; dates associated with the does not pass judgment on or question announcement; the implementation and, where relevant, the right of WTO members to take such removal of the intervention; the source for the lead; and actions and it does not alter the current whether the policy intervention facilitated or restricted trade. long-standing practice of the WTO Trade Such information was checked by three trade policy analysts Monitoring Exercise of verifying information before being published. and measures with members.”4 Each lead is then further investigated by a member of the Associated with the list mentioned is an Excel file which, as Global Trade Alert (GTA) team for possible inclusion in the of 26 November 2021, contained information on 347 trade GTA database. The latter requires meeting seven conditions, policy interventions affecting food or medicines implemented which are detailed in the GTA Handbook (Evenett and Fritz by 102 customs territories. A separate file of export restrictions 2020). When a lead in the EGI initiative met the standard for supplied by the WTO Secretariat on 18 February 2022 publication in the GTA database, where documenting policy 3 These initiatives are part of a wider program of activities by the WTO Secretariat to inform member governments of pertinent COVID-19 medicine-related initiatives, both policy-related and supply chain-related. To this end, the WTO Secretariat has actively engaged with leading pertinent private sector actors. For an overview of such ac- tivities, see https://www.wto.org/english/news_e/news22_e/nama_28jan22_e.htm. Bob Wolfe is to be thanked for the reminder that the WTO’s monitoring of trade policy intervention for medical goods supports a broader process of deliberation and learning by diplomats appointed to permanent delegations to the WTO. 4 More generally, after what was regarded rightly, both internally and externally, as a slow start, the WTO Secretariat has produced a series of papers outlining various as- pects relating to the documentation of trade and trade policy changes relating to medical goods. Of particular relevance here are the observations in WTO (2021) relating to (a) which products should be designated COVID-19-related for the purposes of monitoring and (b) the appropriate level of aggregation to be employed in scaling the amount of trade involved. The same document calls for greater cooperation and coordination on these matters between governments and relevant international organizations. 5 To make the charts strictly comparable across policy monitoring exercises, only in-scope trade policy interventions that came into effect on or after 1 January 2020 were included. Some of the information on policy interventions supplied by the WTO Secretariat related to trade policy acts that took place before 1 January 2020. 6 See Evenett et al. (2021) for an early analysis of the contents of the EGI database. 7 Here, medical goods include medical consumables (such as PPE), medical equipment (such as ventilators), medicines, and COVID-19 vaccines and related distribution items (such as syringes). 8 This methodology document can be downloaded in the files available at https://www.globaltradealert.org/reports/54. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 8 interventions using official sources is at a premium,9 then the monitors mentioned so far collected information on trade entry in the EGI database was replaced by the information policy changes affecting upstream parts, components, medical published in the GTA database. ingredients, and the like. As more information is collected about a trade policy Fortunately, the product coverage of the GTA database goes intervention affecting medical goods, its status in the EGI beyond the medical goods that are covered by the EGI initiative database may change. An entry in the EGI database may and includes so-called biologics. The latter are typically taken initially be supported by a non-official source. However, to be a full range of finished products, intermediate goods, should further investigation of a lead reveal an official source and equipment for different COVID-19-relevant health to support the entry, then the latter source replaces the non- technology categories. Combining information on trade policy official source in the EGI database. Yet further investigation interventions on final medical goods and biologics may shed may uncover sufficient additional information that the entry more light on the totality of state action along relevant supply becomes eligible for inclusion in the GTA database. Therefore, chains. A list of such goods and their HS codes can be found there is a hierarchy in the EGI database. Broadly speaking, the in Innovation Council (2020). highest quality entries in the EGI database are also entries in the GTA database. Entries based on official sources are next For the purposes of this paper, an augmented products list in terms of quality and are seen as superior to those based on comprising EGI medical goods and biologics was created and non-official sources. the resulting database of trade policy intervention is referred to here as EGI+. A total of 808 distinct trade policy interventions At present, the EGI database contains 836 entries relating are contained in the EGI+ monitor. to distinct import or export policy changes undertaken since 1 January 2020 that affect medical goods. Of those 836 Table 1 compares the attributes of the ITC, WTO, EGI, GTA-, entries, 698 met the higher standard to be published in the and EGI+ trade policy surveillance initiatives. The former two GTA database. A further 37 entries in the EGI database are monitors are official, the latter three are not. The latter three sufficiently well documented that at the time of writing they are deliberately designed so that the GTA- monitor here for are being considered for publication in the GTA database. medical goods is a subset of the EGI monitor and, in turn, the Official documentation has been found to support another 27 EGI monitor is a subset of the EGI+ monitor. Comparing the entries in the EGI database.10 This leaves 74 entries in the EGI results of the EGI monitor with those of the GTA- monitor will database that are currently supported by non-official sources. show whether the higher quality entries in the EGI database differ much from the other entries. Comparing the results of As some readers may be interested in the information on trade the EGI and EGI+ monitors will reveal whether expanding the policy changes contained in the entries in the EGI database scope of monitoring to include upstream biologics materially that are also contained in the GTA database, in what follows the affects the findings. “GTA-”11 monitor refers to those 698 trade policy interventions that have met the demanding standards for publication in the Inevitably, tables such as the one below will invite comparisons GTA database. across the five surveillance options.12 In this regard, it is worth noting that Hoekman (2021) includes a systematic One salient feature of trade policy deliberation and analysis comparison of the trade policy information collected as part during the COVID-19 pandemic relates to the contribution of of the WTO and EGI initiatives. It is also worth noting how cross-border supply chains and the potential for trade policy similar the percentages are in the last row of Table 1—all five intervention upstream to disrupt the production and distribution monitors considered here find similar mixes of liberalizing (or of downstream goods. Even though many pertinent medical trade facilitative) and trade restrictive policy intervention.13 goods are produced in such supply chains, none of the 9 More than 97 percent of entries in the GTA database are supported by official documentation or by information supplied by companies that they are legally mandated to supply truthfully. 10 In addition, recall the statistic in footnote 4. 11 The minus sign in GTA- indicates that the resulting sample of trade policy intervention is a (tiny) subset of the entire GTA database, which now contains information on more than 43,000 commercial policy interventions. 12 The annex to this background paper provides one set of apples-for-apples comparisons on the quantum of trade policy changes affecting medical goods documented by the five monitors considered here. 13 Although the mix reported by the WTO Secretariat tilts more towards trade restrictive measures implemented on or after 1 January 2020. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 9 > > > TA B L E 1 . A Comparison of the Five Monitors of Trade Policy Interventions Affecting Medical Goods Monitor Attribute ITC WTO EGI GTA EGI+ Official monitor? Yes Yes No No No Yes (same medical Medical goods covered Yes (medical goods list Yes (same medical Not evident Not evident goods as EGI plus list of specified ex ante? defined) goods list as EGI) published biologics) Traditional import policy Traditional import policy Traditional import policy, & export policies, trade Policy interventions & export policies, trade export policies, trade facilitation measures, Same as EGI Same as EGI covered by monitor facilitation measures, facilitation measures, SPS, TBT, VAT policy and VAT policy changes and VAT policy changes changes Notifications and Official national As EGI but excludes As EGI but excludes Sourcing of information verification of measures sources, some entries that do not meet entries that do not meet Unknown by monitor found by WTO notifications to WTO, the GTA’s 7 rules for the GTA’s 7 rules for secretari-at few media sources publication publication Sources provided for No Yes Yes Yes Yes every entry? Documentation Not evident Yes Yes Yes Yes available online? Latest published update 11/02/2022 26/11/2021 16/02/2022 16/02/2022 18/02/2022 Number of recorded 398 335 836 698 808 pol-icy interventions Percent of recorded 48.0 40.2 51.6 51.9 52.6 interventions liberalizing Note: Table assembled 24 February 2022. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 10 III. Resort to trade policy measures on medical goods: Findings from five approaches to monitoring Since the trade policy measures relating to medical goods evolved over time, one useful way of obtaining a global perspective on the overall resort to relevant trade policy intervention is, for each of the five approaches to monitoring and for each type of policy intervention, to report (a) the total number of measures in force at any point in time from 1 January 2020 and (b) the total number of customs territories responsible for imposing those trade measures at any point in time. As the pandemic unfolded over time, this approach enables readers to see changes in the total number of trade policy interventions in force and the number of countries responsible for them. However, it is important to stress that the health, trade-related, and other impacts of trade policy interventions can differ markedly, even within the same class of trade policy intervention. For example, it may be easier to replace shipments of PPE blocked due to the export controls of a trading partner with domestic production than to replace shipments of COVID-19 vaccines, which are produced in only a small number of nations.14 Figures 1-5 portray graphically the findings for (a), differentiating between measures that (i) facilitate imports of medical goods, (ii) restrict imports of medical goods, (iii) curb exports of medical goods, and (iv) remove export restrictions on medical goods. Collectively these four trade policy intervention types are referred as to as border-related trade policies. Figures 6-10 portray graphically the findings for (b), again differentiating among the four types of policy interventions. 14 Many thanks to Alan Wolff for making this important point. In short, counts of policy intervention—a metric long used by the WTO Secretariat and consequently adopted by independent monitors of trade policy—only tell part of the story. Indeed, this is why trade coverage statistics are also reported in this background paper. After a few more years, applied econometricians may have enough data to be able to confidently estimate the effects of different trade policy interventions during the pandemic. Of course, it is regrettable that more international trade economists have not been able to contribute analyses of the effects of trade policy interventions on COVID-19 medical goods while the pandemic unfolded. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 11 The following findings are gleaned when comparing across 4. The maximum recorded number of relaxed export the four trade policy intervention types and the five monitors restrictions for medical goods in force is 18. considered here: 1. Since the pandemic began, in general15 more import That some of these totals remain so high may come as a reforms affecting medical goods have been introduced surprise given the supposedly temporary nature of COVID-19 and remain in force than any other form of border-related trade policy measures. Figure 11 sheds light on this matter trade policy considered here. as it reports the statistics on the number of days that each 2. So long as trade in biologics is excluded, in general16 class of border-related trade policy intervention affecting export curbs were the second most used trade policy medical goods have been in force. Very few of those policy intervention since the onset of the pandemic. interventions currently in force are less than 90 days old. In 3. Liberalization of export curbs was the least used of the fact, 157 of the import reforms enacted since the start of the border-related trade policies considered here. pandemic have been in force for more than one year. A total 4. All monitors reveal that the number of import reforms of 109 export restrictions put in place on medical goods have and export curbs in force surged in the first and second lasted longer than one year. Left unchanged, these findings quarters of 2020. presage a permanent change in the trade policy treatment of 5. The total number of frequently used trade policies medical goods. affecting medical goods recorded by the official monitors peaked in the second quarter of 2020. The comparable Counts of policy interventions have their uses—indeed totals recorded by the unofficial monitors kept on rising international organizations started the practice of reporting through 2021. such totals more than a decade ago—but some may prefer 6. Official monitors recorded fewer import restrictions than estimates of the total amount of trade potentially affected unofficial monitors and the latter show that the total number by commercial policy changes. Where HS codes can be of such restrictions in force steadily grew over time. attached to trade policy interventions affecting medical 7. Throughout the pandemic, official monitors recorded goods, it is possible to estimate the total value of trade that is fewer trade policy interventions in force than the unofficial potentially covered.17 monitors. 8. When trade in biologics are included (along with the Since the pandemic was declared in early 2020, to avoid the downstream medical products), by the start of 2022, the traditional endogeneity problem, it is standard to use pre-2020 total number of import restrictions in force overtakes the trade flows to estimate the trade covered. Doing so makes total number of export curbs in place. the most sense when demand patterns are stable. However, 9. The total number of customs territories responsible for the demand for medical goods surged once the scale and nature recorded waves of trade policy changes affecting medical of the COVID-19 pandemic became known. The consequence goods surges in the first and second quarters of 2020. then is that the trade coverage estimates reported here— 10. The total number of customs territories responsible for which are based on recorded 2019 UN COMTRADE trade each type of trade policy intervention considered here data—almost certainly understate the total value of trade stops falling in 2021. covered. This caveat should be born in mind when interpreting the following results. The following findings provide a sense of the situation now (February 2022): Recall that the EGI monitor includes published GTA interventions 1. The maximum recorded number of import reforms that affect medical goods. The GTA team conservatively tags for medical goods in force is 244 (219 if biologics are commercial policy interventions affecting trade in goods with excluded). the relevant HS codes. It is therefore possible to extract from 2. The maximum recorded number of export curbs on the EGI those border policy interventions implemented since medical goods in force is 138. 1 January 2020 where HS codes have been assigned. Taking 3. The maximum recorded number of import restrictions on steps to ensure that no bilateral trade flow in any medical medical goods in force is 114 (88 if biologics are excluded). good is double counted, it is then possible to calculate at any 15 The WTO monitoring exercise is the only one to suggest the contrary. 16 The WTO monitoring exercise is the only one to suggest the contrary. 17 For the purposes of what follows policy interventions were tagged with the six-digit HS codes for the medical products implicated. While 8-, 10-, and 12-digit HS codes exist in some jurisdictions, they are not standardized across jurisdictions so those seeking a global perspective are confined to using the six-digit HS codes for the purposes of estimating trade coverage. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 12 point in time the total value of trade covered by each policy of trade coverage then the findings change markedly for the intervention type (i)-(iv). total value covered by import restrictions and import-related facilitative measures (compare the findings of Figueres 12 Figure 12 reports the estimates of the changing trade and 13). The trade covered by import reforms now peaks a coverage throughout the pandemic based on the EGI monitor. year later than in Figure 12, that is, in the fourth quarter of The trade covered by import reforms affecting medical goods 2021. That dozens of import reforms lapsed at the end of 2021 peaked in the fourth quarter of 2020 at $137 billon and has accounts for the fact that as of February 2022, the total trade subsequently fallen back to $105 billion (reflecting the fact covered by import reforms has fallen back to $181 billion. that some temporary import reforms on medical goods have lapsed). In contrast, the trade covered by export curbs on The inclusion of biologics in the trade coverage calculations medical goods peaked in the third quarter of 2021 at $103 doubles the estimates relating to import curbs. As Figure 13 billion and has fallen back only slightly to $98 billion. The trade shows, the total trade covered by import restrictions rises covered by import curbs on medical goods has grown over progressively over time and now stands at $202 billion. time but has never exceeded $30 billion. One consequence In fact, once upstream biologics are taken into account of these findings is that in February 2022 the total amount of the trade covered by import restrictions eventually exceeds medical goods covered by trade restrictions likely exceeds the that covered by import reforms. Should more import reforms trade covered by trade reforms. lapse, then the disparity between the trade covered by facilitative and restrictive measures is likely to grow even Recall that the EGI monitor does not include trade in upstream greater going forward. biologics. Once those goods are included in the calculation EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 13 IV. Subsidy and local preference policies affecting the medical goods sector The border-related trade policy changes discussed earlier should be put in context. For many years, governments have taken steps to favor local producers of medical goods and associated parts and components. Such discrimination can take many forms, including (a) sectoral or firm-specific subsidies, (b) government procurement policies that privilege local suppliers, and (c) policies requiring local sourcing, the hiring of locally qualified staff, and other localization measures. Information on such policy interventions undertaken since November 2008 has been collected by the GTA team. Figure 14 shows year-by-year the total number of subsidy, public procurement, and localization measures found to favor local firms in the medical goods sector. A total of 3,305 instances of such favoritism have been recorded, all of which have been implemented.18 Of that total, the vast majority (2,650) are subsidy awards to commercial operators in the medical goods sector.19 On top of this, 569 changes to public procurement regulations or law have been found that favor local suppliers of medical goods by state bodies. Figure 14 reveals that the total number of instances of favoritism was rising in the years before the COVID-19 pandemic. Having written this, more than 600 instances of favoritism using these three policy instruments were recorded in 2020. One important finding revealed by Figure 14 is that ever since the global financial crisis, there has been an increase in the number of subsidies awarded to producers of medical goods. The three-year moving average rises from 84 awards for the years 2009-11 to 265 awards in the three years before the pandemic (2017-19) and further increases to 363 awards (for the years 2019-21). 18 Again, the caution mentioned earlier concerning the drawbacks of inferences based on counts of policy intervention applies here, potentially with greater force. Any cross-border commercial harm done by the award of subsidies to producers and distributors of medical goods needs to be considered alongside any compelling evidence that the subsidy was necessary, properly designed, properly executed, and that envisaged public health benefits actually ensued directly as a result of the subsidy. Those genuinely concerned about effective climate change policies sometimes worry about the “greenwashing” of subsidies. Surely a parallel concern exists here for those seri- ous about tackling national, regional, and global public health threats. 19 To be clear, subsidies to medical service providers, such as hospitals, are not included in this total. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 14 To put this four-fold increase in the number of subsidy awards financial grants, 78 took the form of state loans, 27 involved to the medical sector in perspective, consider the following: tax or social insurance relief on imported medical goods, 25 over the same time frame the total number of subsidies involved loan guarantees, and 10 were production subsidies. recorded each year in the GTA database rose just under 150 percent. The faster growth in recorded subsidies to the In terms of the types of medical goods receiving state medical sector is not a pandemic-era phenomenon: annual support, bearing in mind that a subsidy may be given to a firm subsidy awards had more than tripled in the medical sector operating in more than one line of business relating to medical before the pandemic hit, whereas they had risen 71 percent goods,22 then from 1 January 2020 until the time of writing: when all sectors of the economy are considered.20 45 percent of subsidy awards23 were received by medical equipment producers (such as manufacturers of ventilators), A week-by-week breakdown of the total number of subsidies 62 percent were received by makers of medical supplies (such in effect since the start of 2020 is provided in Figure 15. This as PPE), another 45 percent were received by firms involved figure excludes 383 firm-specific subsidies awarded in China in discovering or producing medicines, including vaccines, to publicly-listed firms where the calendar year in which a and 71 percent of all specific subsidy awarded decisions financial grant was received is known but the exact date of the benefited firms involved in some type of biologics production. subsidy receipt is unavailable. A total of 330 subsidies to firms Therefore, during the pandemic era, state resources were engaged commercially in the medical goods sectors have made available along the entire production chain of COVID- been documented ex-China, and state resources have been 19-related medical goods. provided in the following ways, among others:21 99 involved 20 While it is flattering to surmise that the GTA team has gotten better at documenting policy interventions over time, productivity improvements of the scale necessary to account for the higher number of recorded subsidy interventions in the medical sector are unlikely in what is, after all, a service sector activity. 21 In 79 cases, non-standard forms of state aid were provided, often in conjunction with a government procurement contract. 22 This explains why the percentages that follow do not add up to 100 percent. 23 So that there is no confusion, these percentages relate to the number of subsidy awards and not to the amount of state resources transferred to the private sector. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 15 V. Policy implications Once the scale of the COVID-19 pandemic became evident in the second quarter of 2020 several initiatives to track trade policy interventions affecting medical goods were launched. Three endured with two official monitors being complemented by a tracker implemented independently of governments. Arguably, all three trackers informed policy deliberation by governments and were covered extensively in the media. The purpose of this background note is to compare and contrast the findings of these trackers as they relate to import and export policy changes implicating medical goods. While the design and execution of these monitors differed in important respects, as the discussion in this paper has shown, there were several common findings. Perhaps the most important is that not every nation felt compelled to restrict exports of medical consumables and equipment soon after the pandemic was declared. For sure, some economies did not produce these goods so there may have been few exports to ban. However, other countries were able to marshal effective public health responses to COVID-19 in the first three quarters of 2020 without restricting exports of domestically produced medical goods. Australia, Canada, and Japan are cases in point.24 Curbing exports was not a prerequisite for mounting an effective public health response to COVID-19. Another common finding is that many trade restrictions on medical goods will need to be unwound if pre-pandemic trading conditions in this sector are to be restored. Many of the import and export curbs have already lasted more than one year. This factual finding goes against the injunction that the exceptional use of trade restrictions should be temporary. Evidently, many governments have not been convinced to remove exceptional measures. This concern has greater force in nations where the COVID-19 pandemic is getting under control. That many governments liberalized trade in medical goods during the pandemic is promising and the question arises as to whether this represents a permanent trade facilitative shift in the political economy of trade policy in this sensitive sector. There must be some doubts on this score as shown by lapse of dozens of import reforms at the start of this year (see the jump in the solid blue lines in Figures 3-5 at the beginning of 2022). 24 That being said, early in the COVID-19 pandemic, Australia did ban the non-commercial export of PPE and hand sanitizer. Note that this measure specifically excluded cross-border delivery by Australian producers of these products. Furthermore, in November 2020, Canada took measures to prevent the export of certain drugs—which implies that for the first eight months of COVID-19, that nation’s government was able to manage their public health response without resorting to export curbs. That said, Canada did not contribute to the wave of export curbs implemented in the first two quarters of 2020. There is no record of any Japanese export curbs on medical goods being put in place. Information on policy changes mentioned in this footnote can be found in both the WTO and EGI inventories of trade policy intervention. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 16 One oversight in ITC, WTO, and EGI trade policy surveillance reversed: WTO rules on exceptions need to be rewritten so is the omission of certain biologics from monitoring. The that zealous public health officials don’t prevent cross-border inclusion of a wider range of finished products, intermediate commerce making its contribution to crisis response. The fact goods, and equipment for different COVID-19-relevant health that countries faced COVID-19 waves at different times meant technology categories has two important policy implications. that the ramped-up production of medical goods could—if First, that the total number of recorded import restrictions rises trade was unimpeded—be shipped to where it was needed considerably. And, second, that the trade covered by import most. Cross-border trade of medical goods made a significant and export policy changes undertaken during the COVID-19 positive contribution to the public health response to the era multiplies. For more than a decade, analysts and officials COVID-19 pandemic. at international organizations have recognized the importance of global value chains, yet such cross-border linkages have not Finally, there is plenty of room for further analysis and been taken fully into account in the trade policy surveillance of deliberation based on the findings of this paper.26 Some COVID 19-related medical goods. This oversight can be fixed. important questions were not asked here. For example, are the shortcomings in trade policy transparency at the national These findings have two implications for multilateral trade level and notifications at the multilateral level associated cooperation during times of systemic stress. The first is that with some governments more than others?27 If so, what steps should be taken to ensure that “temporary means factors account for observed differences across governments temporary.” That is, WTO members invoking exceptions to in transparency towards commercial policy interventions raise trade barriers in emergencies should time-limit their affecting medical goods during the COVID-19 pandemic? trade policy interventions, ideally to six months. Should Were those governments that were less transparent about the emergency persist, then trade restrictions may be renewed trade policy interventions affecting pandemic-era medical for up to another six months. Otherwise, those measures goods the ones that traditionally have frustrated national and should lapse. In short, it should be agreed among WTO multilateral transparency initiatives? members that such trade restrictions lapse unless expressly and publicly extended.25 A related question is whether the provision of relevant trade policy information by governments to the WTO and other The second implication is deeper. The logic underpinning international organizations slowed down or whether the the invocation of exceptions to multilateral trade rules is that cadence of such provision is best thought of as occurring in trade policy must not get in the way of governments seeking occasional bursts followed by longer lulls? A further question to protect human life from unanticipated threats, be they is the extent to which notifications of trade policy intervention national or systematic, or health-related, environmental, or at the multilateral level can be complemented by information economic-related. This logic must be challenged in light of obtained from official national and sub-national websites? developments over the past two years. Evidence shows that Could direct sourcing of information from the latter official eschewing export curbs did not prevent several nations from sources generate a steadier stream of information relevant for mustering an effective public health response. What lessons multilateral trade policy deliberation? are there from these nations? Indeed, does their experience beg the following question: Must an effective, activist state Other institutional matters arise as well. As far as detecting discriminate against foreign commercial interests? (Evenett and recording relevant trade policy information is concerned 2021b). during crises, given the underinvestment in this global public good, the relative merits of partnerships between Moreover, in some cases, governments regretted their different monitors—both official and independent—should reflexive resort to export curbs once it became clear that be actively considered. The comparative advantages and cross-border supply chains of medical goods were being core competencies (such as they are) of the different types of disrupted. If anything, the logic mentioned earlier should be monitor should be explored and the incentives to sustain them 25 It says much about the current absence of a collaborative spirit among delegations to the WTO that even modest proposals such as these could not be agreed during the “Walker process” in the run up to the planned WTO Ministerial Conference in December 2021 (that was ultimately postponed). Since then, the Walker process has been put on a “strategic pause” (whatever that means). In fairness, dozens of WTO members have called for the WTO monitoring function to be strengthened (see, for example, the latest call by WTO members to that end, WTO (2022), signed by Albania; Argentina; Australia; Brazil; Brunei Darussalam; Canada; Chile; Colombia; Costa Rica; Dominica; Dominican Republic; Ecuador; El Salvador; European Union; Guatemala; Honduras; Hong Kong SAR, China; Iceland; Israel; Japan; Kazakhstan; Kenya; Republic of Ko- rea; Kuwait; Lao People’s Democratic Republic; Liechtenstein; Mexico; Moldova; Mongolia; Montenegro; Morocco; New Zealand; Norway; Panama; Paraguay; Peru; the Philippines; Qatar; Singapore; Switzerland; The Separate Customs Territory of Taiwan, Penghu, Kinmen and Matsu; Thailand; Turkey; Ukraine; United Kingdom; Uruguay and Vanuatu.) 26 Alan Wolff is to be thanked for encouraging the addition of some reflections on where future research and collaboration could be usefully developed. 27 See Hoekman (2020) for a valuable and initial assessment of this matter. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 17 once the COVID-19 pandemic is over given consideration. file at the WTO over the past two years, one might conclude Whether those incentives are strengthened or attenuated by that there are limits to the payoff from collecting comprehensive the potential transfer of technology and know-how between and high-quality information. If so, understanding why this is monitors is a topic worth exploring as well. so is critical. One hypothesis is that the agnotology mentioned earlier is alive and kicking as the multilateral trading system A deeper, fundamental question relates to purpose served continues its post-Enlightenment trajectory. by information collection on trade policy changes undertaken by governments during national and systemic emergencies. Another hypothesis is that enough governments are so keen Is the purpose of such collection to affect national (or in the on preserving flexibility during systemic crises that they are case of the European Union, supranational) policymaking not ready to contemplate even incremental steps towards directly or indirectly, possibly through media reporting, enhanced inter-government cooperation. The deeper point is expert commentary, or by empowering certain lobbies with to better understand the relative contributions of high-quality critical information? information, logic, interests, fear, and suspicion to trade policymaking in extremis. For the reality is that trade rules and Or is the purpose to inform the development of new multilateral trade policy surveillance need to be designed for both ordinary norms and disciplines? If it is the latter then, given the and extraordinary times. regrettably little progress made on the trade and public health EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 18 References Bown, C. 2020. “EU limits on medical gear exports put poor countries and Europeans at risk,” PIIE Trade and Investment Policy Watch, Peterson Institute. Evenett, S., and J. Fritz. 2020. GTA Handbook. Available at: https://www.globaltradealert.org/ data_extraction Evenett, S. 2021a. “Chinese Whispers: COVID-19, Global Supply Chains in Essential Goods, and Public Policy,” Journal of International Business Policy, 3(4): 408–29. Evenett, S. 2021b. “Must an effective activist state harm trading partners? “ In F. Graafsma and J. Cornelis (eds.) The International Trade Law Review. Seventh Edition. The Law Reviews. Evenett, S., M. Fiorini, J. Fritz, B. Hoekman, P. Lukaszuk, N. Rocha, M. Ruta, F. Santi, and A. Shingal. 2021. “Trade Policy Responses to the COVID-19 pandemic crisis: A New Dataset,” The World Economy. Forini, M., B Hoekman, and A Yildirim. 2020 “COVID-19: Expanding access to essential supplies in a value chain world” in R. Baldwin and S. Evenett (eds.) COVID-19 and Trade Policy: Why Turning Inward Won’t Work. CEPR Press. Gereffi, G. 2020. “What does the COVID-19 pandemic teach us about global value chains? The case of medical supplies,” Journal of International Business Policy, 3(3): 287–301. Hoekman, B. 2020. “COVID-19 trade policy measures, G20 declarations and WTO reform.” Chapter 6 in S. Evenett and R. Baldwin (eds). Revitalising Multilateralism Pragmatic Ideas for the New WTO Director-General. CEPR Press. October. Jackson, J. 1989. The World Trading System. MIT Press. First edition. Innovation Council 2020. “Bio-Pharmaceutical Manufacturing and R&D: The Impact of Policy Coherence in Trade Policy.” Geneva. Kono, D. 2006. “Optimal Obfuscation: Democracy and Trade Policy Transparency.” American Political Science Review, 100(3): 369–84. Mirodout, S. 2020. “Reshaping the policy debate on the implications of COVID-19 for global supply chains,” Journal of International Business Policy, 3(4): 430–42. WTO (World Trade Organization). 2021. “Improving Trade Data for Products Essential to Fight COVID-19: A Possible Way Forward.” 1 July. WTO (World Trade Organization). 2022. “Statement of Immediate Action to Support the Multilateral Trading System in Preparation for a Successful MC 12.” General Council. WT/ GC/W/841/Rev.3. 7 March. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 19 > > > FIGURE 1. ITC evidence on frequency of trade policy intervention affecting medical goods. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 133 Number of active Covid-19 trade-related policies 102 104 100 62 50 16 16 3 3 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: ITC > > > F I G U R E 2 . WTO evidence on frequency of trade policy intervention affecting medical goods. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 100 98 Number of active Covid-19 trade-related policies 75 79 50 25 17 13 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Authors calculation based on WTO data EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 20 > > > F I G U R E 3 . EGI evidence on frequency of trade policy intervention affecting medical goods. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 250 242 219 Number of active Covid-19 trade-related policies 200 150 147 138 100 88 88 50 18 18 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert > > > F I G U R E 4 . GTA- evidence on frequency of trade policy intervention affecting medical goods. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 214 200 Number of active Covid-19 trade-related policies 184 150 120 108 100 74 74 50 13 13 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 21 > > > F I G U R E 5 . EGI+ evidence on frequency of trade policy intervention affecting medical goods. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 250 242 219 Number of active Covid-19 trade-related policies 200 150 147 138 100 88 88 50 18 18 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert > > > F I G U R E 6 . ITC evidence on number of countries responsible for trade policy intervention affecting medical goods. Number of nations responsible for new trade policies imposed since 1 January 2020 90 75 74 Number of countries with active COVID-19 trade-related policies 60 50 45 25 15 15 0 1 1 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: ITC EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 22 > > > F I G U R E 7. WTO evidence on number of countries responsible for trade policy intervention affecting medical goods. Number of nations responsible for new trade policies imposed since 1 January 2020 56 49 Number of countries with active COVID-19 trade-related policies 40 20 16 10 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Authours calculation based on WTO data > > > F I G U R E 8 . EGI evidence on number of countries responsible for trade policy intervention affecting medical goods. Number of nations responsible for new trade policies imposed since 1 January 2020 80 80 72 63 Number of countries with active COVID-19 trade-related policies 60 52 40 24 24 20 13 13 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 23 > > > F I G U R E 9 . GTA- evidence on number of countries responsible for trade policy intervention affecting medical goods. Number of nations responsible for new trade policies imposed since 1 January 2020 68 66 60 52 Number of countries with active COVID-19 trade-related policies 42 40 20 18 18 10 10 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert > > > F I G U R E 1 0 . EGI+ evidence on number of countries responsible for trade policy intervention affecting medical goods. Number of nations responsible for new trade policies imposed since 1 January 2020 200 98 84 79 75 Number of countries with active COVID-19 trade-related policies 64 63 62 50 25 27 10 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 24 > > > F I G U R E 1 1 . As more time passes, it looks as Milton Friedman was right. “Temporary” trade policy interventions effectively become permanent. Duration of currently active COVID-19 policies Status as of 18 February 2022 Up to 30 days 90 days 365 days More Medical sector Export curbs 0 1 27 109 Export reforms 0 0 4 14 Import cubs 0 6 26 56 Import reforms 1 12 49 157 Source: Global Trade Alert, March 2022 release EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 25 > > > F I G U R E 1 2 . EGI estimates of the value of trade covered by trade policy intervention types. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 Amount trade covered by Covid-19 trade-related policies (USD million) 137,271 105,184 100,000 103,140 98,634 50,000 24,853 27,754 761 727 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert > > > F I G U R E 1 3 . EGI+ estimates of the value of trade covered by trade policy intervention types. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 Amount trade covered by Covid-19 trade-related policies (USD million) 202,972 202,215 200,000 202,215 181,884 150,000 112,400 100,923 100,000 50,000 5,977 5,977 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 Liberalising import Restrictive import Liberalising export Restrictive export reforms curbs reforms curbs Source: Global Trade Alert EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 26 > > > F I G U R E 1 4 . Governments favoritism towards the medical goods sector predates the pandemic. Build-up of new trade policies in force in COVID-19 medical goods sectors since 1 January 2020 Amount trade covered by Covid-19 trade-related policies (USD million) 16 600 59 5 58 400 13 8 42 107 3 14 3 40 200 6 10 8 49 4 1 36 10 5 42 0 37 45 34 68 86 98 106 145 152 305 193 195 212 389 545 156 0 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Localisation measures Public procurement measures Inward subsidies Source: Global Trade Alert > > > F I G U R E 1 5 . Weekly breakdown of subsidy policy interventions affecting medical goods since the onset of the COVID-19 pandemic, ex-China. 275 Cumulative number of sobsidies in force worldwide ex-China 250 225 200 175 150 125 100 75 50 25 0 2020-01-01 2020-04-01 2020-07-01 2020-10-01 2021-01-01 2021-04-01 2021-07-01 2021-10-01 2022-01-01 2022-03-13 Source: Global Trade Alert EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 27 A ANNEX Structured comparisons of the quantum of trade policy intervention in force reported by five different approaches to COVID-19 pandemic- era monitoring on medical goods. EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 28 > > > ANNEX FIGURE 1. A comparison across monitors of the total number of import reforms in force from the start of the pandemic. Total number of liberalising import reforms in force on a given month 200 Number of interventions 100 0 2020-01 2020-07 2121-01 2021-07 2022-01 EGI GTA EGI plus ITC WTO > > > ANNEX FIGURE 2. A comparison across monitors of the total number of import restrictions in force from the start of the pandemic. Total number of restrictive export curbs in force on a given month 150 100 Number of interventions 50 0 2020-01 2020-07 2121-01 2021-07 2022-01 EGI GTA EGI plus ITC WTO EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 29 > > > ANNEX FIGURE 3. A comparison across monitors of the total number of export controls in force from the start of the pandemic. Total number of restrictive export curbs in force on a given month 150 100 Number of interventions 50 0 2020-01 2020-07 2121-01 2021-07 2022-01 EGI GTA EGI plus ITC WTO > > > ANNEX FIGURE 4. A comparison across monitors of the total number of export reforms in force from the start of the pandemic. Total number of liberalising export reforms in force on a given month 15 Number of interventions 10 5 0 2020-01 2020-07 2121-01 2021-07 2022-01 EGI GTA EGI plus ITC WTO EQUITABLE GROWTH, FINANCE & INSTITUTIONS INSIGHT <<< 30