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Global Health Econ Sustain Imports of essential medical products

(v) Medical vehicles and furniture (e.g., ambulances); in the destination country, and the wealth of the buyer
(vi) Protective garments (e.g., face masks, eye protection, country are the main drivers of the trade under study.
gloves, and other personal protective equipment); Furthermore, after analyzing the trade in masks and other
(vii) Medical consumables (e.g., soap, wadding, gauze, medical equipment, Fuchs et al. (2020) demonstrated that
bandages, and cotton sticks). having economic ties with the Asian country is the main
determinant of buyer countries to import these products.
All of these refer to final products and do not include
the raw materials and intermediate goods needed for their Focusing on trade policies, Evenett et al. (2020)
manufacture. The leaders in the global trade in products that identified a surge in trade policy activism between
require more advanced technology, such as medical devices, February and March 2020, alongside the rise in COVID-
are large, vertically-integrated multinational companies 19 cases, and found marked heterogeneity among
headquartered in highly-developed industrial economies countries in terms of the type of measures imposed and
such as the United States, Germany, Switzerland, the how they were implemented. In the same vein, Hoekman
Netherlands, and the United Kingdom, and with production et al. (2021) concluded that the application of export
facilities around the world (OECD, 2020b). However, the restrictions on medical products is strongly correlated
segment of the least technologically sophisticated products, with the characteristics of prevailing public procurement
such as protective garments, is more often outsourced to regimes, based on the analysis of the relationship between
third-party suppliers, usually in developing countries such public procurement regimes and trade policies during the
as Indonesia or Malaysia, with the guarantee of direct first 6 months of the pandemic. Likewise, Curran et al.
oversight and regulatory certification to ensure quality (2021) focused their study on the scope and nature of trade
requirements are met (Bamber et al., 2020). policy and its possible compatibility with existing World
Trade Organization (WTO) agreements. Their results
The rest of the article is organized as follows: Section revealed that the globalizing process taking place in recent
2 offers a review of the literature on the trade in medical decades has slowed down due to the continual political
goods, as well as the impact of COVID-19 on these interventions and the growing trade tensions. According
products. Section 3 explains the estimation methodology to a study that assessed the impact of restrictions imposed
used and the variables included in the proposed model. by Malaysia on imports of medical supplies, Ayub (2020)
Section 4 details the main results of the study. Finally, argued that trade policies should be used as an instrument
Section 5 summarizes the most important conclusions to support public health and that any restrictions standing
drawn from the research. in the way of this should be eliminated.
2. Literature review and conceptual Another relevant perspective is the focus on global value
framework chains (GVCs), which have been the subject of numerous
studies seeking to shed light on the scarcity of medical
2.1. Literature review supplies, providing information that could help decision-
COVID-19 has sparked the interest of the scientific makers (Park et al., 2020; Grumiller & Grohs, 2021). Dallas
community, giving rise to studies focusing on almost et al. (2021) identified the interactions between the type
all spheres of interest, from more general areas such as of state intervention and two structural characteristics of
GVCs: the geographical distribution of production and the
environmental effects (Zambrano-Monserrate et al., attributes of the product. By so doing, they demonstrated
2020; Casado-Aranda et al., 2021), the economic impact the mutual constraints of states and GVCs and revealed
(Hossain, 2021; Pham et al., 2021) or food security (Marti the major role played by structural factors. However,
et al., 2021; Bukari et al., 2022; Marchetti and Secondi, there is no universally agreed line of action to be taken.
2022), to more specific areas such as education (Chertoff While some countries call for greater intervention to
et al., 2020; Sintema, 2020) or the health of children prevent excessive outsourcing and the consequent foreign
(Roberton et al., 2020; Duan et al., 2020). Likewise, dependency, others applaud GVCs for their flexibility,
the trade in goods that are essential for combatting the blaming leaders for undermining the operations defined
pandemic has been analyzed from various perspectives in the GVCs. Studies such as those by Evenett (2020b) and
(Baldwin & Tomiura, 2020; Evenett, 2020a; Vickers & Ali, Gopalakrishnan et al. (2020) assessed state intervention in
2020; Barua, 2020; Hayakawa & Imai, 2021). medical product GVCs by conducting comparative analyses

As the main supplier of medical products, China has of France, Germany, the United Kingdom and the United
been the focus of numerous studies. Shaker (2020) applies States, and the Commonwealth countries, respectively.
an econometric model to analyze the determinants of its Vickers & Salamat (2020) mapped out supply chains,
exports, concluding that aging population, infection rates analyzing major exporters and importers and assessing

Volume 1 Issue 2 (2023) 3 https://doi.org/10.36922/ghes.1207