India has sought collaboration between WTO member countries for increased use of telemedicine services to deal with future pandemics by addressing regulatory barriers and expanding its cross-border supply.

“Deliberation on lessons learnt and sharing of best practices and experiences by the membership can help build effective solutions for bridging the divide in digital capabilities and addressing regulatory barriers that prevent the expansion of cross-border supply of telemedicine services,” per a submission on the ‘Role of Telemedicine Services in Response to the Pandemic’ made by India to the WTO Council on Trade in Services.

The Council on Trade in Services is scheduled to meet on March 9 to discuss various proposals and suggestions by members on furthering the objectives of the General Agreement on Trade in Services (GATS) at the WTO.

At present, the bulk of global trade in health/medical services takes places either through patients travelling to other countries (Mode 2) or commercial presence of an establishment abroad (Mode 3), the paper pointed out.

“Given the pandemic situation, Mode 2 and Mode 4 (when service providers travel across borders) that require movement of people are likely to be largely paralysed. Mode 3 may not be helpful on account of global contraction in FDI during such crisis, its dependence on Mode 4 ,and the initial time needed to set up commercial presence. Cross-border trade in medical services (Mode 1) is, thus, the most suitable mode in pandemic like situations,” it said.

This will not only expand trade of health services during and after the pandemic, but also allow countries to benefit from the positive spill overs of building crucial digital infrastructure, the paper added.

WTO data shows that during the pandemic there was a sharp increase in trade through Mode 1 (which includes telemedicine). “According to WTO estimates, global trade in medical services fell in 2020 with trade through Mode 2 and Mode 4 falling sharply, trade through Mode 3 remaining resilient and trade through Mode 1 (cross border supply) soaring by 14 per cent,” said the submission.

While cross-border trade in telemedicine services has gathered momentum, it remains underdeveloped, it pointed out

Citing examples of countries engaging in telemedicine services, the submission pointed out that such services, including tele diagnostic, surveillance and consultation, are being provided by US hospitals in many Gulf countries and some countries in Central America. Telepathology services are being provided by Indian doctors to hospitals in Nepal and Bangladesh, while teleradiology services by Indian radiologists are being provided to US hospitals. Chinese hospitals, too, provide tele diagnostic services to patients in Chinese Taipei; Macau, China; and some South East Asian countries.

India proposed that WTO members need to assess the challenges and opportunities for expanding telemedicine services and take the necessary steps required. Information could be shared on what domestic programs, policies or regulations have been or are being put in place by various members and what trade facilitating measures have been  taken to promote cross-border trade in telemedicine services, the paper added.

It further suggested that the role Digital Public Infrastructures (DPIs) could play in facilitating technology transfer and promoting digital delivery of health services also needs to be looked into.

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