2007年開始談判的跨太平洋夥伴協定（Trans-Pacific Partnership Agreement，簡稱TPP）終於在2015年10月正式結束。此協定據說是截至目前為止最鉅型的「區域」自由貿易協定（regional free trade agreement），因為其含括了跨越太平洋兩岸的眾多國家，被稱為「新世代」、「高品質」的自由貿易協定。我國於2016年初的總統大選後再次政黨輪替，在選戰過程中難得朝野兩黨對於台灣加入TPP有著共識，雙方所持的論點大致是經濟發展的利益：避免台灣在國際經貿整合趨勢下被邊緣化。當時我國是否真正能加入TPP尚在未定之天，最樂觀的估算也還有一至兩年的時間。然而，2016年年底美國總統選舉結果卻對此發展投下震撼彈。目前多數的觀察家皆認為TPP在美國總統宣布退出談判之後已經被宣判死刑。

對我國而言，雖然失去了加入區域性貿易架構的機會，不過，政府的壓力及民間的疑慮可以暫時解除。然而這並不能單純地看待為塞翁失馬，其理由為：首先，美國雖自TPP抽身，並不表示它棄絕自由貿易，而是轉向雙邊貿易協商。美國為我國重要貿易與戰略伙伴，目前與美方的經貿溝通管道為台美投資貿易架構協定（TIFA），我國政府屢次提出升級成台美雙邊投資協定（BIA）的宣示。然而這對我方並非較佳的選擇，因為與美國一對一談判，我國的優勢並不多。其次，TPP這項多邊（或說區域）自由貿易協定雖標榜具有新的特質，不過其章節內容仍然一再出現各類貿易協商過程中的舊議題，例如智慧財產保護、動植物檢疫防疫、技術性貿易障礙及貿易爭端解決等，我國依舊必須持續面對這些問題，因此，有沒有加入TPP並不會有所改變。最後，貿易自由化的浪潮仍將持續向前發展，在美國強勢重返雙邊貿易協定的大趨勢下，我國政府應重新思考並致力兼顧經貿發展與保障人民健康。

After years of negotiation, 12 countries signed the Trans-Pacific Partnership Agreement in October 2015. The TPP agreement was described as mega regional free trade agreement and promoted as a ＂high quality,＂ ＂new era＂ trade pact. Over the years, Taiwan showed its desire to join the TPP and lobbied for support from the US administration. However, newly-elected US president Donald Trump abandoned the agreement and shifted toward bilateral free trade. Taiwan was left with no choice but to focus on revitalizing its economic ties with the US. This paper examines the contents of the TPP to identify its implications for public health in Taiwan and explores the consequences for Taiwan of the US decision to withdraw from the TPP. The study finds that, firstly, the TPP would have a profound impact on the health sector in Taiwan. Secondly, the contents of the TPP agreement raised concerns about its impacts on public health and a bilateral free trade agreement would involve similar problems. Under the existing US-Taiwan bilateral trade relationship, the government of Taiwan has already constantly been pushed by the US on health-related issues, such as intellectual property rights for medicines and food safety standards. For Taiwan, the tension between trade and protecting citizens' health will persist, with or without the TPP.

跨太平洋夥伴協定（TPP）;自由貿易協定;健康影響;公衛政策

Trans-Pacific Partnership Agreement (TPP); Bilateral Free Trade Agreement; Health Impact; Public Health Policy