Trade, Power, and Public Health: A Political Economy Analysis of Thailand’s CPTPP Negotiation Process

Background The Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) has generated intense debate in Thailand, particularly concerning its implications for public health, intellectual property rights, and access to medicines. Thailand undertook an extended in-country process to provide evidence on its economic opportunity and public health challenges for the cabinet decision during 2018–2022. However, there is no evidence indicating whether Thailand has decided to join the CPTPP. This study examines Thailand’s CPTPP negotiation process using a political economy framework, focusing on the institutional and actor landscape that shaped the negotiations. Methods This study employed a qualitative research design grounded in political economy theory, integrating state-centred and power-centred analytical frameworks. Data collection comprised a document review and in-depth interviews with 31 stakeholders from the health and trade sectors. Results The findings demonstrate that both state and non-state actors played influential roles in shaping public discourse and decision-making. The Ministry of Commerce emerged as the lead negotiating authority, while the health sector’s influence remained limited despite its active engagement. Key stakeholder concerns centred on pharmaceutical access, plant variety protection, and medical device regulatory standards. Conclusion The study highlights the need for stronger institutional mechanisms to promote inclusive stakeholder participation and greater policy coherence between trade and public health objectives in future trade negotiations.