Trading away our health

Posted on March 16, 2015 in Health Policy Context – Full Comment
March 16, 2015.   Stephen Cornish

Last week, behind closed doors in a hotel in Hawaii, negotiators from a dozen countries met to continue negotiations on a trade agreement that will affect an estimated 800-million people and 40% of the global economy: the Trans-Pacific Partnership (TPP).

The negotiations, which began in 2010 between Canada, the United States and 10 other Pacific Rim countries, are being conducted without opportunity for public scrutiny. Currently, U.S. President Barack Obama is asking Congress to grant him the authority to fast-track the TPP without amendments from lawmakers.

Of the many issues at stake, the implications are especially critical for ensuring affordable health care and access to medicines for the millions of people in developing countries where Doctors Without Borders works and also for Canadians.

We know from leaks of the TPP draft text that some governments are attempting to dismantle public-health safeguards enshrined in international law by extending the length of time that brand-name medicines are protected by patents to create new types of monopolistic protection. As a result, pharmaceutical companies will be able to charge unduly high prices for several more years, thereby restricting access to affordable life-saving generic medicines. This will disproportionately affect those who can least afford to pay.

We know that the best way to reduce these high drug prices and improve access to treatment is through generic competition

Currently, in the poorest countries and even at the lowest global price available, the cost of immunizing a child using World Health Organization recommended vaccines has risen a colossal 6,700% since 2001. The stricter intellectual property rules under negotiation in the TPP will only further limit competition, keep prices artificially high and keep vaccines out of reach.

We know that the best way to reduce these high drug prices and improve access to treatment is through generic competition. In fact, everyone from ministries of health to medical humanitarian organizations such as Doctors Without Borders and donor-supported global health institutions rely on affordable, quality generic medicines for 85% of their health programming. Yet certain provisions proposed by the U.S. and other countries in the TPP could greatly limit the reach and effectiveness of these programs, thereby diverting badly needed resources away from patient care.

Canada supports many important global health programs but the effectiveness of this support is at risk. This year, Canada contributed $500 million to the replenishment of the Gavi Vaccine Alliance’s fund. Canada is also one of the leading donors to the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has provided antiretroviral therapy to more than six-million people living with HIV in developing countries.

In addition, Canada provides international assistance to five of the 12 TPP-negotiating countries, amounting to more than $83 million in 2012 and 2013. Two countries involved in the TPP negotiations, Vietnam and Peru, are also on Canada’s “Development Countries of Focus” list, due to an even greater need for development assistance. If harmful provisions in the TPP are accepted, driving up the cost of medicines and vaccines, the impact of this use of Canadian taxpayers’ money could be seriously diminished.

Canada and other countries are opposing some of the most harmful provisions in the agreement

Access to affordable medicines could also become a major concern in Canada. Drug expenditures in this country have been the fastest growing sector of health spending in the last 25 years. Since the mid-1980s, prescription drug spending has more than doubled, costing $27.7 billion in 2012. If Canada does not strongly reject the new protections proposed in the TPP, these expenditures could cost our health-care systems, and all Canadians, billions more per year.

Thankfully, a version of the TPP text leaked in 2013 shows that Canada and other countries are opposing some of the most harmful provisions in the agreement. As the negotiations are nearing an end, countries will be under immense pressure to reach a deal. Canada has a humanitarian duty to resist that pressure and to stand up to the U.S. and others who would seek to benefit their pharmaceutical industries through the TPP negotiations, at the expense of poor countries and of Canadians.

More than 32,000 Canadians have already signed a petition at calling on Canada to stand up for public health. Together we must ensure the TPP does not undermine access to affordable drugs, whether here in Canada or around the world.

When it comes to access to medicines, it is imperative that Canada does not give in and trade away our health.

Stephen Cornish is executive director of Doctors Without Borders Canada.

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