Author: Paul Cawthorne, Asia's Access Campaign Coordinator for Médecins Sans Frontières/Doctors Without Borders (MSF).
This week in Singapore, behind closed doors, government negotiators from 11 Pacific Rim countries meet for the 16th round of negotiations of the Trans-Pacific Partnership (TPP) trade agreement.
The talks ended in Singapore yesterday (Wednesday) and the next round will be held in Peru in May.
This round is a critical week for Singapore and others currently at the negotiation table to make a stand on behalf of millions of people – by rejecting damaging provisions proposed by the US government that could endanger access to life-saving affordable medicines.
US negotiators are proposing a package of contentious provisions in the intellectual property (IP), investment and pharmaceutical pricing chapters of the agreement.
One of the most disturbing demands is that TPP countries accept provisions that would grant US pharmaceutical firms longer-term and stronger monopoly protections on high-priced medicines for diseases such as HIV/AIDS, cancer, and others.
In practice, a 20-year patent is granted to a new brand-name drug usually developed by a pharmaceutical company, meaning no other companies may produce and sell the substance during that period. But, once the patent’s life expires, it is qualified for production as a generic medicine – which is of the same quality but will be sold at a much cheaper price compared to the brand-name drug.
Take HIV: the availability of generic medicines has brought the price of treatment down by 99 per cent, from over US$10,000 per person per year just over a decade ago, to just US$120 today.
These prices have made it possible for eight million people in developing countries to be on treatment today; and for international organisations like the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR (the US government-backed HIV initiative) to reach many more people. Generic medicines account well over 80 per cent of their purchases.
However, there is a US-proposed provision in the TPP talks that would restrict countries’ ability to decide what kind of innovations actually deserve to be patented, lower the criteria for issuing patents, and force governments to grant additional 20-year patents on existing medicines – even on modifications that do not offer any therapeutic benefits to patients.
If all these damaging provisions are allowed to get their way into the agreement, the TPP could severely hurt developing countries’ access to essential medicines.
Essentially, this could keep the cheaper generic drugs away from the market longer and would directly impact TPP member countries: Singapore, Malaysia, Australia, Brunei, Canada, Chile, Mexico, New Zealand, Peru, the United States and Vietnam.
The partnership is meanwhile poised for expansion to include member nations of the Asia-Pacific Economic Cooperation (APEC) that have expressed their interest. Thailand is in the process of joining up, and Japan and the Philippines are actively considering it.
Even more worryingly, US negotiators have said the TPP will be the template for future US trade pacts across the globe.
This implies that many more developing countries with serious health needs will be sucked in to an agreement that does real damage to their already ailing public health systems.
As a medical humanitarian organisation providing treatment in more than 70 countries, Médecins Sans Frontières/Doctors Without Borders (MSF) is gravely concerned about the impact of the agreement on the lives of millions of people in developing countries.
Working at the front line, MSF has seen too many people having already died needlessly because the medicines they need are too expensive or do not exist.
This is one of the issues that have driven MSF to providing medical assistance to countries that cannot cope with their deteriorating health situation and whose governments are overstretched or have little capacity to provide vital life-saving health programmes.
We want that to stop, and one of the solutions has been the cost-effective generic drugs which have made such a difference to lives and the health of people throughout Asia.
TPP governments paying for treatment programmes, either directly or by funding global health initiatives, must not exchange certain damage to public health interests for the possible economic benefits of the agreement.
Governments have both an interest and a responsibility to ensure that new roadblocks are not put in the way of lifesaving affordable medicines. Otherwise, they risk jeopardizing the effectiveness of the very programmes they support.
This article originally appeared in the Straits Times on 14 March 2013.