The clock is ticking. Asian countries are under pressure to sacrifice public health interests to get final agreement on a trade deal. The Trans-Pacific Partnership (TPP), which is being negotiated between the US and 11 other Pacific Rim nations — including Malaysia, Singapore, Brunei, Japan and Vietnam — is on track to become the most harmful trade pact ever for access to low-cost medicines in developing countries.
Last month, the US Congress gave US President Barack Obama “fast track” powers on any deal, which means the TPP is now being pushed toward a rapid conclusion. The fight is not over yet. There is still a chance for all countries in the negotiation — including developing countries like Malaysia, Vietnam, Mexico and Peru — to reject damaging intellectual property (IP) provisions as negotiators meet in Hawaii. Governments paying for treatment programs, both directly and by funding global health initiatives, should prioritize public health in the negotiations.
The talks have been shrouded in secrecy, but thanks to leaked drafts, the public has knowledge about the US proposals for some sections of the deal. What was revealed was the inclusion of dangerous provisions that would dismantle public health safeguards enshrined in international law and lengthen and strengthen patents and other monopolies for pharmaceutical companies. The TPP deal on the table grants pharmaceutical firms longer term and stronger monopoly protections on high-priced medicines for diseases such as HIV/AIDS, tuberculosis (TB), hepatitis C, cancer and others. It will keep the production of generic medicines at bay and lifesaving medicines out of reach for the poorest people.
In the field of health, generic competition saves lives. Doctors working for the international humanitarian organization Medecins Sans Frontieres (Doctors Without Borders) have seen how the availability of low-cost quality medicines and vaccines is important to treat and prevent a wide variety of diseases, including TB, malaria, HIV/AIDS and other infections that afflict the poorest and most vulnerable populations.
While the US has proposed “transition” periods for some of its demands to some developing countries in the negotiations, this is just a form of fool’s gold. Certain exemptions that could be offered to countries such as Malaysia, Peru, Vietnam and Mexico only delay the implementation of some, but not all, harmful provisions and would still undermine access to low-cost versions of life-saving medicines in the long term.
With the conclusion of the TPP trade deal near, another trade deal is being negotiated that also threatens the public health landscape in Asia. The Regional Comprehensive Economic Partnership (RCEP) is a trade deal that replicates the US IP proposal and is being hammered out among all 10 ASEAN members and its six free-trade agreement (FTA) partners — China, India, Japan, South Korea, Australia and New Zealand — basically covering almost half of the global population. The leaked RCEP draft texts on IP tabled by Japan and South Korea are drafted along the lines of the TPP.
RCEP negotiations on IP are at a standoff, with India and ASEAN unwilling to trade away health by adopting IP provisions that protect patents more rigidly than the rules of the WTO. Many developing countries in the RCEP negotiations have already demonstrated leadership to safeguard public health. The Philippines and India have implemented safeguards in their national patent laws to limit “evergreening” — a tactic that pharmaceutical firms use to keep drugs under monopoly for longer periods. Malaysia, Indonesia and Thailand have also issued compulsory licenses to ensure procurement of generic medicines at competitive prices for HIV, heart disease and cancer.
The TPP and RCEP — mega trade deals in the Asian region — mutually reinforce the most harmful IP provisions and extend them across Asia. If trade deals that promote abuse of the patent system are endorsed, the public health gains these countries have fought hard for in the past decades will be undermined. Governments will have less ability to take legal action to try to ensure that medicines are accessible to everyone in need. For countries with high rates of hepatitis C, namely the Philippines, Malaysia, India, China and Myanmar, promoting generic competition is the best opportunity to make treatment — costing in the US as much as US$1,000 per pill — and other vital drugs and vaccines accessible and affordable to treat and prevent diseases that take thousands of lives each year in Asia and beyond.
Governments have both an interest and responsibility to ensure that new roadblocks are not introduced in the way of lifesaving, affordable medicines. They must make a stand on behalf of millions of people before the TPP deal is sealed and sets a new, low standard for those other trade deals on the horizon.
Maria Guevara is the Medecins Sans Frontieres regional humanitarian representative for ASEAN.
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