The Trans-Pacific Partnership: A Danger to Public Health
This year, 12 different countries have been involved in negotiations on the terms of the Trans-Pacific Partnership (TPP), a huge and very secretive free trade agreement between a cluster of nations in the Asia-Pacific region and the Americas that together account for roughly 40% of the world’s GDP and 26% of the world’s trade respectively. Talks began in 2005 between Singapore, Chile, New Zealand and Brunei; this persisted until the US took the lead in brokering the negotiations in 2009. Today the TPP consists of Australia, Brunei, Malaysia, Mexico, New Zealand, Canada, Peru, Singapore, Vietnam, Japan, the US and Chile. It contains 29 chapters covering a host of topics, ranging from financial services to telecommunication, food safety and standards, and is expected to eliminate tariffs and other barriers on goods and services while standardizing regulations and laws between partner countries. Due to the secretive nature of the negotiations, much of what is known about the TPP has been acquired through documents leaked by sources such as Wikileaks. What has been released has experts and scholars concerned about the public health implications of the TTP. Medecins Sans Frontieres has even called it “the most harmful trade pact ever for access to medicine”.
Generic brand competition in pharmaceuticals is extremely important for health, especially for people in developing countries. Without it, the poorest populations that often need the drugs most cannot afford the high prices that patent holding pharmaceutical companies charge. For instance, fifteen years ago antiretroviral therapy (ART) drugs used to treat HIV/AIDs cost over $10,000 per person per year. Millions died each year, not because medicine was unavailable, but because they couldn’t pay. Eventually, a strong marketplace for generic ARTs and increased drug production in developing countries (80% of ARTs used in the developing world are currently produced in India) reduced the price by 99%. Looking forward, a lack of competition for new drugs can cause serious problems in fields such as cancer treatment, where new drugs routinely cost over $100,000 per person.
Previous trade agreements, such as the Korea Free Trade Agreement, have had detrimental effects on public health and access to medicine, leading former President Bush to repeal parts of it. The TPP has the potential to be much more damaging due to its extensive patent protections. Pharmaceutical and medical devices companies would receive 20 years of patent protection which could then be extended a further 20 years for any changes to product and indefinite amount of times. So if a drug was intended for one purpose and another use was found or the delivery method was changed a new patent could be created. The TPP would also require surgical techniques, medical tests and treatments to be patented, thereby widening the gap in available medical treatment.
Another dangerous TPP provision is the Investor-State Dispute Resolution system. It seeks to provide a mechanism for investor parties to directly sue governments for not abiding by terms of agreement. The agreement is very far reaching, and includes legislation that will hamper food safety and environmental regulations, all the while making any government attempts to create competition in the drug market result in legal action if a corporation believes it is being treated unfairly. Some of the highly-ranking public health systems in the world, like Japan and Australia’s, would be bankrupted by the increased prices. Furthermore, they could be sued for their regulation of health insurance prices and profits; companies that consider their treatment unfair could allow outside companies to enter TPP countries and demand access and looser restrictions.
From a public health standpoint the power this affords to tobacco companies is extremely troubling. Tobacco was originally meant to be an exception to many of the TPP’s stipulations. This meant that restricting its importation and sale as well as imposing regulations on cigarette branding and advertisement practices were still legal. However, at some point during the negotiations the US began to advocate for the rights of tobacco companies to sue governments and undermine health regulations in foreign tribunals. A similar case is currently pending between tobacco company Philip Morris and Uruguay over graphic anti-smoking packaging based on a 1991 trade agreement. With a decrease of smoking in the US, tobacco companies are hoping to find new markets in the developing world and flood them with their products. Tobacco’s highly addictive and harmful nature makes it one of the single most important preventable causes of death in the world. Under the TPP, tobacco companies could use legal methods to undermine any attempts by public health agencies to curb youth smoking, leaving developing countries simply unable to afford the price tag associated with the legal backlash of challenging the tobacco industry.
The Trans-Pacific Partnership has been billed as a model agreement for the countries in the Asian-Pacific region and even the world. In reality, it has very serious and very far reaching implications. The current status of the agreement would ignore government’s responsibility to ensure their peoples’ public health interests and the third-world citizens’ right to access their cure by destroying the legal framework intended to guard public health all in the name of commercial interest. Restricting access to vital medicine and increasing the power of tobacco companies will quite literally result in the deaths of millions.