Monday, May 11, 2015
Health Affairs Blog
May 8, 2015
The Trans-Pacific Partnership: A Threat To Global Health?
By Deane Marchbein, President of the Doctors Without Borders USA Board
Lost in the political discussions over the passage of the Trans-Pacific
Partnership (TPP)—a trade agreement currently being negotiated in secret
between the U.S. and 11 other Pacific-Rim nations—is the very real
negative impact it would have on global health.
Doctors Without Borders/Médecins Sans Frontières (MSF) works in over 60
countries, and our medical teams rely on access to affordable medicines
and vaccines. We are deeply concerned that the TPP, in its current form,
will lock-in high, unsustainable drug prices, block or delay the
availability of affordable generic medicines, and price millions of
people out of much-needed medical care.
The public health repercussions of this deal could be massive. The
negotiating countries represent at least 700 million people, and U.S.
negotiators refer to the TPP as a "blueprint" for future trade deals.
The TPP attempts to rewrite existing global trade rules and would
dismantle legal flexibilities and protections afforded for public health.
We have concerns with several U.S. government demands in the TPP. For
example, the TPP would lower the standard for patentability of
medicines. It would force TPP governments to grant pharmaceutical
companies additional patents for changes to existing medicines, even
when the changes provide no therapeutic benefit to patients. These
provisions would facilitate "evergreening" and other forms of abuse of
the patent system by lengthening monopolies and delaying access to
Another concerning provision in the TPP involves so-called "data
exclusivity" for biologics, a new class of medicines that includes
vaccines and drugs used for cancer and multiple sclerosis treatment.
Data exclusivity blocks competing firms from using previously generated
clinical trial data to gain approval for generic versions of these drugs
and vaccines. If pharmaceutical companies have their way, the TPP will
block generic producers of biologics from entering the market for at
least 12 years, during which patients would be forced to endure
Twelve years of data exclusivity is not only unprecedented in any trade
agreement, it is not the law in any of the TPP negotiating countries
outside of the U.S., and it would keep lifesaving medicines out of reach
of millions of people.
Research And Development
As an organization caring for patients worldwide, Doctors Without
Borders understands that there should be incentives to recover research
and development investments and to promote innovation. Unfortunately,
the public is in the dark on what this research and development truly
costs. We are told that it costs billions to research and develop a new
medicine, although a significant amount of early research and
development actually happens at publicly funded centers and universities.
We are told that the only way to ensure that people receive the
medicines they need is by increasing intellectual property provisions,
such as those encapsulated in the TPP. In reality, the existing
monopoly-based innovation system that the TPP is attempting to
standardize has left us with more patents and fewer medical breakthroughs.
As TPP countries aim to conclude negotiations in the next few months, it
is essential that the United States and other negotiating countries work
to protect existing access to medicines' safeguards and to promote a
public-health driven biomedical innovation system.
Doctors Without Borders/Médecins Sans Frontières website:
"TPP: A Bad Deal for Medicine":
Coalition letter to President Obama:
Comment by Don McCanne
Doctors Without Borders/Médecins Sans Frontières, recipients of the
Nobel Peace Prize, are warning us of an imminent threat to global health.
The U.S. Senate is expected to act as soon as tomorrow on granting
President Obama fast track authority to approve the Trans-Pacific
Partnership Agreement (TPP) - an international trade agreement. Fast
track approval would prevent the agreement from being modified by
Congress, as it would limit their role to an up-or-down vote.
Although the TPP agreement is still secret, it is known that there are
many provisions that should be modified or removed. Amongst the more
important are the provisions that would allow the pharmaceutical and
biomedical industries to lock in high prices for their products, which
would price millions of people out of much needed medical care. Blanket
approval of TPP would precipitate a series of expensive and unnecessary
global medical crises.
This issue should be of direct concern for advocates of single payer
reform. A state or national program would have to comply with
international agreements, even if that meant perpetuating the outrageous
pricing policies of the pharmaceutical and biomedical industries -
policies that would impair access to much needed treatments.
President Obama is currently campaigning heavily for fast track
authority on behalf of the industries that would profit, while
criticizing advocates of social justice for their opposition. Sorry, but
we have to work with those who place the people first, including Doctors
Without Borders/Médecins Sans Frontières.
The most urgent task: Contact your Senators today and tell them to
REJECT fast track authority that would allow the President to
unilaterally set the terms for TPP.
NOTE: The issues are complex. Sen. Elizabeth Warren was specifically
cited by Pres. Obama as being "absolutely wrong" in her opposition to
fast track authority. Today, at the following link, she fires back at
REMEMBER, IF IN DOUBT, DON'T!
at 2:20 PM