Sacrificing health care for trade

Access to life-saving drugs in play, writes Stephen Cornish.

Worldwide, millions of people die each year because they cannot afford medicines. Countries like Canada and the United States should be taking action to make life-saving treatments more affordable to them. But officials in Ottawa are negotiating an agreement that threatens just the opposite.

Canada is hosting a round of closed-door trade talks toward an eventual Trans-Pacific Partnership agreement (TPP), an ambitious trade deal between rich countries like the United States, Japan and Canada, and developing nations such as Vietnam, Peru, Malaysia and Mexico. Included in the negotiations are intellectual-property provisions which could make this the worst agreement ever for public health.

Trade negotiations have long been at the centre of a global battle to find balance between access to medicines and innovation. Governments must foster an innovative pharmaceutical market. In turn, those innovations must be used for their rightful purpose: to provide treatment to those who need them to survive. Sadly, that balance is missing, with devastating consequences.

All too often, pharmaceutical companies exploit flawed intellectual-property systems by re-patenting old drugs for new uses. This lets them keep drug prices artificially high without necessarily inventing new medicines. And when new drugs are invented, they are often priced beyond the reach of patients. For example, a new treatment for Hepatitis C, Sovaldi, can cure up to 90 per cent of cases, but it costs as much as $84,000. Prices like these form part of a broader trend which has seen drug costs triple in the United States since 1987.

These imbalances cost developed nations billions of dollars every year. But when this flawed model is exported to the developing world under the guise of free trade, the costs are measured in lives lost.

The war for access to medicines is at risk of being lost.

Such was the case in the late 1990s as AIDS began to ravage Africa, while the pharmaceutical industry, backed by Western governments, demanded more than $10,000 per patient annu — ally for drugs. Thankfully, a broad coalition, including Médecins Sans Frontières/Doctors Without Borders, fought back, leading to cost reductions of nearly 99 per cent. Generic firstline AIDS drugs now cost $140 a year and 12 million people are receiving life-saving treatment.

But if that battle was won, the war for access to medicines is at risk of being lost. Since the 1990s, a number of trade deals have reduced access to medicines by driving up drug prices. However, some provisions being considered in the TPP negotiations are so damaging this agreement could belong in a class of its own.

Leaked texts show the U.S. wants to extend patent and regulatory monopolies through the TPP, meaning it would take longer to access low-cost generic versions of new drugs. The newest treatments developed for AIDS and drug-resistant tuberculosis are already priced out of reach in the developing world.

When public health is at stake in rich countries, they don’t trade away public health for patent rights. Faced with the anthrax scare of 2001, Canada overrode patent rights and imported stockpiles of generic medicines. Many countries considered a similar move in response to bird flu. But this discretion is under fire, too. Last year, U.S. pharmaceutical company Eli Lilly sued the Canadian government for $500 million after the Supreme Court rejected the patent for two of its drugs. Eli Lilly used provisions in the North American Free Trade Agreement, but similar provisions, which could go even further, are being proposed in the TPP.

Thankfully, voices of reason may have been expressed at the negotiating table. A version of the TPP text leaked last November suggests Canada and some other countries are opposing some of the most harmful provisions.

But as negotiators aim to reach a deal this year, pressure is intense and trade-offs will be made. When it comes to access to medicines, it is imperative that Canada does not bow to U.S. pressure. More than 26,000 Canadians have signed a petition telling Canada to stand firm for public health. Medicines should not be a luxury.