The TPP May Be Dead, but Big Pharma’s Still Getting Away With Murder

The Trans-Pacific Partnership may officially be dead yet a looming free trade battle remains in the Pacific Rim.

In March, the Regional Comprehensive Economic Partnership concluded its 17th round of talks. RCEP is a five-year-old proposed trade agreement between 10 countries of the Association of Southeast Asian Nations, like India, China, and Laos and six states, like Japan and Australia, that have existing free trade agreements in the region. It’s essentially comprised of TPP nations, without the Americas and the United States.

RCEP trading partners represent 30 percent of global GDP and about half of the world’s population. As the talks continue, global health activists are alarmed. Like the TPP, the pharmaceutical industry has a lot at stake in this deal. So do much of the world’s poor.

Today the world’s largest pharmaceutical corporations dictate the way their products come to market. They sculpt global free trade.

Indeed, one of the most contentious parts of the TPP was providing excessive market protections for American drug companies and their allies. Nations push Big Pharma’s agendas, likely to curry favor with the industry and good will with countries in which its executives call home. The global health community must insist RCEP’s Big Pharma demands not find their way into the final agreement.

The RCEP negotiations are under wraps, without much input from public health experts. At the expense of medicine access, all 16 RCEP countries already accept fairly pro-Pharma terms like protecting 20-year patents for a swath of treatments that prohibit generic drug competition. Leaked text reveal South Korea and Japan advancing intellectual property provisions that go beyond current World Trade Organization arrangements.

In 1994 at the behest of the United States, the European Union, and other developed countries WTO member nations ratified the Agreement on Trade-Related Aspects of Intellectual Property Rights, giving Big Pharma exclusive monopoly power to market their drugs in WTO member nations. Public health safeguards were included to boost access for lower cost generics in lower-income member countries. Yet, they were largely open for interpretation between Big Pharma, their allies, and developing countries. The AIDS epidemic gripping the world immediately put these safeguards to the test.

In 1998, a feud erupted between Big Pharma and South Africa, entangling the United States and the world. The South African Pharmaceutical Manufacturers Association and 39 multinational pharmaceutical corporations filed suit against South Africa on the grounds they violated their international WTO trade agreement and the South Africa constitution.

South Africa passed a law to import cheaper generic drugs and generic substitution of off-patent medicines to largely treat its AIDS patients. At the time, 65 percent of HIV-positive cases were in Africa and one in seven new cases were in South Africa. Through the resolve of activists, former President Nelson Mandela and then-United Nations Secretary General Kofi Anan, Pharma dropped its case in 2001.

Since this episode and others, WTO ministers clarified TRIPS provisions and trade flexibilities for low-income nations to access affordable versions of Big Pharma’s high priced medicines. In 2001, in Doha, Qatar, ministers adopted a declaration on TRIPS to allow nations to prioritize public health over intellectual property and solidify WTO’s medication access commitments to support low-income patients.

But for every trade advancement in the name of improving public health and access to essential medicines, Big Pharma counters.

Their demands now infect the RCEP and stifle global access to medicines.

South Korea and Japan have introduced policies, many that are commonly referred to as TRIPS-plus, that boost Pharma’s rights before the courts, while extending their monopoly power and patent life. With these provisions, it’s certain what little flexibilities the WTO allows poor countries to access generics are under assault. New arrangements should bolster such flexibilities, not make them ineffective.

Fortunately, India and some South East Asian countries are playing tough. They added a provision to safeguard trade flexibilities that permit affordable access to lifesaving treatments. India was able to remove an evergreening provision that’s terrible for access. Evergreening is a patent reform proposal that allows pharmaceutical companies to slightly modify a drug and extend its monopoly life without making it more novel, safe or effective. Activists cite it as an emerging health access threat.

But whatever such nations challenge Pharma with, they need more support. Pharma’s free trade tactics kill.

In New Delhi, India I spoke with Doctors Without Borders’ Access South Asia Head Leena Menghaney to learn how the fearless Nobel Peace Prize winning organization is tracking RCEP and staging campaigns to confront Pharma overreach. She said that “Pharma’s role in these trade talks is overwhelming. For every pro-patient proposal advocates make, Pharma works with the world’s most powerful countries to crush affordable medicines access. That’s the cruel tactic.”

Without public pressure, Leena warned a final deal could prove devastating for poor patients. She cautions that that RCEP is part of a global access to medicines fight. She’s watching how low-income patients in the United States are responding to sky-high drug costs and what U.S. officials are doing about it. It’s important for the public not to withdraw or fall for pharmaceutical public relations antics that protect their image in the face of their pricing decisions.

As RCEP talks continue, Leena’s words of caution are friendly reminders that activists need to stay vigilant if they care about patients getting the life-saving medicines they need to survive.

In parts of the world where patients live on less than one U.S. dollar a day, Pharma’s greed proves to be a death sentence for many. We all know it doesn’t have to be.