Public Health and Medicine Policies

Abstract

This chapter examines the extent to which the proposed Trans-Pacific Partnership Agreement may impact on public health and medicines policies in the countries party to the agreement. Its predictions are based chiefly on a critical analysis of two sets of submissions from influential US health and medicines-related corporations and industry bodies to the US Trade Representative (USTR) in 2009. The first set of submissions was on the TPPA itself and the second arose in relation to the Section 301 Trade Watch List. The submissions sought TPPA provisions that fell into four broad categories: (1) impeding the market entry of generic medicines and increasing the monopoly privileges of patented medicines; (2) restricting the capacity of governments to operate evidence-based systems that assess the cost-effectiveness of health technologies; (3) creating committee mechanisms for ongoing lobbying of governments on these issues; and (4) including investor-state dispute settlement procedures that would allow foreign corporations to sue governments if their investments are impeded, for example, by public health legislation. When the first formal round of TPPA negotiations was held in Melbourne from 15-19 March 2010, health and medicines issues were not phrased in the above terms. Instead, the brief official memorandum released afterwards to the public stated that future negotiations were officially set to include investor-state dispute settlement, ways to promote 'regulatory coherence' and how to ensure small-to-medium corporate enterprises (SMEs) are able to benefit from the agreement. 1 Naturally, the communiqué did not present these issues as reflecting a US industry agenda for health and medicine policy that would in effect be pushed onto the other parties. Yet, this is exactly what is likely to happen, if only because no TPPA nation except the US has a powerful health industry sector with the capacity to influence the negotiation agenda so strongly. This is partly a function of the size of the respective economies, but it also reflects a protracted and fundamental lack of vision and organisation among the TPPA Health and Medicines Provisions Free trade agreements were initially designed to reduce tariffs or taxes placed at the border on goods coming from one country to another. In time, however, various US industry groups have successfully transformed US-led trade agreements into opportunities to facilitate their monopoly advantage by influencing the legislation and policies that other countries can implement, under threat of trade sanctions. This happened particularly in areas of intellectual property rights (IPRs, now also referred to as intellectual monopoly privileges or IMPs) such as copyright, trade marks and patents (especially pharmaceutical patents). Multilateral trade agreements that have impacted on domestic public health and medicines policies include the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) (which required, for instance, increased pharmaceutical ...

The Trans-Pacific Partnership Agreement: a threat to affordable medicines and public health

“…PhRMA has long criticized medicines insurance schemes premised on cost-effectiveness and reference pricing such as the Pharmaceutical Benefits Scheme (PBS) in Australia and PHARMAC in New Zealand. The PhRMA submission to the USTR on the TTPA specifically targets alleged 'market access barriers... inadequate consultative mechanisms and transparency concerns in countries like New Zealand' [ 6 ]. But the governments of Australia and New Zealand are unlikely to accept the whole-sale winding-back of the PBS and PHARMAC.…”