Worlds Apart: Making Sure Trade Policies Improve Global Health | Commentary
As a member of Congress and a physician, I am very proud of the enormous generosity of the American people. Through their engagement, and their tax dollars, Americans help millions of disadvantaged people around the world by providing access to medical care and essential drugs.
Unfortunately, we are also currently negotiating sweeping international trade agreements that may curtail our ability to continue helping the poorest of the poor.
Working as a doctor in sub-Saharan Africa during the 1980s, I witnessed the AIDS epidemic devastate entire communities. I saw adults die far too young and watched women pass HIV to their newborns without a cure or a compressive response. Amazingly, assuring an AIDS-free generation is not only within reach today; it is, in fact, an official policy goal of the U.S. government. And while the global progress of HIV/AIDS treatment and prevention is impressive, it is just one of many global disease control efforts that the United States has spearheaded and pursued.
With America’s record of global health leadership in mind, I am troubled by what may happen to access to medicines for the poor around the world as a result of our new trade agreements.
The Trans-Pacific Partnership is being negotiated right now. It includes 10 countries of the Pacific Rim, including developing countries such as Peru, Malaysia and Vietnam. If the TPP agreement is done right, it will encourage and support American exports and create needed jobs in the United States. The critical intellectual property provisions of the pact should protect inventors and developers of breakthrough innovations, but they cannot be so restrictive that they cost millions of lives in less developed countries.
At the beginning of TPP negotiations two years ago, for reasons that are unclear, the U.S. asked the other 10 countries to accept new and very rigid intellectual property measures that would greatly limit availability of the affordable generic medicines that the success of U.S.-supported global health programs require. For example, more than 98 percent of HIV/AIDS medicines used to fight AIDS in Africa are generics, mostly made in Asia.
The United States is currently party to many international agreements that include strong intellectual property protections. These agreements protect innovation, including 20-year patents on new drugs, but they also allow enough flexibility for poorer countries to respond to public health needs with accessible, low-cost drugs. We worked hard to get these rules in place and they are working well.
But the U.S.’ current TPP proposal on medicines upends the present well-structured balance by extending monopoly protections much further. It would force people in developing countries to wait longer for affordable medicines, if they can access them at all. It would extend patents beyond the current 20-year norm and block national regulators from using existing clinical trial data to approve the production of generic or “bio-similar” drugs.
Alarmingly, the proposal also outlaws “pre-grant opposition” that allows doctors and patients to provide information to their governments about patents they believe do not meet national rules, an important democratic safeguard. The proposal also requires the patenting of new versions of old medicines, even when the new versions offer no additional therapeutic benefits. It even requires patenting of surgical, therapeutic and diagnostic methods, which not only is unethical but also could increase medical liability and the cost of practice.
Six years ago, my congressional colleagues and I battled similar issues during negotiations on trade pacts with Peru, Colombia and Panama, and we reached bipartisan agreement to protect public health. The “May 10th Agreement,” as it’s called, is working but now some are insisting on abandoning that effective approach.
The TPP may create millions of jobs here in the U.S. It also must facilitate even broader access to lifesaving medicine in our partner nations. The current U.S. proposal is being revisited now; it must be modified to reflect the beneficial balance we established years ago.
Global health, innovation and access to medicines are top priorities for many members of Congress and should be for this administration.
A TPP agreement that exacerbates already-delayed access to generic medicines is unacceptable. TPP has been called a “21st Century Agreement,” but it will be anything but fresh if it makes crucial medicines even scarcer throughout the developing nations of the world.
Rep. Jim McDermott, D-Wash., is co-chairman of the bipartisan Congressional HIV/AIDS Caucus.