[Ip-health] HuffPo Impact Blog: TPP: Still a Terrible Deal for Poor People's Health
Jennifer.Reid at newyork.msf.org
Tue Jul 15 14:31:36 PDT 2014
TPP: Still a Terrible Deal for Poor People's Health
Dr. Manica Balasegaram
Executive director of MSF’s Access Campaign
Posted: 07/14/2014 6:16 pm EDT Updated: 07/14/2014 6:59 pm EDT
When the intellectual property (IP) chapter of the U.S.-led Trans Pacific
Partnership (TPP) trade agreement was leaked late last year, it confirmed
everything public health watchers had warned about for years. The
far-reaching 12-country trade agreement would deny access to affordable
medicines for patients across all TPP countries by strengthening and
lengthening drug patent and regulatory monopolies and delaying generic
competition. Several negotiating countries balked at the blatantly
anti-public health provisions, so the U.S. proposed giving the poorest
countries more time to comply with a few provisions.
According to the new U.S. proposal, TPP countries would be divided into
two groups using the World Bank's income classification system. Countries
that currently fall below the high-income line (e.g. Malaysia, Mexico,
Peru and Vietnam) would be temporarily exempt from three of the most
harmful provisions, each of which would serve to block or delay the
availability of more affordable versions of medicines."
Other provisions similarly harmful to public health would still be
immediately required of all countries. The limited exemption would remain
in effect for a specific period of time, which would either be determined
by when the country graduates to "high income" status according to the
World Bank income classification, or be arbitrarily set through a TPP
U.S. negotiators have described this proposal as an important concession
in the interest of public health. But further analysis by Oxfam and
Doctors Without Borders/Médecins Sans Frontières (MSF), reveals that the
U.S. plan would not only leave the worst aspects of the TPP intact, it
would be devastating to hundreds of millions of poor people living in all
TPP countries. It would also further exacerbate income and health
inequalities in these countries.
The U.S. proposal draws an arbitrary and unfair line to determine which
countries would have to comply with all TPP provisions right away. World
Bank income classification is an inappropriate measure of a country's or a
population's capacity to afford high-priced medicines. The classification
dates back to the 1980s and only measures a country's per-capita average
of total income. Looking at average income doesn't account for uneven
distribution of income within a country, or its public health needs.
The map of poverty has changed since the 1980s. Today, the majority of the
world's poor no longer live in poor countries, but rather in places where
there is greater wealth along with higher inequality.
The fact that MSF is increasingly responding to the unmet medical needs of
patients living in countries considered middle or high income is a clear
representation of this shift. MSF now operates in more than 30 countries
classified by the World Bank as middle or high income. Activities range
from short-term emergency response and HIV and TB programs, to programs
for refugees and migrants and emergency obstetrics and trauma surgery.
To assess the impact of the TPP, MSF and Oxfam used the U.S.
Medicaid-defined poverty line ($21.50/person per day) to estimate how many
millions will live below it once countries cross the high-income
threshold. In eight of the 12 TPP countries for which there is data, more
than a quarter of a billion people will live below the U.S. Medicaid line
when their country is classified as high income. By the time Malaysia and
Mexico reach high income designation, more than 80 percent of their
populations will still fall below this poverty line. Among current
high-income TPP countries, which will be forced to immediately adopt all
TPP provisions, the percentage of the population under this poverty line
ranges widely, going as high as 69 percent in Chile.
As countries become richer by World Bank standards and are expected to
invest more funds towards health care and medicines, continued access to
affordable medicines and generic competition will become even more
The ability to manufacture and/or purchase low-cost generic medicines
requires maintaining a balance in a country's patent system between
monopoly protection and public health. Yet, the TPP will reduce or
eliminate that balance by curtailing existing legal flexibilities, and
limiting government discretion to negotiate medicine prices.
Under existing international trade rules negotiated less than 20 years
ago, which implemented the strictest IP global norms in history, countries
were assured of the right to use basic legal safeguards to facilitate
generic competition to protect public health. With the TPP, the U.S.
government is attempting to re-write the rules.
No matter how long some of the most onerous provisions are delayed, the
TPP in its current form will be a terrible deal for all countries
involved. Negotiating countries must not be fooled by this so-called
compromise from U.S. negotiators. The TPP is as damaging today as it has
ever been. For the health and well-being of at least 800 million people,
countries must reject these terms.
Researcher, MSF Access Campaign
Doctors Without Borders/Médecins Sans Frontières (MSF)
333 Seventh Avenue, 2nd Floor, New York, NY 10001
Email: jennifer.reid at newyork.msf.org
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