[Ip-health] Ruth Bergan and Natalie Sharples in The Guardian: How UK trade policies could help heal global healthcare inequalities
thiru at keionline.org
Mon Nov 28 06:35:13 PST 2016
How UK trade policies could help heal global healthcare inequalities
One third of the population cannot access essential medicines. Leaders must
push for trade deals that drive down the cost of healthcare for the world’s
Ruth Bergan and Natalie Sharples
Tuesday 22 November 2016 07.00 GMT
Theresa May’s recent visit to India, during which discussions about
cooperation over trade in health services were a priority, is a reminder
that trade and investment cannot be isolated from other areas of policy.
Key among these is universal health coverage – the provision of quality
medical services to all people when they need them, without causing
financial hardship. This is a concept that is having its moment: it is
championed by everyone from health activists to the World Bank, and is one
of the targets in the sustainable development goals.
Healthcare innovations won’t cure global health inequality – political
What is obvious, but perhaps less palatable to some of its advocates, is
that achieving universal health coverage requires addressing polices far
beyond the health sector. Policies that need to work for universal health
coverage include those on water and sanitation, nutrition and education,
but also global policies and practices that impede the right to health.
In the context of Brexit, UK trade is one such policy we urgently need to
examine. Trade has huge implications for health. This was seen very clearly
in the EU’s failed attempt to agree a trade deal with India. When the EU
proposed to include stricter patenting rights for companies in the deal,
Indian negotiators, the UN and activists all raised serious objections,
fearing it would drive a huge increase in the cost of medicines relied on
by poor communities across the globe.
Fears about trade rules are well-founded. One third of the world’s
population lacks access to essential medicines. New treatments for people
living with HIV in middle-income countries can cost between $3,000 (£2,400)
and $28,000 per person each year. No surprise that for many people this is
out of reach. Inequalities in power between companies and citizens is at
the heart of this. Patent protection given to pharmaceutical companies
through provisions in trade agreements restricts access to cheaper, generic
medicines and pushes up drug prices. In the US, the Food and Drug
Administration reports that the cost of a generic drug is 80% to 85% lower
than the brand name product.
Similar power distortions are unmistakable in bilateral investment
treaties. Like the controversial TTIP and Ceta agreements, these trade
deals include a parallel judicial system allowing companies to sue
governments at private international tribunals, curbing the ability of
states to provide for the right to health for their people, and undermining
Companies are already using such provisions to challenge government health
policy. In 2012, pharmaceutical giant Eli Lilly began legal proceedings
against the Canadian government for $500m for invalidating two of its
patents. The invalidations were the result of a new national law that
required the “utility” of an invention to be demonstrated when the patent
was filed – in other words the drug did not do what the inventor said, or
implied, it would do when the patent application was made, as was the case
with the two contested drugs from Eli Lilly. The company then sued Canada
under the Nafta treaty for lost profit and unfair treatment – a lawsuit
that is not only intended to challenge the withdrawal of the patents but
also Canada’s national law.
While there are no public cases of health companies suing India, UK
companies have certainly been using the provisions of UK bilateral
investment treaties to challenge other aspects of Indian government policy.
Vedanta Mining and Vodafone have both challenged changes to Indian tax law.
The companies had used offshore vehicles to buy out Indian companies,
neatly avoiding having to pay significant amounts of tax. When India
attempted to close the loophole (pdf) that allowed this to happen, the
companies used the UK-India treaty to sue the government for “compensation”.
Every day 16,000 children under-five (5.9 million a year) die. The causes
of their deaths are largely preventable, meaning these children are not
killed by illness, but bad policies. As the Alma Ata – the first
international declaration underlining the importance of primary health care
– made clear almost 40 years ago, health inequalities within and between
countries are “politically, socially and economically unacceptable”.
Achieving universal health coverage requires training more health workers,
improving health information systems and mobilising more domestic
financing. It also requires addressing the global causes of poverty and
inequality. Trade and investment policies should be first on the list.
India has already revised its bilateral investment treaties to limit the
range of policies that can be challenged. The UK now has an opportunity to
make sure its own trade policy supports the health of people across the
world. We must demand that MPs act now to ensure it.
• Natalie Sharples is senior policy advisor at Health Poverty Action
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