Secretive US Trade Deal Could Endanger Global Health Gains

Much of the concern focuses on a host of provisions that would impact the ability of poor communities to get cheap generic medicines.
By @clbtea |
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    In this May 2013 photo released by the United Nations African Union Mission in Darfur (UNAMID), Dr. Mohamed Dawalbeit, treats a man with hepatitis at a hospital in El Sereif village, North Darfur, Sudan. Public advocates warn that restrictive new provisions to the Trans-Pacific Partnership would significantly curtail access to affordable medicines and health care in developing countries.

    In this May 2013 photo released by the United Nations African Union Mission in Darfur (UNAMID), Dr. Mohamed Dawalbeit, treats a man with hepatitis at a hospital in El Sereif village, North Darfur, Sudan. Public advocates warn that restrictive new provisions to the Trans-Pacific Partnership would significantly curtail access to affordable medicines and health care in developing countries.

    WASHINGTON — As a major free trade agreement nears the end of negotiations, the United States appears to be doubling down and even strengthening its demands for restrictive new provisions that public health advocates warn would significantly curtail access to affordable medicines and health care in developing countries.

    Internal documents recently published by WikiLeaks have painted a picture of an intransigent U.S. increasingly frustrated by the slowness of negotiations around the proposed 12-member Trans-Pacific Partnership. Talks toward the supersized free trade area, which would cover around 40 percent of the global economy, have dragged on for four years, and on Tuesday wrapped up another unsuccessful round in Singapore.

    Health and development advocates worry that the TPP, which is being seen as a blueprint for future U.S. trade deals, would give unprecedented powers to the pharmaceutical industry.

    “The U.S. government is trying to use deadline pressure to force negotiators to accept the most damaging restrictions on public health and access to medicines ever to be imposed on developing countries,” Rohit Malpani, director of policy and analysis for Doctors Without Borders’ Access Campaign, said during the Singapore talks.

    “The U.S. government seems determined to give pharmaceutical companies more power to raise the cost of medicines for millions of people around the world, while curtailing the power of governments to protect public health. [We] urge all TPP countries to reject political pressure to accept damaging rules in the final push to conclude the negotiations.”

    The Obama administration, which has been spearheading the TPP talks, had repeatedly trumpeted a deadline for the talks of the end of this year. Yet even as the Singapore round failed to result in agreement, wide, even intrinsic gaps remain between many of the countries’ positions, according to reportedly internal documents published this week.

    Indeed, this memo, which appears to offer a candid snapshot of countries’ negotiating positions, depicts the U.S. Trade Representative as an outlier in the extremity and doggedness of some of its demands.

    “[T]he U.S. is exerting great pressure to close as many issues as possible … However, the chapters that were reviewed by the [chief negotiators] did not record much progress,” the memo, reportedly written in November by one of the governments party to the TPP negotiations and published on Monday by WikiLeaks, states.

    The U.S. chief negotiator “met with all 12 countries and said that they were not progressing according to plan. One country remarked that up until now there had not been any perceivable substantial movement on the part of the U.S., and that is the reason for this situation.”

    The memo’s authenticity has not been substantiated, nor is it known which government’s views it may reflect. A spokesman for the USTR on Monday told the media that some elements of the document are “outdated” or “totally inaccurate,” though the talks have been held in such secret that few details are available other than by leak.

    “I suspect that USTR is getting desperate to reach a final deal, as it must be disheartening to create self-imposed deadline after deadline,” Arthur Stamoulis, executive director of the Citizens Trade Campaign, a watchdog group here, told MintPress.

    “That being said, it’s clear who’s behind [the U.S.] agenda: these large corporate interests … While it’s good to see that other countries are still resisting, it’s discouraging to see the U.S. going to the mat so strongly for this corporate power push.”


    Continually under attack

    One of the most contentious of the dozen and a half chapters under negotiation deals with intellectual property rights. While this is an issue that perhaps most directly impacts on the global trade regime’s interaction with community health on the ground, the details also highlight the frustrations being voiced by civil society advocates around the world.

    “On access to medicines, it’s truly appalling what appears to be proposed for this agreement, which includes some significant backtracking on gains that we’ve made in previous trade agreements,” Ellen R. Shaffer, co-director of the Center for Policy Analysis on Trade and Health, told MintPress.

    “It looks like they’re discussing proposals to offer much more leeway than previous agreements, which would ultimately restrict the right and ability of governments to play a role in setting drug lists and drug prices.”

    Shaffer has also been at the forefront of a broad-based campaign among the U.S. public health community to highlight apparent concessions being made to the tobacco industry in the TPP talks. While Washington is urging that tobacco products be given no special consideration under the agreement, other governments have countered that these items should be exempted from a broader lifting of trade restrictions to continue to allow for government restrictions on tobacco availability, advertising, pricing and other considerations.

    “Politically, public health is always fighting an uphill battle when it comes to trade, and that’s probably because to decision-makers it always looks like the power is with the opposition – the industry,” Shaffer said.

    “In fact, tobacco plays such a negligible role in the U.S. economy these days, even while we lose so much on tobacco-related diseases, it’s pretty clear that we should be doing whatever we can to shut down the tobacco industry. Our economic and trade policy should be consistent with our public health policy, but it’s not.”

    According to critics, other proposals being pushed by the U.S. are similarly tilted toward corporate interests.

    According to a leaked copy of the full Intellectual Property chapter, made public in mid-November, these proposals would allow for the patenting of surgical methods, an option that is currently banned by U.S. law and would make such procedures far more expensive. They would also create new limits on public insurance schemes.

    More broadly, much of the concern focuses on a host of provisions that would significantly impact on the ability of poor communities to access cheap generic medicines. Currently, for instance, drug patents extend for 20 years, while the U.S. proposals would extend this period for an additional five years.

    Other proposals would counter current trade law to allow for the patenting of minor updates of old medicines, a change that would vastly push out the timeframe under which generic medicines could be introduced. Similar concern arises over a provision that would extend the window for “data exclusivity,” under which companies are essentially given monopolies over certain types of drugs, even when their patents run out.

    The global public health impact of generic drugs has been undeniably transformative over the past decade. According to estimates by Doctors Without Borders, competition from generics has brought down the price of antiretroviral medicines by almost 99 percent, allowing for the massive donor-funded multilateral attack on HIV that experts now say could essentially do away with the disease within decades.

    Of the antiretroviral drugs used today in developing countries, some 80 percent are generic copies produced in India. Indeed, 98 percent of the ARVs purchased by PEPFAR, the United States’ flagship anti-AIDS program and the largest in the world, are generics.

    Current international trade regulations, as agreed to in 1995 under the World Trade Organization, include safeguards to allow countries to try to balance public health concerns with valid commercial interests. Yet according to Doctors Without Borders, since these provisions were agreed to they have been “continually under attack” by the pharmaceutical industry.

    “Developing countries that try to promote the use of generics are frequently the target of litigation by pharmaceutical firms and are subject to diplomatic pressures, such as the threat of sanctions, by Western governments seeking to protect commercial interests,” the group said.

    “The TPP represents the most far-reaching attempt to date to impose aggressive … standards that further tip the balance towards commercial interests and away from public health.”


    Fast track

    While opponents of the TPP talks are hailing the failure of the Singapore round, which will now push the negotiations into next year, many are now turning their attention to growing unease in the U.S. Congress over the secrecy with which the TPP talks have been undertaken. Indeed, lawmakers have been in the unusual situation of being forced onto the sidelines of the negotiations, with few reportedly having access to the entire TPP text.

    Yet while Congress would ultimately need to approve of any eventual agreement text, the Obama administration is now ratcheting up a call for federal lawmakers to give up any opportunity to tweak the draft. Under so-called Fast Track authority, common in major trade talks, Congress would cede much of its power to the executive branch and, instead, take a simple up-or-down vote on the draft.

    The administration, echoing past administrations, says such certainty is needed to get other governments to enter seriously into the complexity of multilateral trade talks. Yet many members of Congress are expressing skepticism, with some urging their colleagues to refuse to allow Fast Track authority.

    “The fact is that the TPP threatens American consumers, workers and manufacturers, and there is strong bipartisan opposition to so-called ‘fast-track’ procedures that leave Congress out of the process for amending agreements,” three members of Congress, Louise Slaughter, D-NY, Rosa DeLauro, D-CT, and George Miller, D-CA, said last week in a statement. “As history has taught us, we can’t afford to give up our Constitutional authority to protect American jobs by amending flawed trade agreements.”

    Others say that multilateral trade negotiations themselves have become too complex, particularly given the unequal dynamics between members.

    “We really need to keep finding better ways to deal with questions of political clout and economic and social inequality,” CPATH’s Shaffer said. “Having countries with the economic and political power of the United States negotiating with countries like Vietnam – well, I hope on some level this will work out for Vietnam, but you have to wonder who benefits from these kind of discussions and who will benefit ultimately from an agreement.”

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