As United States trade representatives thrash out an international trade deal in Chicago, truly ominous developments are unfolding behind the scenes.
Leaked drafts of the U.S. position show that the government is pushing provisions to tighten intellectual property laws that will make price-busting generic competition impossible. In short, the U.S. is pushing to severely restrict access to affordable medicines where they are needed most - in the developing world.
The U.S. is negotiating the Trans-Pacific Partnership trade agreement with Australia, Brunei, Chile, Malaysia, New Zealand, Peru, Singapore and Vietnam. But the significance of the deal reaches beyond those countries. It will be used as the basis for future agreements between the U.S. and other developing and developed countries.
In the field of health, competition saves lives. Monopolies backed up by patents keep the price of medicines out of reach for longer. Because generic manufacturers were free to make cheaper versions of AIDS drugs, the price of HIV treatment has fallen by more than 99 percent over the last ten years -- from over U$10,000 for one year's treatment in 2000 to as low as $60 today.
This is why I am alarmed by the U.S. pursuing measures that would strangle the production of generic medicines, and force the price of new drugs to remain high.
The leaked papers reveal a number of U.S. objectives: to make it impossible to challenge a patent before it is granted; to lower the bar required to get a patent (so that even drugs that are merely new forms of existing medicines, and don't show a therapeutic improvement, can be protected by monopolies); and to push for new forms of intellectual property enforcement that give customs officials excessive powers to impound generic medicines suspected of breaching IP.
And there's more.
The U.S. will also reportedly introduce measures to make it harder and more expensive for generic drugs to get regulatory approval, and to lengthen patent monopolies for pharmaceutical firms so that they keep generics out and prop up drug prices for longer. All of these measures are known to hit the availability of affordable medicines in developing countries hard.
This deal is set to be sealed behind closed doors. Under no obligation to make its negotiating texts public, the U.S. Trade Representative's office has instead published a white paper claiming their TPP proposals will remove barriers to access to medicines. The document not only fails to provide the technical details necessary for effective public scrutiny, but also expresses a fundamentally flawed premise that speeding up market entrance of brand-name, monopoly-priced drugs will, in itself, solve the challenge of access to affordable, quality medicines. The truth is that the U.S. position outlined in its leaked TPP proposal actually creates barriers to access and thwarts generic competition.
With this devastating agenda, the U.S. is back-pedalling on the promises made to the developing world.
In 2007, President George W. Bush committed to abide by key public health safeguards in future free trade deals in a bipartisan agreement with Congress, called the New Trade Policy. This policy, which is expressly not mentioned in the USTR white paper, obligates the U.S. to refrain from pushing countries to adopt many of the very same measures it is now promoting as a part of the TPP.
Most worryingly, though, is that the U.S. trade representatives' stance is not only a backflip on previous commitments to ensure public health safeguards - the U.S. is also shooting itself in the foot.
In June, I attended the United Nations High Level Meeting on HIV/AIDS in New York. There I witnessed the U.S., plus the other UN Member States, commit to '15 by 15': scaling up to a total of 15 million people on HIV treatment by 2015.
The U.S. is by far the greatest funder of global HIV programs. It poured in 54 percent of all donor government disbursements in 2010, committing $5.5 billion. The U.S. President's Emergency Plan for AIDS Relief (PEPFAR - another Bush policy) relies principally on the purchase of generic antiretroviral medicines. The U.S. is also the biggest contributor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, another global health player that relies heavily on generics - as indeed does Doctors Without Borders.
If an extra six million people need to be put on HIV treatment over the next four years, then we need to find solutions to rein in drug prices and keep treatment affordable. We need to find ways of getting as much bang from PEPFAR and the Global Fund bucks as possible.
And yet the U.S. is trying to club up with countries in a deal that keeps the cost of medicines high. Again, the fear is that whatever ends up in this free trade deal ends up as the basis for all future agreements with other countries.
As the negotiators gather in Chicago to hammer out their trade deal, are they paving the way for the '15 by 15' pledge to be another broken promise?