Doctors Without Borders: TPP a threat to global health

The Trans-Pacific Partnership: A Threat To Global Health?

By Deane Marchbein, President of the Doctors Without Borders USA Board of Directors
Health Affairs Blog, May 8, 2015

Lost in the political discussions over the passage of the Trans-Pacific Partnership (TPP)—a trade agreement currently being negotiated in secret between the U.S. and 11 other Pacific-Rim nations—is the very real negative impact it would have on global health.

Doctors Without Borders/Médecins Sans Frontières (MSF) works in over 60 countries, and our medical teams rely on access to affordable medicines and vaccines. We are deeply concerned that the TPP, in its current form, will lock-in high, unsustainable drug prices, block or delay the availability of affordable generic medicines, and price millions of people out of much-needed medical care.

The public health repercussions of this deal could be massive. The negotiating countries represent at least 700 million people, and U.S. negotiators refer to the TPP as a “blueprint” for future trade deals. The TPP attempts to rewrite existing global trade rules and would dismantle legal flexibilities and protections afforded for public health.

Problematic Provisions

We have concerns with several U.S. government demands in the TPP. For example, the TPP would lower the standard for patentability of medicines. It would force TPP governments to grant pharmaceutical companies additional patents for changes to existing medicines, even when the changes provide no therapeutic benefit to patients. These provisions would facilitate “evergreening” and other forms of abuse of the patent system by lengthening monopolies and delaying access to generic competition.

Another concerning provision in the TPP involves so-called “data exclusivity” for biologics, a new class of medicines that includes vaccines and drugs used for cancer and multiple sclerosis treatment. Data exclusivity blocks competing firms from using previously generated clinical trial data to gain approval for generic versions of these drugs and vaccines. If pharmaceutical companies have their way, the TPP will block generic producers of biologics from entering the market for at least 12 years, during which patients would be forced to endure astronomical prices.

Twelve years of data exclusivity is not only unprecedented in any trade agreement, it is not the law in any of the TPP negotiating countries outside of the U.S., and it would keep lifesaving medicines out of reach of millions of people.

Research And Development

As an organization caring for patients worldwide, Doctors Without Borders understands that there should be incentives to recover research and development investments and to promote innovation. Unfortunately, the public is in the dark on what this research and development truly costs. We are told that it costs billions to research and develop a new medicine, although a significant amount of early research and development actually happens at publicly funded centers and universities.

We are told that the only way to ensure that people receive the medicines they need is by increasing intellectual property provisions, such as those encapsulated in the TPP. In reality, the existing monopoly-based innovation system that the TPP is attempting to standardize has left us with more patents and fewer medical breakthroughs.

As TPP countries aim to conclude negotiations in the next few months, it is essential that the United States and other negotiating countries work to protect existing access to medicines’ safeguards and to promote a public-health driven biomedical innovation system.

Doctors Without Borders/Médecins Sans Frontières website, “TPP: A Bad Deal for Medicine”:

Coalition letter to President Obama:



By Don McCanne, MD

Doctors Without Borders/Médecins Sans Frontières, recipients of the Nobel Peace Prize, are warning us of an imminent threat to global health.

The U.S. Senate is expected to act as soon as tomorrow on granting President Obama fast track authority to approve the Trans-Pacific Partnership Agreement (TPP) - an international trade agreement. Fast track approval would prevent the agreement from being modified by Congress, as it would limit their role to an up-or-down vote.

Although the TPP agreement is still secret, it is known that there are many provisions that should be modified or removed. Amongst the more important are the provisions that would allow the pharmaceutical and biomedical industries to lock in high prices for their products, which would price millions of people out of much needed medical care. Blanket approval of TPP would precipitate a series of expensive and unnecessary global medical crises.

This issue should be of direct concern for advocates of single payer reform. A state or national program would have to comply with international agreements, even if that meant perpetuating the outrageous pricing policies of the pharmaceutical and biomedical industries - policies that would impair access to much needed treatments.

President Obama is currently campaigning heavily for fast track authority on behalf of the industries that would profit, while criticizing advocates of social justice for their opposition. Sorry, but we have to work with those who place the people first, including Doctors Without Borders/Médecins Sans Frontières.

The most urgent task: Contact your Senators today and tell them to REJECT fast track authority that would allow the President to unilaterally set the terms for TPP.

NOTE:  The issues are complex. Sen. Elizabeth Warren was specifically cited by Pres. Obama as being “absolutely wrong” in her opposition to fast track authority. Today she fired back at the President.