I found myself asking this question last year when AIDS patients in Guatemala asked me why my government was promoting a trade agreement that will raise prices on antiretroviral medications by undercutting market competition.

I learned that tucked away amid chapters on tariff reduction and investors' rights in the Dominican Republic-Central American Free Trade Agreement (DR-CAFTA), concealed behind the innocuous-sounding title "intellectual property rights," lies what just may be a death sentence for many in the Dominican Republic and Central America, the U.S.'s latest trading partners in what some have described as a southward extension of the North American Free Trade Agreement.

When my students and I met with doctors, nurses, public-health officials and patients' rights advocates in Guatemala on a research trip last summer, we were struck by how many of them told us that the reason they opposed CAFTA was because they favored free trade.

Free trade, of course, is all about bringing down barriers to competition so that prices fall and consumers benefit. Yet by instituting new forms of market monopoly such as "test data exclusivity," the intellectual-property provisions in CAFTA actually extend the length of time during which the major pharmaceutical companies' products are guaranteed sole access to markets.

In January, 11 Democratic members of Congress, among them Rep. Jim McDermott, D-Seattle, sent a letter to the U.S. trade representative who brokered this agreement, arguing that "the test data secrecy/market exclusivity rules will slow the introduction of generic drugs, decrease competition, raise prices and hinder access to life-saving medicines in the DR-CAFTA countries."

These elected officials understand that for diseases like HIV/AIDS, where many leading drugs are still in their patent period, extending the length of patents means curtailing the lives of patients.

Just what are the impacts of this "test data exclusivity"? Because generic producers are simply required to show their drugs are equivalent to a brand-name drug that has already been determined to be safe, they need not replicate the expensive clinical trials conducted by the Big Pharma manufacturers when they bring their product to market; this enables them to sell their product cheaply. Yet, the DR-CAFTA institutes a mandatory five-year period during which no one will be allowed access to major pharmaceuticals' test data, effectively barring generic production.

Pharmaceutical patents were first introduced to ensure that innovators who developed new drugs would be able to recoup their startup costs by enjoying a monopoly for a limited period of time. Profit incentives may indeed be necessary to protect innovation; the question is whether existing protections for pharmaceutical profits require expansion, and at what price?

In 2001, the World Trade Organization established, in the Doha Declaration, a set of safeguards to ensure that intellectual-property rules do not impede the ability of developing countries to protect public health. In 2002, the U.S. Congress passed the Trade Promotion Authority Act, directing the U.S. trade representative to uphold this agreement. Why is the Bush administration seeking to undercut international guidelines through agreements like the DR-CAFTA, which extend pharmaceutical monopolies further than ever?

For every AIDS patient currently receiving brand-name antiretrovirals in Guatemala, 10 could be treated using generics. For the underfunded health ministries in Central America that today struggle to provide AIDS drugs to tiny fractions of their countries' infected populations, even one more year of market monopoly means thousands who could have been treated with generics must go without the medications they need to survive.

A trade agreement that exchanges human lives for pharmaceutical profits is anything but "free."

© 2005 Seattle Times