Bolstering long-held criticisms from public interest groups, newly leaked sections of the Trans-Pacific Partnership (TPP) show how Big Pharma is employing "an aggressive new form of transnational corporatism" to increase profits at the expense of global health.
The TPP's "Healthcare Annex"—which seeks to regulate government policies around medicines and medical devices—would give big pharmaceutical companies more power over public access to medicine while crippling public healthcare programs around the world and "tying the hands" of the U.S. Congress in its ability to pursue Medicare reform and lower drug costs.
"The Great Treaty is taking shape in complete secrecy, because along with its undebated geostrategic ambitions it locks into place an aggressive new form of transnational corporatism for which there is little public support."
—Julian Assange, WikiLeaksIn a scathing analysis of the leaked text, which was published Wednesday by WikiLeaks, Australian public health expert Deborah Gleeson declares:
The purported aim of the Annex is to facilitate ‘high-quality healthcare’ but the Annex does nothing to achieve this. It is clearly intended to cater to the interests of the pharmaceutical industry. Nor does this do anything to promote “free trade”: rather it tightly specifies the operation of countries’ schemes for subsidizing pharmaceuticals and medical devices with the aim of providing greater disclosure, more avenues for pharmaceutical industry influence and greater opportunities for industry contestation of pharmaceutical decision making.
The inclusion of the Healthcare Transparency Annex in the TPP serves no useful public interest purpose. It sets a terrible precedent for using regional trade deals to tamper with other countries’ health systems and could circumscribe the options available to developing countries seeking to introduce pharmaceutical coverage programs in future.
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The TPP, currently being negotiated behind closed doors, would link the United States with Pacific Rim countries from Canada and Chile to Japan and Australia into a new regimen of so-called "free trade" rules that would cover 40 percent of the global economy.
"The leak is just the latest glaring example of why fast-tracking the TPP would undermine the health of Americans and the other countries and cost our government more, all to the benefit of pharma’s profits."
— Lori Wallach, Public Citizen's Global Trade Watch
President Barack Obama is trying to gain Fast Track approval from the U.S. House of Representatives as early as tomorrow, having already obtained it from the Senate, which would grant him increased power to push the TPP and other mammoth trade pacts through Congress.
Public health groups have long been part of the coalition of TPP opponents, charging that it would undermine efforts to ensure access to affordable, life-saving medicines in both the United States and abroad.
Wednesday's leak appears to bolster those claims.
According to the New York Times, which obtained the Healthcare Annex in collaboration with WikiLeaks, the document provides pharmaceutical companies with "new opportunities to challenge the decisions of trading partners on which drugs they will offer their citizens through government health care programs and the rates at which they will reimburse drug sellers."
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The Times continues:
A version of the Trans-Pacific Partnership annex that leaked in 2011 made explicit reference to “competitive market-derived prices,” promising drug companies the chance to appeal rates deemed insufficient. Those are gone, “a victory for the non-U.S. partners to some extent,” Ms. Gleeson, the Australian expert, said.
But Pacific accord negotiators do appear ready to grant pharmaceutical and medical device makers more power to influence participating governments. The 12 countries involved, and any others that might join later, would have to disclose rules and guidelines for deciding which medical products would be made available through government programs and at what rate providers would be reimbursed.
Drug companies and medical device makers would have to be given “timely opportunities to provide comments at relevant points in the decision-making process.” And governments would have to offer a review process “that may be invoked at the request of an applicant directly affected” by the decisions of national health care authorities.
Watchdogs say such provisions could give Big Pharma more influence over Medicare, particularly as regards pharmaceutical and medical device procurement and reimbursement.
In a fact sheet (pdf) distributed in response to the revelations, Public Citizen's Global Access to Medicines Program said the text raises critical questions such as:
Could companies use the Annex to compel Medicare to cover expensive products without a corresponding benefit to public health? Medicare reimbursement is limited to products that are “reasonable and necessary” for treatment. But the TPP "recognize[s] the value" of pharmaceutical products or medical devices through the "operation of competitive markets" or their "objectively demonstrated therapeutic significance," regardless of whether there are effective, affordable alternatives.
Furthermore, noted Peter Maybarduk, director of the Global Access to Medicines Program: "This leak reveals that the Obama administration, acting at the behest of pharmaceutical companies, has subjected Medicare to a series of procedural rules, negotiated in secret, that would limit Congress’ ability to enact policy reforms that would reduce prescription drug costs for Americans—and might even open to challenge aspects of our health care system today."
As the Times reports, pharmaceutical firms and their trade associations have filed by far more lobbying disclosure forms on TPP negotiations than any other industry, according to the watchdog Sunlight Foundation.
Of course, concern over the TPP's implications for healthcare policy wasn't limited to U.S. stakeholders. The Sydney Morning Herald reported:
Trade and healthcare experts are deeply concerned that the TPP agreement has the potential to undermine Australia's Pharmaceutical Benefits Scheme (PBS) and other similar health programs such as that administered by New Zealand's Pharmaceutical Management Agency.
They say TPP countries will face a much greater risk that big pharmaceutical companies will contest government decisions relating to the listing or otherwise of medicines for reimbursement and engage in expensive litigation, with the result that consumers will pay more while corporate profits will be protected.
"The annex highlights the great influence of Big Pharma in the debate over the TPP," Australian National University law professor Matthew Rimmer told the newspaper. "Big pharmaceutical companies will use procedural rules to bully countries in the Pacific Rim to roll back their public health regimes."
TPP opponents said Wednesday's revelations offer just one more reason for lawmakers to demand increased transparency and oppose Fast Track legislation.
"The leak is just the latest glaring example of why fast-tracking the TPP would undermine the health of Americans and the other countries and cost our government more, all to the benefit of pharma’s profits," said Lori Wallach, director of Public Citizen's Global Trade Watch.
Meanwhile, WikiLeaks publisher Julian Assange urged readers to consider the latest leak in a broader context.
In a statement released alongside the leaked text, Assange said, "It is a mistake to think of the TPP as a single treaty. In reality there are three conjoined mega-agreements, the TiSA, the TPP and the TTIP, all of which strategically assemble into a grand unified treaty, partitioning the world into the west versus the rest."
He continued: "The Great Treaty is taking shape in complete secrecy, because along with its undebated geostrategic ambitions it locks into place an aggressive new form of transnational corporatism for which there is little public support."