by David Bodapati
Trading Away Health – The Regional Comprehensive Economic Partnership
Next week, Hyderabad is set to host the 19th round of Regional Comprehensive Economic Partnership (RCEP) from July 24 to 28, a regional trade agreement between India, the ten member states of the ASEAN and, Australia, China, Japan, New Zealand, and Republic of Korea. This trade deal threatens to undermine the ability of some of the world’s poorest people to get access to good quality medicines at cheap and affordable prices.
Since 2012, the RCEP trade agreement has been under negotiation between the ten members of the Association of South East Asian Nations (ASEAN) (Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, Vietnam) and the six countries that have existing trade agreements with ASEAN: Australia, China, India, Japan, New Zealand and the Republic of Korea. Notably, the RCEP countries are home to nearly 50% of the global population, including some of the world’s most impoverished and marginalised communities.The RCEP trade agreement is being negotiated in secret, without input from public health stakeholders.
“Amongst a handful of developing countries with a huge production capacity to manufacture quality-assured generic medicines, India did not grant patents on medicines till 2005 and thus, its generic companies produce some of the cheapest life-saving drugs in the world,” said Shailly Gupta, Deputy Head, MSF Access Campaign (India).
Death warrant to people living with HIV
Known as the ‘pharmacy of the developing world’, India played a major role in scaling up treatment to 17 million people across the world by lowering the price of anti-retrovirals (HIV medicines) from Rs. 6 lakh ($10,000) per patient per year in 2001 to less than Rs.18,000 ($300). The Indian government presently provides free Anti-retrovirals (ARV) to 9.94 lakh people (out of 24 lakh) living with HIV. Any trade agreement which forces the increase in price of these life-saving medicines will not only hamper the Indian government’s public health programme but is a sure death warrant to thousands of HIV positive people in India.
Similarly, the drug Imatinib can completely cure Chronic Myeloid Leukaemia (CML) or Blood Cancer. A month’s treatment using one of the branded varieties of Imatinib drug would cost Rs 1.24 lakh per patient per month while it is just Rs 5,720 per month per patient with the generic variety.
“As a medical treatment provider, Doctors Without Borders/ Médecins Sans Frontières (MSF) relies on affordable, quality generic medicines to treat a number of diseases. In fact, 97 per cent of the medicines used by MSF to treat HIV are generics sourced from India,’’ said Gupta.
“As a medical humanitarian organisation working in nearly 70 countries, MSF is concerned that demands for intellectual property provisions in the intellectual property and investment chapters could potentially challenge a government’s capacity to initiate and execute policies to protect public health and ensure affordable access to medicines for all,” she added.
According to the leaked text, Japan and the Republic of Korea are pushing for provisions that go far beyond international trade rules (known as TRIPS-plus rules) to extend drug corporations’ patent terms and introduce the most damaging form of clinical trial data monopolies. Further, the proposed elevated levels of IP enforcement would delay generic competition and translate into higher prices for lengthier periods of time, which would, in turn, prevent the flow of affordable generic medicines from producer to patient. These provisions offer pharmaceutical corporations a blank cheque for abuse. In developing countries, where people rarely have health insurance and must pay for medicines out of pocket, high prices keep life-saving medicines out of reach – and this is often a matter of life and death.
Dangerous trend
RCEP’s damaging provisions are similar to those included in the Trans Pacific Partnership (TPP) trade agreement between the United States and eleven other Pacific Rim countries signed in February 2016 after years of secretive negotiations. Seven countries are common to both the TPP and the RCEP. The TPP has been repeatedly referred to as “the worst trade deal ever for access to medicines.”
“It is disturbing to note that Japan and the Republic of Korea (who are also part of the TPP) are seeking to include similar damaging IP provisions in a trade agreement that includes many more developing countries,” said Leena Menghaney, Head South Asia, MSF Access Campaign.
“Multinational pharma corporations view robust, affordable generic medicines produced and marketed by Indian suppliers as an enormous threat to their profits.,” she added.
Dr Gopal Dabade, President, Drug Action Forum – Karnataka, feels that India’s patent law and the argument that multinational drug manufacturing companies based in the US and Europe deserve compensation for the large amounts they spend on research is not valid. “Most of the innovation happens at public-funded institutions and universities. The teams here do the basic research and then the drug companies develop it and market it. There are countless studies that show that drug companies really spend more on advertising and promotion. At times they may even spend on research, it’s mainly to gauge how to sell a drug better,” says the renowned doctor and health activist.
“Prime Minister Narendra Modi recently visited USA to meet president Donald Trump.During their meeting one important agenda was that India should amend its Patent Law so as to suit the American drug manufacturing companies. It is not just USA but also the European Commission which is currently having trade negotiations with India which is called a Free Trade Agreement (FTA). It suggested India to make changes so that it will bring more profits to the big drug companies in Europe. But this will also seriously hamper access to medicines across the developing world,” Dr Dabade added.
If the IP provisions proposed in RCEP are accepted, access to affordable life saving medicines will be restricted for people in India and around the world who rely on life-saving affordable generics made in India. Many organisations and activists are gathering in Hyderabad to undertake protests and marches to oppose the trade treaties which can trade away the health of the poor people.
David Bodapati is a journalist turned health activist working with networks of people living with HIV and other marginalised groups to support Access to Medicines.
