Many health care providers are deeply concerned about the Trans Pacific Partnership (TPP), a free trade deal that the U.S. Senate agreed to "fast-track" last month. This means our Senators will neither debate nor amend the eventual final draft of the TPP. Instead, they will take a simple yes or no vote on a humongous set of policies that will impact the health of millions. There are still several important civics hurdles before this free trade deal is finalized, and our policymakers must consider how TPP is detrimental to medicine and public health for all of us.
1. Those already high costs for prescription drugs could skyrocket.
Millions of us, regardless of whether we have asthma, AIDS, cancer, tuberculosis, or diabetes depend on generic medications to keep us alive and healthy. These lower priced medications make it possible for public health agencies and health care providers to care for millions of patients. On "Dr. America," in my conversation with Eva Dominguez from the Alliance for Retired Americans, she pointed out that patients already face huge prices for biologics: a patient with rheumatoid arthritis can pay $2,632 to $5,264 per month for a 40 milligram injectable kit of Humera. On the one hand, President Obama and other political leaders have agreed that these costs need to be reduced, and lowering patent protections can facilitate the use of cheaper biosimilars and generic medications.
On the other hand, these same politicians support the Trans Pacific Partnership, which threatens the affordability of biologics and thousands of prescription drugs by greatly expanding intellectual property protections. Extending these protections is a gift to the pharmaceutical companies owning patents on expensive brand-name medications, and a disaster for makers of generic medications who will have to wait as long as 20 years to produce life-saving treatments. For groups like the Foundation for AIDS Research (amFAR), patent protections of antiviral drugs have already been obstructive to saving entire communities, and TPP worsens these circumstances and puts lives at risk unnecessarily. Regardless of your diagnosis, you should never have to sacrifice your wealth or decades of your time for your health.
2. Could candy companies sue Michelle Obama for encouraging healthy eating?
The TPP includes a legal mechanism called Investor State Dispute Settlement (ISDS), which allows a corporation to sue local, state, and/or federal governments whenever that corporation worries its products are threatened by new government policies. For instance, if the government of a country participating in TPP passes legislation to enhance warning labels on cigarette packs, a Big Tobacco company could sue that government, as happened in Australia and Uruguay, because profits from cigarettes are threatened by common-sense public health education. Here in America, Maryland recently passed a ban on fracking for two and a half years, after which fracking will be strictly regulated. As Marylanders learn more about the health consequences of fracking, the state's new regulations may be "troublesome" for Big Oil companies, who could theoretically use ISDS to sue the state.
To be clear, under ISDS, international trade lawyers would convene a special legal forum to resolve the dispute. Our courts and judges, the parts of our democracy in charge of determining what is just, would be left out. Furthermore, governments and public health agencies acting in the interests of health and wellness would not have any means of appealing the decision made by an ISDS.
When doctors, public health groups, and concerned citizens advocate to Congress and legislatures for anti-tobacco programs, regulations on chemicals, and food safety policies, we are not attacking capitalism or free trade. These efforts to build healthier and safer communities should not be undermined to protect the profits of mega-corporations. If a government is afraid of expensive super-secret lawsuits from multi-billion dollar companies, then political leaders may avoid applying public health research in new policies that could benefit the well-being of millions.
By voting against the Trans Pacific Partnership, Congress has an opportunity to stand with thousands of doctors and public health experts, and remind America and the world that we should not be forced into false choices between staying healthy and facilitating commerce. We need to continue our efforts to provide medications for patients, reduce smoking, make our food safe, and protect our air and water. This work should not be undermined by TPP's protections for wealthy mega-corporations or by TPP's legal tricks to intimidate democratically elected leaders. Time is running out for everyday Americans to take action against the Trans Pacific Partnership. Contact your members of Congress immediately and tell them free trade should not cost our health.