Thank you for the opportunity to address the committee on this important issue.
I'm a humanitarian affairs advisor with Doctors Without Borders/Médecins Sans Frontières. I'm here to present our perspectives regarding the negative impact that the Trans-Pacific Partnership agreement, or the TPP, will have on access to affordable medicines.
I'm joined by my colleague in New York, Judit Rius Sanjuan, who has followed the TPP negotiations closely for several years.
MSF is an international humanitarian organization that provides impartial medical assistance to people in nearly 70 countries. For more than 40 years, we have been providing medical assistance to people affected by armed conflicts, natural disasters, disease epidemics, malnutrition crises, and other emergencies. In 2014, alone, we performed more than 8 million outpatient consultations, vaccinated more than 1.5 million people during measles outbreaks, and responded to other medical emergencies ranging from Ebola outbreaks in West Africa to the refugee crisis in Europe, and many others.
As a medical treatment provider that needs both affordable access to and innovation for medical technologies, MSF is able to speak about the relationship between trade, intellectual property, and health, and about the role competition has played in enabling access to medical care for millions.
Drug prices need to be affordable so our patients, and millions of others still waiting for treatment, can get the medicines they need. In our experience, generic competition in the production and distribution of health technologies saves lives by reducing prices and increasing access. Countries, and medical treatment providers like MSF rely on affordable, quality, generic medicines to treat many life-threatening diseases, including tuberculosis, malaria, HIV/AIDS, and other infections that afflict the poorest and most vulnerable populations.
Our analysis of the text of the TPP has identified that this agreement represents a major concern for public health. We will submit a brief with more information on our analysis, but some of our concerns relate to the following provisions.
First, the TPP requires countries to grant additional 20-year patents for modifications of existing medicines for new uses, methods of use, or new processes of a known product. This lowers the standards of patentability and creates new monopolies for existing medicines.
Second, the TPP requires countries to protect clinical trials data with additional periods of exclusivity. These data exclusivity obligations will restrict access to medicines, even when patents no longer apply or never existed, giving companies another way to keep prices high for longer, and further delaying competition. This includes a specially extended period of data exclusivity for a certain class of drugs known as “biologics”, which includes, for example, many new cancer treatments, vaccines, and potential Ebola treatments.
Third, the TPP requires countries to grant patent term extensions beyond the initial 20-year patent term if companies argue that there have been delays in the regulatory or patent-granting process.
The effect of these provisions will be to keep medicine prices high for longer by further delaying price-lowering competition. There are additional provisions that fail to balance commercial and public health interests, and further restrict the ability of governments to address high health care costs and to regulate medicine prices.
If enacted in its current form, the TPP will go down in history as the worst-ever trade agreement for access to medicines for developing countries. This is of vital importance to Canada, because Canada has made many important contributions to global health, for example, as one of the largest donors to Gavi, the vaccine alliance, where Canada has contributed more than $1 billion to improve access to affordable vaccines in developing countries and, most recently, by committing $785 million to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Provisions such as those included in the TPP undermine these investments and reduce the efficiency of the dollars pledged by unnecessarily driving up the price of medicines, meaning that instead of being used to procure needed medical services, dollars end up in the pockets of already-profitable pharmaceutical companies.
Instead of using trade deals like the TPP to extend monopolies for pharmaceutical companies, Canada should seek to establish improved global norms to fix the broken research and development system.
The sole reliance on high medicine prices backed by exclusivities and monopolies is a flawed paradigm for funding innovation. This leads to unaffordable prices while failing to stimulate innovation for diseases where patients have limited purchasing power, like neglected tropical diseases or where medicines like antibiotics have to be used sparsely.
It is not too late to prevent the further restrictions on access to affordable medicines that would be created through the TPP. MSF urges Canada to protect the right to health of millions of people who will be negatively impacted if the TPP is implemented in its current form.
The TPP should be modified or rejected. Rather than implementing measures that will lock in high prices, Canada should champion efforts to improve the world's research and development system to ensure that biomedical innovations address pertinent public health needs and are accessible and affordable to all who need them.
Judit and I would be pleased to answer any questions that members of the committee may have for MSF.