First off, I'd like to thank the Standing Committee on International Trade for inviting me. My name is Dr. Chetan Mehta. I'm a family and addictions medicine physician who works at Queen West Community Health Centre and for the addictions medicine service at Women's College Hospital.
I'm speaking today on behalf of Canadian Doctors for Medicare, or CDM. CDM is committed to evidence-based policy reform that advances publicly funded health care and systems that treat patients based on need, not their ability to pay.
Our organization is concerned about TPP's impact on the health outcomes of Canadians. Today, even without the ratification of TPP and CETA, many of them face severe barriers to accessing the medications they desperately need. Many of these issues that Canadians face are determined by forces beyond their control, by policy and trade decisions made by government, corporations, and panels such as yours.
We've highlighted three provisions in the trans-Pacific partnership agreement that have the potential to negatively impact the health of our patients.
The first is that the TPP's extension of patents to medical procedures constitutes a most significant divergence from existing medical and legal structures. Currently procedures such as laparoscopic surgery or interventional procedures are protected from patent restrictions, giving the medical community instant access to the best techniques that are available. Under TPP, new techniques would be subject to patents, meaning that the next breakthrough—the next laparoscopic surgery, for example—could be hidden behind legal and political barriers and rendered less accessible as a result.
Many of these services have the potential to save lives. This kind of patent reform could significantly affect allied health professions as well—for example, dentistry, physiotherapy, or respiratory therapy—that are increasingly linked to hospital care. There is little doubt that the quality of Canadian health care overall would suffer as a result, both from patients being blocked from accessing the appropriate services and Canadian innovation being hampered.
The second provision, the strengthening of patents for new pharmaceuticals, has received the most attention, and for good reason. It could have a profound impact on those who rely on medications, especially those without drug insurance plans. The TPP allows drug companies to extend the term of a new patent by five years or more, depending on whether delays in the patent approval process are considered “unreasonable”. Similar provisions have appeared in other trade agreements, but TPP weakens their required justification for an unreasonable delay, opening up new opportunities for patent extension and further delay regarding the development of generic alternatives.
Generic drugs are essential to health systems globally. For example, MSF lobbied to have the cost of HIV medications brought down by 99% through the introduction of generic alternatives; these generic manufacturers still made profits. By extending patents, we delay the development of generic drugs, and we do so at a massive cost to the patients who rely on them. The TPP's patent provisions are corporate interests with no proven benefits to public health.
Recent history has shown that longer patents actually decrease R and D. When patents were extended to 20 years in 1989, the pharmaceutical industry's promise was to increase R and D budgets to 10% of overall spending. Instead, R and D has dropped to as little as 3%, while marketing budgets to doctors have grown. The end result has been that increased patent protection delivers more profits but less innovation.
I'm happy to discuss my case study of hepatitis C drugs. It shows that these new drugs currently cost $80,000 to $150,000 per course of treatment, per person, in the Ontario health system. The risk to public and private insurers is significant today, and it would be worse under TPP.
Our final concern is the weakening of government regulatory powers under TPP. You may know that this occurs through a process called ISDS, which has been discussed at length. ISDS claims allow corporations to challenge foreign government policies that diminish, or have the potential to diminish, their earnings.
ISDS claims are not new. What is new is the emphasis on potential losses. The TPP's ISDS provisions can be launched by corporations on the basis of alleged financial losses, not proven financial losses.
Along with existing structural flaws, these details further erode state regulatory powers in the realm of public health and Health Canada and potential medical device and drug safety. While these developments certainly unfold in front of small asymmetric tribunals, their effects are felt by patients across the country, patients directly exposed to corporate decision-making when public health regulation is blocked.
The TPP carries with it the potential to compromise and jeopardize the health and lives of patients. It does so by blocking access to innovative techniques, creating barriers to medically necessary drugs, and strengthening the means by which multinationals can avoid and deter regulation, even if that regulation is designed to benefit Canadians and save lives.
For these reasons, and for others not dealt with here, we urge the federal government to subject the trans-Pacific partnership to a rigorous and transparent health impact analysis, and ask that the results be made available to all Canadians.
If we are going to ratify a trade agreement with sweeping health implications that touch the lives of us all, we should be clear about the consequences.
Thank you very much.