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Negotiating Away Health? Why Physicians Should Care About the Trans Pacific Partnership (TPP) and Transatlantic Trade & Investment Partnership (TTIP)

Posted by January 30, 2015 at 9:45 AM

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Written by Elizabeth Wiley, MD, JD, member NPA FDA Taskforce

Over the last five years, a new generation of “mega” trade agreement negotiations have emerged that seek to establish a new global trade governance framework with far-reaching potential implications for health and health care. The size, scope and lack of transparency of these negotiations are unprecedented.

Launched in 2010, Trans Pacific Partnership (TPP) includes twelve negotiating parties: Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, United States and Vietnam. The Transatlantic Trade & Investment Partnership (TTIP) negotiations include the European Union and United States. Between the TPP and TTIP, forty countries representing more than 60% of the global gross domestic product (GDP) are involved in current negotiations, and the Obama Administration has signaled that these agreements will serve as a model for all future agreements. Thus, TPP and TTIP negotiations will likely have truly global ramifications.

So why should physicians care about trade negotiations?

If successful, these agreements could significantly reshape the environment in which we, as physicians, serve patients and practice medicine. On a truly global scale, these agreements may affect:

To date, TPP and TTIP negotiations are conducted largely in secret with disparate access to draft texts and negotiators afforded to industry through US Trade Representative (USTR) Advisory Committees. Draft texts have been leaked for chapters of both agreements and paint a troubling picture of where negotiations are headed. The lack of transparency in negotiations has made advocacy and engagement by public health and other civil society groups challenging.

Access to Medicines

Leaked draft texts of TPP and TTIP suggest that these agreements may include aggressive TRIPS-plus ( )(-plus) intellectual property provisions that could have devastating effects on the affordability and accessibility of medications. A recent UNITAID report described how such provisions would prevent generic entry into the market, resulting in higher drug costs. Of particular concern are harmful provisions that would:

  • Require patent linkage that would delay approval of generic drugs
  • Allow “evergreening,” or extensions of patent protections for minor modifications of existing drugs
  • Protect extended data/market exclusivity for drugs and establish lengthy data exclusivity protections biologics
  • Extend patent protection for patent examination/review processes
  • Prevent clinical trial data transparency
  • Use transition periods to leverage support for more unsavory IP protections

A related concern is ensuring that an exception for the patenting of diagnostic, therapeutic and surgical techniques, similar to 35 USC 287(c), in any agreement. Such an exception is essential to preventing potential liability for patent infringement for health professionals performing procedures.

Investor State Dispute Settlement (ISDS)

Of particular concern is the possible inclusion of a broad investor-state dispute settlement (ISDS) mechanism in these agreements. ISDS provides a way for investors to bring claims against governments and seek compensation. ISDS cases are generally adjudicated by panels of private corporate attorneys with little transparency. When incorporated into much smaller scale trade agreements, these provisions have been used to challenge successful, evidence-based public health initiatives such as cigarette plain-packaging. ISDS has also been used by pharmaceutical companies to enforce patent protections and prevent generic drugs from entering the market. More than half of ISDS cases are either settled or decided in favor of the investor. Moreover, there is concern that the mere availability of ISDS may deter governments from adopting policies to protect health.

What can physicians do to ensure that the TPP and TTIP advance rather than undermine health and access to care?

Given the potential implications of these trade agreements on health and health care services, it is critical that we, as physicians, engage in negotiations and with law-makers. NPA recently signed on to a letter with many other organizations expressing concern about potential implications of intellectual property and ISDS provisions on access to medicines. As TPP and TTIP negotiations continue, look for more NPA trade and health advocacy activities and opportunities.

Interested in getting involved in NPA trade & health advocacy?
Email Liz Wiley at

Additional Resources:
Public Citizen (TPP)
Public Citizen (TTIP)
Knowledge Ecology International (TPP/TTIP)
CPAH Public Health Voice in Trade Policy Campaign
Health Action International (TTIP)
Trans Atlantic Consumer Dialogue (TTIP)
Greens/European Free Alliance (TTIP)
AFL-CIO & ETUC Joint Declaration (TTIP)

One Response to “Negotiating Away Health? Why Physicians Should Care About the Trans Pacific Partnership (TPP) and Transatlantic Trade & Investment Partnership (TTIP)”

  1. David E.H. Smith says:

    NATIVE CANADIANS to JOIN Trans Pacific nations, EU, China, et al, in SUIT against Corp. Canada Re; Deprivation of Due Diligence Treaty Info?

    HOW to DISCOURAGE CORPORATE USA, et al, “Need” to FLEECE NON-Shareholders & GLOBALLY EXPAND & DiLUTE $17+ Trillion DEBT.

    TPP/CETA/C-CIT Treaties; SUING The Global Corporate Economy; the harmless NON Shareholders. ‘Coveted’ HK Investor; BUY GOLD?

    Higher Taxes (But, No ‘NEW’ Taxes), More Cuts to Services to Pay Secret TPPartnership Tribunal Penalties; NON Shareholders Have to Pay SHAREHOLDERS, corporate America, Japan, et al.

    How Much are You Selling your Right to Sue the Global Corporate Economy for?
    But, WILL CHINA, The Muslim World, INDIA, et al, SUPPORT PUTIN (BRICS, et al); The WHITE KNIGHT?

    It will be good for, not only the NON shareholders of the enterprises that will be generated by the on-going global “cooperation” of corporate treaties, agreements, partnerships, et al, including the China – Canada Investment Treaty, The Trans Pacific Partnership, the EU – Canada CETA,
    for the potential shareholders, as well,
    who are quite interested to know if President Xi Jinping (China) will support Russia as a co-member of B.R.I.C.S. when President Putin uses his potential role as “The White Knight”.

    And, while President Putin’s potential support as “The WHITE KNIGHT” in the development of the CETAgreement, et al, litigation below can dramatically off-set the hundreds of billions of dollars due to the present & future sanctions leveled by American led, et al, corporations & financial institutions via their governments’ signing their global corporate economic treaties/”arrangements”,
    and the potential for making trillions of dollars for the Russian economy over the next 30 – 40 years & beyond,
    are the citizens (SHAREHOLDERS & NON shareholders) of Germany & JAPAN just being prudent in wanting to wait for the outcome of:
    1) The Submission to The SUPREME COURT of CANADA & the highest court in Germany, et al, to make their findings regarding “The Submission”:
    “The SHAREHOLDERS & Corporations of AMERICA, Australia, Canada, et al
    the harmless Canadian NON shareholders, both; Native & non Native, et al”?


    2) “The MERKEL (Chanc. Germ.) Letter; To Sue, or, Be Sued”?

    Have the federal representatives of the nations that are the potential signatories of CETA, TPP, et al, willingly provided the NON shareholders of China, Canada, Europe, the Trans Pacific nations, et al, with the aforementioned information? Are the federal representatives, et al, depriving the NON shareholders of Canada, et al, of the due diligence information that enables the family of the NON shareholders of Canada, et al, to make informed decisions regarding their financial planning?

    And, would a reasonable person conclude by a preponderance of the evidence, &/or, beyond a reasonable doubt, that these documents, et al, demonstrate that the SHAREHOLDERS of AMERICA, CANADA , the EU & Trans Pacific nations, et al, really do not care which NON shareholders pay them the punitive penalties, etc., by way of their secret (“Death-Star Chamber”) TRIBUNALS, as long as its not the SHAREHOLDERS who pay & not their corporations regardless of which country the corporations:
    1) operating from,
    2) maintain their headquarters,
    3) use to do their cyber banking, accounting, “taxation”, etc.
    4) et al?

    And, re; the CHINA – Canada Investment Treaty, is it understandable why the “coveted” Hong Kong investor & his associates are “concerned” with the aforementioned findings of The SUPREME COURT of CANADA, et al, & the effects of the findings, et al, on the EU, AMERICA, the Trans Pacific nations, et al, treaties with CHINA, et al?

    In regard to arms sales; how about the sale of arms (non nuclear) in general in regard to the “trade” treaties that are continuing to be secretly negotiated and how will the Tribunals, both; B.R.I.C.S. & non BRICS, adjudicate, decide & penalize the NON SHAREHOLDERS for the sale of legitimate, semi- legitimate & “illegal” sales of arms within the signatories nations & the those of others, &/or, unaligned? Of particular, interest is China, which does have an treaty with Canada, which puts China “at odds” with other arms manufacturing & nuclear powers that it (China) does not have any “arrangements” with.
    Are these types of questions that your politicians & the corporate lobbyists calls “forget-me-nots” (“Buyer Beware”) that will be (maybe) worked out after the fast tracked signatures are obtained?

    And, what do you think is the significance of the line in The Submission to The Supreme Court of Canada ‘…And, lest one forgets that the revelation of the present perilous international treaties/’arrangements’ began with the regard for the rights of Native Canadians as per the Treaties/”arrangements” that corporate Canada & the Government of Canada have ‘foisted’ upon Native Canadians…’? What are the various ways that this line will cost the SHAREHOLDERS, et al?

    On the other hand, it may be worth repeating yet again,
    ‘What the TREATY of VERSAILLES was to the 20th century PALES in COMPARISON to the TPP, CETA, C-CIT, NAFTA, et al, in the 21st’.

    And, how will YOUR submission to YOUR highest court IMPROVE upon The Submission that is presently before The Supreme Court of Canada?

    David E.H. Smith
    – Researcher
    – ‘Qui tam…’
    Please consider sharing the enclosed information & questions with 10 members of your family, friends, associates in order that they can use the due diligence info to make more informed decision about their families’ financial planning, & then they can share it with 10 others…
    For more Information & Questions re; The Relationship between Human (Nature) Rights & Economics by way of the C-CI Treaty, the CET Agreement, TPP, et al, and The WAD Accord

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