[Ip-health] San Diego Union Tribune op-ed on CAFTA

[Mike Palmedo]

http://www.signonsandiego.com/uniontrib/20050711/news_mz1e11heifet.html

CAFTA blocks access to medicines

San Diego Union-Tribune
By Ruth M. Heifetz
July 11, 2005

Californians are being told by boosters of the Central America Free
Trade Agreement that it is a great deal for our software industry. With
or without CAFTA, this powerful lobby will do well in the region, and so
will others. But public health in the United States and Central America
will be put at risk, and many Central Americans will suffer because of
reduced access to many essential medicines if this version of CAFTA
passes Congress.

Thanks to CAFTA, resource-poor nations of Central America will see long
delays in the introduction of generic competition =96 the most important
tool to reduce the price of medicines.

Under current law, when the patent for a drug runs out, generic
manufacturers have been able to utilize the data the original company
produced to get government approval for their own version of the drug.
In addition, governments often issue a "compulsory license" to encourage
other manufacturers to jump into the market to produce low-cost
alternatives for essential drugs.

Under CAFTA, once a brand-name firm has submitted the data needed to
sell its drug, firms or governments in Central America will not be able
to utilize that data to create a generic version of the drug for five
years =96 even if the drug's patent has expired, and even in a public
health emergency. Moreover, the five years could extend to 10 because
Central American nations are obliged to wait after the drug is first
introduced in the United States, and then wait again after the drug is
introduced in their own countries.

If Central American countries try to issue compulsory licenses
authorizing generic competition for products under patent, they will be
thwarted because the special monopoly on the data will block generics
from entering the market. Nations, rich and poor, regularly issue
compulsory licenses. The United States is no exception. In one notable
case, Secretary of Health and Social Services Tommy Thompson threatened
to issue a compulsory license on the antibiotic CIPRO at the height of
the anthrax scare. The threat alone was enough to force Bayer to lower
its price.

But CAFTA allows for no exceptions. None for costly HIV/AIDS drugs
needed by an estimated 275,000 Central Americans, none for the "big six"
infectious disease killers in the developing world such as tuberculosis,
pneumonia and malaria, none for deadly conditions like cancer or heart
disease, and none for new vaccines to counter emerging global threats
like the avian flu.

The sole reason for this provision in CAFTA is so that U.S.
pharmaceutical firms can continue to profit from vulnerable Central
American citizens, a travesty for which big pharma and its supporters
should be ashamed.

Health professionals opposing CAFTA include the American College of
Preventive Medicine, the American Public Health Association, the Center
for Policy Analysis on Trade and Health, the Hesperian Foundation,
Physicians for Human Rights and Physicians for Social Responsibility.

Besides pre-empting the production and humanitarian distribution of
affordable lifesaving medicines, another public health concern is that
CAFTA rules pre-empt the authority of public officials to protect health
standards such as professional licensing, environmental and occupational
health, alcohol and tobacco protections, privacy rules and patients'
rights. For example, tobacco companies would be granted the ability to
directly challenge national and state tobacco control laws under CAFTA's
investment provisions.

CAFTA also undermines access to vital services including health care,
water supply and sanitation, education and energy. By covering health
care and other services under trade rules, CAFTA facilitates
privatization of these services, making them less affordable, especially
for vulnerable populations, and less accountable. While health is
universally recognized as a human right, it may become a market
commodity if trade agreements don't protect affordable universal access
to health care.

CAFTA also undermines public health objectives of government
procurement. Currently, local, state and national governments'
procurement contracts can specify standards for medical and financial
privacy, quality and performance, local sustainable economic
development, environmental protection, public health and safety, gender
and racial equity, labor practices, and human rights.

CAFTA rules on government procurement undermine these important
capabilities. Under CAFTA, government actions to favor local companies
or service suppliers, or to impose technical specifications, can be
challenged as barriers to trade. The United States has agreed to include
health care services in this chapter.

The absence of formal representation for health care and public health
in the negotiation of CAFTA is disturbing. While many industries sit on
advisory committees to the U.S. trade representative, there are no
representatives from public health. No impact assessments are conducted
on trade in health services.

So the choice on CAFTA is urgent and clear. California's congressional
delegation should vote "No" and say "Yes" to fair trade that puts human
rights first and does no harm to our neighbors in Central America.

Heifetz, a physician and public health specialist, is senior lecturer in
the Department of Family and Preventive Medicine at the UCSD School of
Medicine.