Obama vs. Medical Access

Most mainstream political discourse on health policy in the US today revolves around the Affordable Care Act, better known as “Obamacare.” Liberals praise the bill for expanding healthcare access and conservatives decry the bill as government overreach. But as political partisans squabble, Obama is busy promoting a policy that will use government overreach to deny affordable care to patients in the developing world: The Trans-Pacific Partnership.

The Trans-Pacific Partnership (TPP) is a multilateral international trade agreement. While some refer to these agreements as “free trade” agreements, they do much more than just lift trade barriers. Trade agreements usually expand the scope and power of “intellectual property” (IP). The primary function of IP is to grant IP-holders exclusive production access, thereby preventing competition. For this reason, IP “rights” are better understood as patent and copyright monopolies.

When it comes to medicine, the price increases associated with pharmaceutical patents cost lives. Judit Rius Sanjuan of Doctors Without Borders says, “Policies that restrict competition thwart our ability to improve the lives of millions with affordable, lifesaving treatments.”

Humanitarian groups like Doctors Without Borders rely on generic drugs to treat patients in poor countries. Generic production of drugs has especially helped AIDS patients, dramatically decreasing their medical expenses. Indeed, a Doctors Without Borders report explains that, “About 80 percent of donor funded anti-AIDS drugs and 92 percent of drugs to treat children with AIDS across the developing world comes from generic manufacturers.” Patent monopolies threaten such patients by restricting production of generic drugs.

The Obama administration has proposed provisions to the TPP that would radically expand patent monopolies. For example, proposed TPP provisions would require that governments grant patents for slight modifications of already existing products. This practice, known as “evergreening,” allows pharmaceutical companies to keep monopolies on drugs after their patents would ordinarily expire.

The IP section of the TPP proposed by the US would grant participating countries new powers to stall medical shipments in customs. Customs agents would be permitted to seize drugs deemed “confusingly similar” to trademarked products. Similar policies exist in Europe, allowing us to see how such customs operations work out in practice.

In a 2008 case, Dutch customs officials seized AIDS medications on their way from India to Nigeria. The non-profit Clinton Foundation had purchased the medication with help from UNITAID, an arm of the World Health Organization. According to the Financial Times, the seizure put the lives of “dozens” of patients at risk.

Such provisions seem to fly in the face of Obama’s stated commitment to “affordable care.” In fact, when it comes to international medical access, Judit Rius Sanjuan says, “Bush was better than Obama on this.”

But the central thrust of these policies doesn’t change much from administration to administration. Under the banner of “free trade,” politicians promote agreements that restrict trade and competition, all to bolster corporate profits. It’s tempting to laugh at just how Orwellian it is to call these anti-competitive policies “free trade.”

But it’s hard to laugh when the state threatens medical access for patients throughout the developing world.

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