PRIORITIZING HEALTHPRIORITIZING HEALTHIN U.S. TRADE POLICY:IN U.S. TRADE POLICY:

A CASE EXAMPLEA CASE EXAMPLE

2004 Political Crisis: 2004 Political Crisis: PharmaceuticalsPharmaceuticals

Public outcry about high drug Public outcry about high drug pricesprices U.S. pays highest prices in the worldU.S. pays highest prices in the world Reimportation proposals in U.S. Reimportation proposals in U.S.

CongressCongress

Pharma Political Strategy:Pharma Political Strategy:Trade AgreementsTrade Agreements

A. Protect high prices in US marketA. Protect high prices in US market Block reimportation (“parallel Block reimportation (“parallel

importation”)importation”)

B. Maintain Intellectual Property B. Maintain Intellectual Property structure in regional trade agreements structure in regional trade agreements with low/ middle-income countries with low/ middle-income countries ““TRIPS-Plus” trade rules extend patentsTRIPS-Plus” trade rules extend patents Restrict production and sale of generics Restrict production and sale of generics Market to small number of wealthy Market to small number of wealthy

individualsindividuals

Australia Trade AgreementAustralia Trade AgreementCPATH 2004: CCPATH 2004: Caution aution

NeededNeededAnalysis – U.S. Australia FTA:Analysis – U.S. Australia FTA: Could block reimporting lower Could block reimporting lower

priced drugs into USpriced drugs into US

Challenges effective methods for Challenges effective methods for controlling drug prices in Australiacontrolling drug prices in Australia

Could affect popular US drug price Could affect popular US drug price programs for VA, Medicaid, programs for VA, Medicaid, MedicareMedicare

Education & Outreach Education & Outreach 2004 U.S.-Australia FTA2004 U.S.-Australia FTA

U.S. Trade RepresentativeU.S. Trade Representative Meetings/correspondence regarding specific Meetings/correspondence regarding specific

provisionsprovisions U.S. CongressU.S. Congress

Testimony before House Ways and Means Testimony before House Ways and Means CommitteeCommittee

Meetings with Congressional Trade and Health Meetings with Congressional Trade and Health staffstaff

Congressional Committees on Health, V.A.Congressional Committees on Health, V.A. Civil SocietyCivil Society

Widely disseminated analysis to national and Widely disseminated analysis to national and local domestic organizations which focused on local domestic organizations which focused on increasing access to affordable medicine in U.S.increasing access to affordable medicine in U.S.

Senator Clinton Town Hall – Senator Clinton Town Hall – N.Y.N.Y.

““Is the Senator Is the Senator considering considering supporting the supporting the Australia Free Australia Free Trade Agreement, Trade Agreement, which could which could prohibit drug prohibit drug reimportation into reimportation into the United States?” the United States?”

Senior, Senior, ConstituentConstituent

Congress ObjectsCongress Objects

FTA achieves corporate policy agenda FTA achieves corporate policy agenda without public debatewithout public debate

Kennedy, Schumer, McCain, Gutknecht: Kennedy, Schumer, McCain, Gutknecht: Get public health representation! Get public health representation!

Bob Graham, Strickland, Evans: Protect Bob Graham, Strickland, Evans: Protect VA!VA!

Allen, Rangel, Levin: Never again! Allen, Rangel, Levin: Never again!

Sen. Charles SchumerSen. Charles Schumer It has become clear in recent weeks that the It has become clear in recent weeks that the

pharmaceutical industry has not only done pharmaceutical industry has not only done everything in its power to thwart drug everything in its power to thwart drug reimportation legislation before this reimportation legislation before this Congress, but now they have hijacked the Congress, but now they have hijacked the trade agreement negotiation process as well. trade agreement negotiation process as well. That practice has to end. That practice has to end.

The provision is nothing more than a The provision is nothing more than a backdoor opportunity to protect the big backdoor opportunity to protect the big pharmaceutical companies' profits and keep pharmaceutical companies' profits and keep drug prices high for U.S. consumers drug prices high for U.S. consumers

U.S. Trade Policy ChangeU.S. Trade Policy Change

Australia: Congress draws line in the Australia: Congress draws line in the sandsand

Vitter/Stabenow/Northup/DeLauro billsVitter/Stabenow/Northup/DeLauro bills Ban using trade agreements to address Ban using trade agreements to address

drug reimportationdrug reimportation

Call for consumer representatives in Call for consumer representatives in policypolicy

U.S. ceases to propose trade rules U.S. ceases to propose trade rules banning drug importationbanning drug importation

Vital Human Services for Vital Human Services for SaleSale

“ “Some kinds of public policy choices Some kinds of public policy choices should be decided by democratically should be decided by democratically elected governments, not by elected governments, not by unelected trade bureaucrats.”unelected trade bureaucrats.”

U.S. Senator Jon Corzine (D-NJ)U.S. Senator Jon Corzine (D-NJ)

Elements for ChangeElements for Change TransparencyTransparency

Publicly accessible analysis and debate of Publicly accessible analysis and debate of trade proposalstrade proposals

AccountabilityAccountability Communication with Congressional decision-Communication with Congressional decision-

makers, including in their districts linking makers, including in their districts linking trade and healthtrade and health

Opportunity and TimingOpportunity and Timing Public attention and national debate on the Public attention and national debate on the

issue issue (in this case affordability of drugs in U.S.)(in this case affordability of drugs in U.S.)

FTAA: Free Trade Area of FTAA: Free Trade Area of the Americas - DEFEATEDthe Americas - DEFEATED

Launched in 1994. Negotiating Launched in 1994. Negotiating deadline: 2005deadline: 2005

NAFTA for all 34 countries in NAFTA for all 34 countries in North, Central, South America and North, Central, South America and the Caribbean the Caribbean (except Cuba)(except Cuba)

Most comprehensive proposed trade Most comprehensive proposed trade agreement in history, would have agreement in history, would have affected more than 800 million peopleaffected more than 800 million people