MEXICO CITY, Mexico and LIMA, Peru — As a man in a smiley doctor costume waves gigantic foam hands to an electronic beat, Guillermo Ocampo waits patiently in line to buy his prostate cancer medicine.
The bargain basement pharmacy in downtown Mexico City, Farmacias Similares, charges $17 for two weeks’ worth of the generic drug bicalutamide.
Around the corner, the patented original of the same medication sells for $83 under the brand name Casodex. That’s more than the 51-year-old security guard earns in a week.
“This medicine stops the cancer from growing and that keeps me alive,” says Ocampo, who like many Mexicans has no health insurance. “I simply couldn’t afford to pay for the patented version. I don’t know what I would do.”
Ocampo is not alone. Generic drugs have boomed in Latin America, where millions of poorer patients now rely on them to stop killer diseases and alleviate debilitating symptoms.
Just in Mexico, generics accounted for 84 percent of the medicine market last year, according to the government. That has saved the poorest Mexicans a total of $1.3 billion over the last four years.
But now hundreds of millions of patients around the Pacific rim face losing the chance to use new, cheap generic drugs to treat a host of conditions, including cancer, multiple sclerosis, Alzheimer’s and rheumatoid arthritis.
That’s thanks to the Trans-Pacific Partnership, or TPP, a Washington-backed mega-trade agreement that would include Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, the United States, and Vietnam.
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Several other countries are also interested in joining, including South Korea. But so far China, whose government promotes its huge generics industry, is staying outside the club.
It will be the largest trade deal ever, accounting for roughly 40 percent of the global economy. Governments, including the Obama administration, say it will boost jobs, trade and economic growth, and even raise environmental standards.
But the TPP also appears to have a darker side. Thanks to lobbying from the pharmaceutical industry, treaty drafts are thought to include a number of technical clauses, like longer patent periods, which would extend monopolies for eye-wateringly expensive brand name drugs.
That would cut off the supply of new, generic medicines — often up to 80 percent cheaper — for years or possibly even decades.
We say “appears” and “thought to” because no one outside the negotiations really knows. The talks are being held behind closed doors. And lawmakers in each of the TPP member countries will only be offered up-and-down votes on the entire treaty text, which will be thicker than an old-school phone book, once the negotiations have finished.
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For patients without health insurance, like Ocampo, that could spell adios to the chance for new treatments for his prostate cancer.
Even for those covered by public or private health insurance, especially in poorer countries such as Peru and Mexico, that may put many treatments beyond already stretched health care budgets.
“The TPP agreement is on track to become the most harmful trade pact ever for access to medicines in developing countries,” warns Doctors Without Borders, an international aid organization.
Peter Maybarduk, of Washington, DC-based consumer advocacy group Public Citizen, adds that the deal “will lead to unnecessary suffering and deaths.”
“These are the most aggressive set of measures, promoted by the pharmaceutical industry, backed by the US government, that we have ever seen in a trade agreement,” Maybarduk, who heads the group's Global Access to Medicines Program, tells GlobalPost.
“These countries want to sign these trade deals with Washington because they want access to US markets and political influence. In return, the US pressures them to restructure their economies in favor of US corporate interests.”
Although WikiLeaks in October published a negotiating draft of the TPP chapter on intellectual property, which would establish the new medicine market rules, details remain vague.
Campaigners like Maybarduk are relying on building up personal relationships with negotiators, including waiting in corridors in conference centers around the Pacific rim, to glean clues.
Public Citizen believes the most harmful clause may be a push from the Obama administration to extend “market exclusivity” for so-called biologics to 12 years in all TPP member countries. Biologics are cutting-edge treatments derived from living organisms. They now include gene and cellular therapies, vaccines, and allergy shots.
That clause would mean no generic versions could be brought to market within 12 years of the branded original first going on sale.
The measure would be separate from any patents for any new compounds within the medication, which run from the time they were first invented.
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The US pharmaceutical industry, which saw sales of nearly $400 billion in 2014, has been lobbying the Obama administration over the TPP. The sector argues that the exclusivity measures are needed to maintain innovation, by rewarding drug companies that create new treatments.
In a statement emailed to GlobalPost, industry umbrella group the Pharmaceutical Research and Manufacturers of America said strong intellectual property rights play “a critical role in building market-based incentives for innovation, creativity, and advanced global drug discovery, the benefits of which are shared with patients around the world.”
The drug-making group’s spokesman Mark Grayson added that they “help spur development and investment, which will enable countries to provide better health care, including medicines, for their citizens.”
The Mexican and Peruvian governments did not respond to GlobalPost’s repeated requests for comment. Nor did the office of the United States Trade Representative, the White House agency leading the US negotiating team.
Back at Mexico City’s Farmacias Similares, patients are starting to worry.
At the pharmacy, Juan Cruz, a 56-year-old computer repairer, is buying a $3 generic antibiotic for a foot infection. “The multinational companies want to make even more money. But you have to look at the economy of most Mexican families,” he says.
“People are struggling to get by and the cost of medicine can break them. The Mexican government needs to stand up for our interests.”