The discussion about the economic impact of the Trans-Pacific Partnership (TPP) on dairy farmers and auto workers has begun. But in Canada, an important discussion about the TPP is still waiting in the wings.
Across the world, specialists have raised concerns about the negative health impacts of the TPP. The former chief economist of the World Bank, Joseph Stiglitz, believes that the TPP will cost lives. In Australia, the Faculty of Medicine at the University of New South Wales reported significant health impacts such as the ability to regulate alcohol and food quality. And, the Faculty of Public Health Medicine, part of the UK's Royal College of Physicians, says that the TPP's sister trade deal could undermine the National Health Service through privatization and public health could be hobbled as trade is prioritized over health.
The most-discussed health impact of the TPP is access and costs of essential medicines. Based on expert analysis, it is likely that the TPP will raise the costs of medications for Canadians by strengthening intellectual property rights for pharmaceuticals. But the agreement will go even further by delaying the availability of cheaper generics, making it easier to patent drugs and extending patentability to diagnostic, therapeutic and surgical procedures.
Medical innovations that used to be freely shared could come at a cost to our healthcare system. At the moment, one in nine Canadians do not take medications as prescribed because of cost. The TPP will make this figure worse.
The health risks of the TPP do not stop with prescription drugs. The mechanism that allows transnational corporations and foreign investors to sue the Canadian government over policies that they believe may damage their current or expected future profits offers a fundamental challenge to improving health. The TPP will produce a private, international, quasi-judicial investor's court with power to extract hundreds of millions from Canada for industry because of the loss of perceived future returns. The court is far from independent; not available to the public or domestic companies; and supersedes Canadian law.
There are similar provisions in NAFTA, but the TPP quasi-court is expected to go even further. Canada is already one of the most sued countries in similar courts, and this has restricted our ability to pursue international best practices in public health.
For instance, pursuing policies to reduce tobacco, alcohol and unhealthy food consumption would open Canada to litigation. In a particularly egregious case, Phillip Morris used similar provisions to sue Australia for its tobacco plain packaging laws because the law worked. Phillip Morris argued that the law decreased smoking, and thereby reduced their expected profits and so they should be compensated.
Given all of this, the TPP court could pose a roadblock for Canada to fulfill its obligations with regard to the right to health, including access to healthcare and the underlying social determinants of health. For example, the TPP could block governments from establishing a national PharmaCare plan that would increase access to prescription drugs but could decrease pharmaceutical companies' profitability.
Canada may be prevented from addressing economic inequality, which is damaging to health, by limiting buy-local and social procurement policies that benefit local communities. Canada has already lost such a case in which the buy-local provisions in the Ontario Green Energy Act were rescinded.
But in addition to these clear and material factors linked to health, we should not underestimate the impact of ceding power to non-elected quasi-judicial bodies. The healthiest societies are those where people feel they are in control. Social efficacy increases social capital and improves public health. Social capital may erode and health may decline if Canada cedes authority to quasi-judicial bodies that can overrule the policies enacted by our democratically elected governments.
While progressive trade deals can be beneficial, there is plenty in the TPP to be concerned about and we need a conversation about the impact of prioritizing trade over health. Joseph Stiglitz warns, "The whole world may come to pay the price [of the TPP] in the form of worse health and unnecessary deaths."
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