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Health Services and Access to Medicines and Other Health Technologies

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Trade Agreements and Public Health

Part of the book series: Palgrave Studies in Public Health Policy Research ((PSPHPR))

Abstract

This chapter explores the implications of trade agreements for the provision of health services and access to medicines and other health technologies. It first examines the potential effects of the General Agreement on Trade in Services and subsequent bilateral and regional trade agreements on the provision of universal health care and the ‘brain drain’ of health workers from low-income countries. Next, the intellectual property rights (IPRs) provided for pharmaceuticals by the Agreement on Trade-Related Aspects of Intellectual Property Rights are described, and the way in which these IPRs have been expanded and extended through subsequent bilateral and regional trade agreements elaborated. This chapter also considers other mechanisms through which trade agreements can affect access to health technologies including rules applying to marketing approval processes, pricing and reimbursement and pharmaceutical advertising.

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Notes

  1. 1.

    The ruling by the European Court of Justice (ECJ), since affirmed in a declaration of EU member states, renders inapplicable any investor-state arbitration clauses in international bilateral investment treaties between EU member states. No new intra-EU investment arbitration proceedings can be, or will be, initiated.

  2. 2.

    A compulsory licence allows a third party to make or import a generic version of a drug that is under patent, without the permission of the patent owner [43]. Parallel importation involves importing a patented medicine from another country where it is available at a lower cost.

  3. 3.

    Evergreening involves accumulating additional patents for minor variations on the same product, effectively excluding competitors from the market after the patent on the original product has expired.

  4. 4.

    Generic manufacturers must rely on the test data submitted by the originator company to establish the safety and efficacy of the drug, in order to avoid repeating clinical trials, which would be both expensive and unethical. Data exclusivity therefore causes a delay in the market entry of generics, and is a form of intellectual property which, unlike a patent, cannot be challenged in the courts.

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  1. School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia

    Deborah Gleeson

  2. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada

    Ronald Labonté

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Gleeson, D., Labonté, R. (2020). Health Services and Access to Medicines and Other Health Technologies. In: Trade Agreements and Public Health. Palgrave Studies in Public Health Policy Research. Palgrave Pivot, Singapore. https://doi.org/10.1007/978-981-15-0485-3_3

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