Comment on “A Dose of TPP’s Medicine” published by Foreign Affairs March 23, 2016

PEAH is pleased to post a comment by Fifa Rahman and Chase Perfect on a recent article "A Dose of the TPP's Medicine - Why U.S. Trade Deals Havent Exported U.S. Drug Prices" authored by Thomas J. Bollyky, Senior Fellow for Global Health, Economics, and Development at the U.S.Council on Foreign Relations

Fifa Rahman

by Fifa Rahman

Policy Consultant, Malaysian AIDS Council

chase perfect

and Chase Perfect (MA, MsPH)

Access to Medicines Policy Officer, HIV/HCV Drug Affordability Project Coalition Plus

Comment on “A Dose of TPP’s Medicine” published by Foreign Affairs March 23, 2016


With regards to the recently published submission

“A Dose of the TPP’s Medicine” by Thomas Bollyky

 we would like to highlight several problems with the article’s presentation. The first concerns the fact that the data Bollyky used to support his argument are not public. As such, there is no way to verify his claims, nor is there an opportunity to parse his excessively broad aggregate summary. The promulgation of conclusions drawn from private data lowers the standards for dialogue on any issue, but it has been especially damaging to the access-to-medicines debate. After all, it is not the first time that industry-friendly arguments have benefited from a glaring lack of transparency. Recent estimates from Joseph Dimasi et al. on the costs of drug development have employed much the same technique.

Also, given both the significant historical role of the USTR in denying millions of South Africans access to life-saving HIV medicines and the USTR’s continuous support for South Africa’s notoriously-regressive IP systems, we found it surprising that Mr. Bollyky would use South Africa as a comparison. In addition, Mr Bollyky stated that there was ‘no upward trend in the prices of drugs launched in the three years after these agreements went into force’. It takes more than three years for any effect to be seen on delay of generics. For example, Lexchin & Gagnon (2014) predict the increase in drug costs caused by the Comprehensive Economic Trade Agreement (a trade deal between EU and Canada, also known as CETA) will start in 2023 – with CETA implementation beginning in 2015.

Bollyky’s challenge not only lacks open evidence, it also misses the point; prices are already exorbitant, and already threaten patients’ access to medicines. By imposing further restraints on future capacity to act on this front, these trade deals double down on policies that led drug prices to levels that have–to speak plainly–deadly consequences.

Finally, we were disturbed that, despite the fact that Mr. Bollyky was previously the director of intellectual property and pharmaceutical policy at the Office of the U.S. Trade Representative (USTR), no mention of his past connections were made anywhere in his submission. In this spirit, we openly acknowledge our own affiliation with the access-to-medicines movement.


Fifa Rahman, Policy Consultant, Malaysian AIDS Council

Chase Perfect (MA, MsPH), Access to Medicines Policy Officer, HIV/HCV Drug Affordability Project Coalition Plus