|Since the eighties and the fall of Muldoon, political orthodoxy has generally held that free trade is good for the New Zealand economy, dismantling unfair subsidies and protectionist tariff barriers- but is the forthcoming Transpacific Partnership Agreement (TPPA) going to make life more difficult for people living with HIV/AIDS?
At present, Medsafe and Pharmac regulate the purchase and distribution of pharmaceuticals and medical devices between them. Medsafe evaluates the quality, scope and effectiveness of new medications, while Pharmac decides whether they are eligible for subsidisation. This has meant that New Zealand is able to keep its imported pharmaceutical costs down because it has no pharmaceutical industry of its own, and can import cheaper generic versions of drugs rather than paying the full price from their manufacturer, which would cause a government budget blowout and might be passed onto the end user of the drugs through increased purchase costs at the local chemists.
What is the TPPA? It began its existence as the Transpacific Economic Partnership and was first canvassed at the Asia-Pacific Economic Cooperation Forum in 2002. Originally, it consisted of the antigay Sultanate of Brunei, Chile, New Zealand and Singapore. Malaysia, Australia, Peru, Japan and the United States joined later, although not without controversy from leftist and rightist opponents within New Zealand, Australia and the United States.
Unfortunately, Pharmac is bitterly resented by pharmaceutical multinationals precisely because it is able to contain costs within the New Zealand public healthcare system, enabling money to be spent elsewhere within that context. The approval process also means that new drugs take from ten to fifteen months from the time that they are developed within the United States to arrive here if they are approved.
For People With HIV/AIDS, this can be a long and arduous wait, particularly if they are developing tolerance for their current course of medication and/or combination therapy of suitable drugs. On the positive side, that period also enables there to be adequate time for side-effects and unforeseen consequences to become apparent.
The Global Commission on HIV and the Law has warned that national pharmaceutical purchasing policies may not be easily assimilable to intellectual property clauses within the TPPA, which may impact New Zealand and other nations with similar pharmaceutical regulatory regimes. Modern healthcare economics emphasises the need for preventative, primary health care within public health provision. This means that early intervention and expenditure prevents further downstream expenses such as practitioner wages, medical equipment wear and tear, hospital bed occupancy and other incidental costs. The introduction of protease inhibitors has meant a lengthened lifespan for PLWHAs.
Recommended: Jane Kelsey (ed) No Ordinary Deal: Unmasking the Trans Pacific Partnership and Free Trade Agreement: Wellington: Bridget Williams Books: 2010. “Don’t weaken Pharmac for US drug lobby say Labour, Greens” New Zealand Herald: http://www.nzherald.co.nz/business/news/article.cfm?c_id=3 Craig Young - 2nd August 2015