Tobeka Daki lived in the Eastern Cape of South Africa, and was the mother of two sons. In 2013, she was diagnosed with HER2-positive breast cancer. What should have been good news for Daki is that there is a medicine called trastuzumab, marketed under the name Herceptin, that can be effective at treating her form of breast cancer. The groundbreaking research that led to the discovery of trastuzumab was funded by the U.S. government. A year’s dose can be manufactured for about $176.
The bad news for Daki was that global trade agreements had ensured that the multinational corporation Roche held monopoly rights to trastuzumab throughout most of the world, including South Africa. So the corporation was free to set a price of about $34,000 in South Africa for a year’s worth of doses — 193 times the manufacturing cost. That cost was also five times more than Daki’s entire income. She died on Nov. 24, 2016, never having received trastuzumab.
Tobeka Daki became one of 10 million people who die each year because they cannot afford the cost of medicines. Most medicines are inexpensive to make, and virtually all were discovered thanks to government investments. So, it is no exaggeration to say that the worldwide network of medicine monopolies, which give unchecked power to charge virtually any price on life-essential goods, were the cause of most of these deaths. Proposed terms in the new NAFTA, called the U.S.-Mexico-Canada Agreement (USMCA) by the Trump administration, would strengthen and create more medicine monopolies across North America. But the faith community, led by a broad coalition of denomination leaders and advocacy groups, is pushing back.
The Trade-Related Aspects of Intellectual Property Rights Agreement of 1994, commonly known as TRIPS, sets the stage for corporations to obtain medicine monopolies worldwide. Those corporations have eagerly taken advantage, maneuvering for as much exclusivity as possible. Virtually every medicine has a fortress of monopolies built around it: for example, the corporation AbbVie has taken out 247 patent applications on Humira, the world’s best-selling drug.
This is an enviable business model: The corporations that sell the medicines make record-breaking profits and spend more on marketing and lobbying than they do on research. New cancer medicines average over $100,000 per patient. Some medicines are now priced as high as $750,000.
Yet the law does not have to work against patients. The TRIPS agreement permits countries to choose to create far-cheaper generic alternatives to monopoly-protected medicines. They can do so either through compulsory licensing (allowing companies to manufacture generic medicines with some reimbursement for the patent holders), or importation of generics from other countries.
But access to generic medicines has been undercut by so-called “TRIPS-Plus” trade agreements that include even more corporate monopoly protections than the original deal. The USMCA is firmly in that TRIPS-Plus category. Among other monopoly-extending terms, the USMCA would add a frightening barrier to the existing NAFTA: a full 10 years of what is called “data exclusivity” on biologics drugs. Data exclusivity blocks would-be competitors from accessing the information needed to gain approval to sell cheaper “biosimilars.” It is a monopoly separate from patent protection, designed to last beyond the life of the patents the corporation already received.
Biologics, made from living organisms, are some of the most impactful new medicines, especially for treating cancers and autoimmune diseases. They are often the most expensive, too. The USMCA proposes to create longer monopoly protections for biologics than any trade agreement in history. It would force Canada and Mexico to lengthen monopolies under their national laws, and handcuff the U.S. from pursuing the many national proposals to reduce our own data exclusivity period.
The bottom line is this: If the new NAFTA becomes law, it will cause unnecessary deaths in the U.S., Mexico, and Canada. There will be thousands more like Tobeka Dakis.
For people of faith, this is unacceptable. All major religious and moral traditions embrace a responsibility to provide for the poor and the sick. And that obligation goes beyond direct care, calling us to use our voices to protect those in desperate need of medicines.
The leaders of major Christian denominations have come together to urge the president and Congress to do better on the USMCA. Organized and supported by Jubilee USA, leaders of the U.S. Catholic, Episcopal, Methodist, Lutheran, United Church of Christ and Presbyterian churches sent a joint letter last May. The letter states, “We call on you to ensure that terms of a renegotiated NAFTA avoid enhanced and extended monopolies on life-essential medicines. Instead, we ask that a renegotiated NAFTA reaffirm . . . the human right to health and access to medicines for all.”
A similar call was issued last year by a coalition of faith advocacy organizations, including NETWORK, the Columban Center for Advocacy and Outreach, and the Maryknoll Office for Global Concerns. (The organization I’m affiliated with, Faith in Healthcare — formerly known as People of Faith for Access to Medicines — also signed this statement.)
The signers of these faith statements have followed up their letters with a continued push for health care justice. All persons of faith, and their organizations, are invited to add their names to the denomination letter, available at the Jubilee USA website. And Representatives Susan Davis (D-Calif.) and Jan Schakowsky (D-Ill.) are leading a coalition of members of Congress demanding that the Trump administration reopen the USMCA and remove medicine monopolies. NETWORK and other organizations are urging people of faith to call on our congressional representatives to join in.
The USMCA will not become law without congressional approval, and recent history shows that is no certainty. Concerns about medicine monopolies helped scuttle the Trans-Pacific Partnership Agreement in 2017. If the faith community insists that every life like Tobeka Daki’s deserves to be protected, our voices could make the difference.
Fran Quigley directs the Health and Human Rights Clinic at Indiana University McKinney School of Law and is active in the Religion and Socialism working group of the Democratic Socialists of America.
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