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WikiLeaks released the secret draft of the healthcare annex to the transparency chapter of the Trans-Pacific Partnership (TPP) on June 10. If the TPP is adopted, the annex would adversely affect national pharmaceutical schemes, such as Australia's Pharmaceutical Benefits Scheme and New Zealand's Pharmaceutical Management Agency (PHARMAC).

The TPP is a free trade deal being negotiated by countries on the Pacific rim: the US, Australia, Singapore, New Zealand, Chile, Brunei, Canada, Malaysia, Mexico, Peru, Vietnam and Japan. These countries represent about 40% of global GDP.

“Transparency” in the TPP does not refer to revealing the otherwise secret activities of corporations and governments to the public, but rather granting corporations better access to, and influence over, government regulations.

The previously leaked intellectual property chapter of the TPP showed that it aimed to strengthen pharmaceutical monopolies, primarily by providing more chances to apply for and extend patents.

The leaked healthcare transparency annex shows the TPP would also give corporations better chances to have their medicines taken up by national pharmaceutical schemes.

A previously leaked healthcare annex was even worse. It appears the US was forced to water it down due to opposition from other countries. But there are still major problems

: “It is clearly intended to cater to the interests of the pharmaceutical industry. Nor does this do anything to promote 'free trade': rather it tightly specifies the operation of countries’ schemes for subsidising pharmaceuticals and medical devices with the aim of providing greater disclosure, more avenues for pharmaceutical industry influence and greater opportunities for industry contestation of pharmaceutical decision making.”

The annex has measures to include review processes involving “at a minimum, a substantive reconsideration of the application” that potentially allows for decisions to be remade at pharmaceutical companies' behest.

The draft allows countries that now prohibit direct-to-consumer advertising of pharmaceuticals to continue to do so, but it would lock in any loopholes in national laws that permit companies to get round these prohibitions.

The annex does say that state-to-state dispute settlement cannot apply to this area, but says nothing about prohibiting investor-state dispute settlement (ISDS). ISDS allows corporations to sue governments for changes to laws or regulations that impact on their profits, even perceived future profits.

Gleeson said :“It sets a terrible precedent for using regional trade deals to tamper with other countries’ health systems and could circumscribe the options available to developing countries seeking to introduce pharmaceutical coverage programs in future.

“The impact of the 2014 annex provisions in their current form would be felt most by New Zealand. There are several provisions that could have detrimental effects on PHARMAC, adding new transaction costs and significantly reducing its flexibility and autonomy.”

The US House of Representatives voted 218 to 208 in favour on June 19 of a fast-track bill, called Trade Promotion Authority (TPA), . It would enable any trade deal to be put to Congress for a straight yes or no vote, without debate. This is seen as crucial to the conclusion of the TPP negotiations, as many countries will not reach final agreement until they are certain the US will do so.

The previous week, Democrats in Congress opposed to the TPP had defeated the bill by voting down an associated measure called Trade Adjustment Assistance (TAA), which would renew an expiring program to help workers hurt by trade deals.

The TAA was thus cut from the TPA bill by Republicans eager to see it passed. Pro-TPP Democrats only voted for TPA on the guarantee that Republicans will also support TAA. The bill and the separated TAA must now be voted on in the Senate, then sent back to the House of Representatives.

There is concern that the Republicans, with majorities in both chambers, and who oppose TAA out of ideological opposition to any policy that is even remotely pro-worker, will not keep their promise and will vote against TAA.

The reported that a pro-TPP House Democrat who met with President Barack Obama on June 17 said that the president told him he would sign the fast-track bill into law before Congress had passed a bill to renew TAA.

But White House spokesperson Josh Earnest said: “The only legislative strategy that the president will support is a strategy that results in both TPA and TAA coming to his desk.”

House speaker John Boehner said the TAA would be added on to a bill renewing trade benefits for African countries. But members of the Congressional Black Caucus warned against using this bill as a “bargaining chip”.

House Democratic leader Nancy Pelosi, who voted against fast-track, said she did not see a path forward for the TAA.

There is popular opposition to the TPP, and therefore the fast-track, due to the experience of the North American Free Trade Agreement (NAFTA), which was responsible the loss of US manufacturing jobs and the destruction of Mexican agriculture.

The effects of this opposition and pressure from unions and other groups was reflected by Democrat Congresswoman Louise Slaughter, who said, “This thing is modelled after NAFTA, which cost us 5 million jobs.”

This is why even pro-TPP Democrats insist on passing the TAA. But TAA would only offset a tiny part of the problems caused by the deal. For example, in relation to digital media, , “TAA will not prevent the TPP from extending the term of copyright protection to a uniform life plus 70 years throughout the Pacific Rim, and simultaneously locking in that term at home.

“It won't stop the imposition of [Digital Millennium Copyright Act]-like laws that prevent users from bypassing ['digital rights management' or copy protection software] simply in order to view or make fair use copies of their media.

“It will not prevent foreign corporations from suing the American government to stop it from adopting pro-user laws or policies, for example on orphan works (or, conversely, American corporations from suing our trading partners for introducing such laws or policies).”

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