British Medical Journal warns of health impacts of UK membership of CPTPP

April 18, 2023: At the end of March, the 11 members of the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) agreed to admit the UK to the deal, but the text of the conditions of entry will not become public until after it is signed later this year. There is widespread criticism of this move in the UK, and the British Journal of Medicine has spelt out the concerns on public health.

The existing 11 members of the CPTPP are Australia, New Zealand Canada, Mexico, Peru, Chile, Japan, South Korea, Vietnam, Singapore and Brunei Darussalam. The UK will be the 12th. China and Taiwan have also applied to join.

Public Health expert Courtney McNamara and her colleagues argue that joining the CPTPP could increase industry influence in public health standard setting, make it more difficult for governments to regulate for the benefit of health, increase the costs of medicines and generate economic insecurity and, potentially, job losses, with knock-on effects for health.

They urge the government to take seriously its commitment to “do no harm” and commission a health impact assessment before signing. If the Conservative government fails to do so, they say that public health scholars and professionals should take on the task.

They warn of the following specific risks:

  • the CPTPP requires that foreign corporations be informed of and can contest any new health labelling regulation. Although not a veto power, it allows health-harming industries to influence public health standard setting.
  • the CPTPP imposes the highly contentious Investor-State Dispute Settlement (ISDS) system, giving foreign corporations a special legal right to sue the UK government in an international tribunal if they can argue that a regulation has undermined their profits. ISDS has been used to challenge a wide range of public health regulations, including measures on tobacco control, taxation, and health insurance.  After public campaigning in Australia and the UK kept ISDS out of the UK-Australia FTA, those governments have agreed not to apply ISDS to each other in the CPTPP, but it will apply between the UK and other CPTPP members.
  • the CPTPP specifies that public health regulations, such as product bans, must be based on “documented and objective scientific evidence,” which rules out the use of the precautionary principle.
  • the CPTPP requires that member countries extend the time a drug is under patent any time a drug company makes even minor—often trivial—modifications to an existing medicine, thus maintaining monopoly prices for medicines beyond the 20-year limit specified by the World Trade Organisation (WTO).
  • the CPTPP will enable some economic sectors to expand, and will also generate economic insecurity and, potentially, job losses, in other sectors, with clear public health impacts.