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Last week, behind closed doors in a hotel in Hawaii, negotiators from a dozen countries met to continue negotiations on a trade agreement that will affect an estimated 800-million people and 40% of the global economy: the Trans-Pacific Partnership (TPP).

The negotiations, which began in 2010 between Canada, the United States and 10 other Pacific Rim countries, are being conducted without opportunity for public scrutiny. Currently, U.S. President Barack Obama is asking Congress to grant him the authority to fast-track the TPP without amendments from lawmakers.

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Of the many issues at stake, the implications are especially critical for ensuring affordable health care and access to medicines for the millions of people in developing countries where Doctors Without Borders works and also for Canadians.

We know from leaks of the TPP draft text that some governments are attempting to dismantle public-health safeguards enshrined in international law by extending the length of time that brand-name medicines are protected by patents to create new types of monopolistic protection. As a result, pharmaceutical companies will be able to charge unduly high prices for several more years, thereby restricting access to affordable life-saving generic medicines. This will disproportionately affect those who can least afford to pay.