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The original NAFTA normalized a set of restrictive rules on patents and other intellectual property privileges. It also paved the way for such rules in subsequent trade agreements — including the Trans-Pacific Partnership (TPP) — that are aimed at limiting the options available to countries in their efforts to make medicines available and affordable, including for the world’s poorest.

Depending on what it says, a “modernized” NAFTA could make things even worse, not just for those in North America, but globally, if the new deal serves as a template for future deals.

For example, using what flexibilities remain under current WTO rules, some generic pharmaceutical manufacturers are producing low-cost medicines, providing life-saving access to drugs for some of the world’s most marginalized people. Rapidly scaling up life-saving HIV treatment for millions of people in developing countries has only been possible by using low-priced, quality-assured generics, particularly from Indian manufacturers.

However, legal frameworks such as India’s, that have facilitated such production over the last 15 years, would be under threat if the more restrictive intellectual property rules being pushed in trade agreement negotiations were to take hold. With the TPP’s future uncertain, Big Pharma and the U.S. are now using the NAFTA renegotiations as a new forum. Rest assured that any further restrictions secured in a renegotiated NAFTA will be advanced as a “minimum standard” that countries are pressured to include in other trade agreements. We’ve seen this tactic time and again; it’s the history of NAFTA itself.