Open Letter on PBS and FTA

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					To the Honourable John Howard MP, Prime Minister of Australia and
The Honourable Mark Latham MP, Leader of the Opposition,

27 September 2004


       Safeguards to ensure Protection of the Pharmaceutical Benefits Scheme from
                     Provisions in the Australia-US Free Trade Agreement


We the undersigned, urge bipartisan cooperation to ensure that prior to formal bilateral
ratification of the Australia US Free Trade Agreement (AUSFTA) in late October 2004,
additional safeguards are attached to the treaty to clarify ambiguities in the text that may
undermine the integrity and basic framework of the Pharmaceutical Benefits Scheme (PBS).

The course of negotiations and subsequent public debate has highlighted that the US1 and
Australia2 may have significantly different interpretations of key articles and provisions in
the AUSFTA text related to the PBS. A unilateral interpretative declaration would put on
record Australia’s interpretation of these ambiguities, which could play a vital role to protect
the PBS in the event of a dispute under the AUSFTA. Additionally, in light of recent
comments by the Deputy US Trade Representative 3 indicating intent to use the joint
AUSFTA implementation committees and working groups for ongoing changes to the PBS,
we urge full transparency of these processes and that the PBS cost-effectiveness pricing
system be protected from the scope of these committees. These measures could be taken in
accordance with the rules of international law and should not delay ratification of the
AUSFTA.




Footnotes:
1
  ‘The FTA makes suitable progress on addressing Australia's drug price controls’ (Senator Kyl, Congressional
Record: July 15, 2004 (Senate), p.S8208).
2
    ‘We have secured absolute protection of the Pharmaceutical Benefits Scheme. Yes, some of the American
drug companies did try and get in under the radar on that subject, but we didn't agree’ (PM John Howard,
Archival footage, 29/07/04 quoted in Holmes, A Bitter Pill?, 4 Corners, ABC, 02/08/2004).
3
  ‘Crucially, the FTA also establishes a Medicines Working Group that will provide a forum for ongoing
dialogue on Australia’s system of comparing generics to innovative medicines. We urge Congress to act quickly
to approve the U.S.-Australia FTA, so that we may begin implementing agreed provisions and working toward
further reform. (Testimony of Deputy U.S. Trade Representative Josette Sheeran Shiner before the Committee
on Finance, Subcommittees on Health Care and International Trade, United States Senate, April 27, 2004. p5)


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While the extent of the increased risk to the PBS is subject to debate, trade agreements
should not be the forum to drive reforms to domestic health programs such as the PBS. We
note these sentiments are shared by many US Representatives.4 We therefore urge prior to
the exchange of notes in October 2004, bipartisan commitment to the establishment of such
safeguards that clarify Australia’s understanding that the PBS system is protected in the
AUSFTA.

Yours Sincerely,

The undersigned

(ORGANISATIONS)




Professor Peter Sainsbury                                        Morrie Mifsud, JP
President, on behalf of the                                      State President Combined Pensioners &
Public Health Association of Australia                           Superannuants Association of NSW Inc



Andrew McCallum
President, on behalf of the                                      Denele Crozier
Australian Council of Social Service (ACOSS)                     Executive Officer on behalf of
                                                                 Women's Health NSW



Peter Kell
Chief Executive Officer, on behalf of the                        Dr Patricia Ranald
Australian Consumer Association (ACA)                            On behalf of the Australian
                                                                 Fair Trade and Investment Network



Professor Gwen Gray
Deputy Convenor, on behalf of the
Australian Women’s Health Network


4
 ‘Domestic healthcare policy should not be decided in trade agreements–It is wrong for us to interfere with
another country's domestic health policy, particularly when it comes to the affordability of medicine which is an
equally sensitive issue here in the United States’ (Representative Henry Waxman speaking during US
Congressional debate on the AUSFTA, US Congressional Record- Extensions of Remarks, 16 July 2004,
p.E1397-E1398).


Open letter on PBS and AUSFTA 27 January 2004                                                           2/4
(INDIVIDUAL SIGNATORIES)



                                                         Professor Paul Gatenby
Frank Fenner, AC, CMG, MBE, FRS, FAA, FRACP, FRCP.       Dean
John Curtin School of Medical Research                   Medical School
                                                         The Australian National University




Emeritus Professor Bob Douglas                           Julian Disney
Founding Director (1989-2001)                            Director, Social Justice Project University of NSW
National Centre for Epidemiology and Population Health   Former President ACOSS and World President of the
Australian National University                           International Council on Social Welfare (ICSW)




Dr. Ron Wells, AM., M.D., F.R.A.C.P.
Former Deputy Director-General,
Commonwealth Department of Health                        Professor Michael Dodson
                                                         Former Aboriginal and Torres Strait Islander Social
                                                         Justice Commissioner
                                                         Professor and Chairperson
                                                         Institute for Indigenous Australia and
                                                         Australian National University
Richard Refshauge SC
Director of Public Prosecutions
Australian Capital Territory



                                                         Professor Simon Chapman
                                                         School of Public Health
                                                         University of Sydney
Professor David Henry
Professor of Clinical Pharmacology
University of Newcastle
Former Chair, Economic Sub-Committee of the
Pharmaceutical Benefits Advisory Committee
                                                         Professor Wayne Hall Ph.D.
                                                         Professor and Director
                                                         Officer of Public Policy and Ethics
Professor Wayne Smith                                    Institute for Molecular Bioscience
School of Medical Practice & Population Health           University of Queensland
University of Newcastle



        Open letter on PBS and AUSFTA 27 January 2004                                          3/4
(INDIVIDUAL SIGNATORIES CONTINUED)




Dr Thomas Alured BA LLB (Hons) B Med. PhD
                                                          Pieta Laut
                                                Dr Buddhima Lokuge
Senior Lecturer, ANU Medical School                       Executive
                                                Medical School and Director
Lecturer, ANU Law Faculty                                 Public Health Association of Australia
                                                Regulatory Institutions network
                                                Australian National University



Dr Peter R Mansfield,
Director, Healthy Skepticism Inc
General Practitioner and Research Fellow
Department of General Practice                          Dr Buddhima Lokuge
                                                Pieta Laut Executive Director, Public Health
University of Adelaide                                  Health Policy Consultant
                                                Association of Australia
                                                        Visiting Fellow, Medical School and
                                                        Regulatory Institutions network
                                                        Australian National University

Jennifer Clarke
Lecturer, ANU Law Faculty                       Dorothy Broom, PhD, FASSA, AM
                                                Senior Fellow
                                                National Centre for Epidemiology & Population Health
                                                        Dr Peter R Mansfield,
                                                The Australian National University
                                                        Director, Healthy Skepticism Inc
                                                        General Practitioner and Research Fellow
Catherine Curtain                                       Department of General Practice
Law School, Melbourne University                        University of Adelaide



                                                Dr Angela Taft
                                                Research Fellow
                                                Mother and Child Health Research,
Martyn Goddard                                  La Trobe University
Former member of the                            Former Vice-President (Policy)
Pharmaceutical Benefits Advisory Committee,     Public Health Association of Australia
Former member of the
Australian National Council on AIDS




Open letter on PBS and AUSFTA 27 January 2004                                              4/4

				
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