The Trans-Pacific Partnership Agreement: Exacerbation of Inequality for Patients with Serious Mental Illness

Negotiations for the Trans-Pacific Partnership Agreement (TPP) in 2014 sparked considerable concern and debate about its possible impacts on public health. The negotiations involved a diverse set of 12 countries from around the Pacific Rim: Australia, Brunei, Canada, Chile, Japan, Malaysia, Mexico, New Zealand, Peru, Singapore, Vietnam and the United States. Leaked documents from the negotiations suggested that the TPP could have a potential negative impact on equitable access to medicines and public health regulation.

A journal article in the Australian & New Zealand Journal of Psychiatry by Erik Monasterio and Deborah Gleeson considers the likely impacts of the TPP on access to healthcare and public health initiatives to improve the health and lifespan of patients suffering from serious mental illness (SMI). SMI includes schizophrenia and related disorders, bipolar disorder, depressive disorder, neurotic disorder and substance abuse disorder. 

The authors explain that premature mortality and physical health disparity are associated with SMI, as well as SMI’s link to obesity and tobacco and alcohol use. According to the article, people with SMI also have diminished access to quality treatment for physical disorders. Provisions that were being negotiated in the TPP included investor-state dispute settlements, requirements that would make it more difficult for governments to introduce innovative health policies and provisions that would expand monopolies on medicines and reduce cost-constrainment capacities of regulatory bodies. Overall, the TPP had the potential to impact the health of people with SMI by constraining tobacco, alcohol and food regulations and reducing access to medicines.