Even as the eighth round of negotiations on the Regional Comprehensive Economic Partnership (RCEP) trade agreement take place in Kyoto, civil society and patient groups, including the international medical humanitarian organisation Médecins Sans Frontières (MSF) have launched a global campaign urging India to protect access to affordable medicines.

Millions of people in developing countries could be affected if India caves in to pressure, said the MSF spokesman urging the Indian Prime Minister Narendra Modi to stand strong in the face of intensifying pressure from the United States, Japan, Switzerland and the European Union to change India’s laws and policies in ways that would severely restrict the country’s ability to produce affordable medicines, upon which millions of people around the world rely.

Through the RCEP negotiations, Japan is seeking to put in place several damaging provisions, all of which go beyond India’s obligations under international trade rules. They would allow companies to perpetually extend their monopolies by making modifications to existing medicines, a common pharmaceutical industry practice known as ‘evergreening.’ Further measures would allow companies to get a de-facto monopoly through the backdoor—even for drugs that do not merit a patent under India’s law—by restricting the ability of the drug regulatory authority to register generic drugs, unless expensive and unethical clinical trials are replicated, so-called ‘data exclusivity’, the MSF said.

More than 80 per cent of the medicines MSF uses to treat over 200,000 people living with HIV in its projects are Indian generics, and MSF sources essential medicines from India to treat other diseases, including tuberculosis and malaria. India also produces affordable versions of medicines for non-communicable diseases, now considered too expensive even for healthcare systems in developed countries.

“As doctors who have been relying on affordable medicines and vaccines made in India to do our work, we cannot afford to stand by silently as the tap of life-saving drugs gets turned off for people in our projects and beyond”, said Dr Joanne Liu, international president of MSF. “We want to send India a strong message of support as the world is watching anxiously to make sure it remains the ‘pharmacy of the developing world.”

Started in May 2013, the RCEP is being negotiated between the 10 ASEAN (Association of Southeast Asian Nations) countries and six trading partners, Australia, China, India, Japan, New Zealand and South Korea.