Through the 1990s, Médecins Sans Frontières (MSF) helped lead a global fight to reduce the costs of HIV/AIDS medications that were previously all but unavailable in some of the world’s poorest countries.

Back then, thousands were dying not because treatments didn’t exist, but because people could not afford pills that cost patients as much as $15,000 a year. Today, and thanks in large part to those efforts, comparable drugs can be purchased for less than $1 a day.

Those victories over pharmaceutical companies and unfair international patent laws are documented in the 2013 film Fire in the Blood, which recently played in Vancouver at an MSF forum on the topic.

Speaking ahead of that event, Stephen Cornish, executive director of MSF Canada (also known as Doctors Without Borders), told the Straight that the battle MSF is fighting now is the Trans Pacific Partnership (TPP), an agreement for which Canada is currently involved in negations.

An MSF website describes the TPP as “the most harmful trade agreement ever for access to medicines”, and Cornish said he doesn’t think that’s overstating the issue.

“This is a trade deal that we’re signing that could limit the availability to access to medicine,” he explained on the phone from Toronto. “There are some provisions which are looking to severely increase IP [international patent] restrictions around pharmaceutics, and so we are very concerned that this will potentially limit affordable access to medicines for millions of patients around the world.”

Specifically, Cornish said the TPP should not extend patent terms nor allow companies to “evergreen” patents, which would provide for continual extensions.

“We fully understand the need for them [pharmaceutical companies] to make a profit; they are public companies,” he said. “The difficulty is in ensuring that the prices on medicines are serving a public good and are accessible.”

Fire in the Blood dispels a number of myths that often come up in debates around the pricing of pharmaceutical drugs.

The loudest reaction from the audience during the Vancouver screening came when the film’s narrator revealed that only 1.3 cents of every dollar a drug company makes in sales is reinvested in research and development. Much more money is spent on advertising, lobbying politicians, and wooing doctors.

Cornish noted that there are some indications that the government of Canada is playing a positive role in TPP negotiations by pushing back against patent provisions that could limit access to medicines. But he added that that’s not entirely clear, because talks between the 10 would-be signatories are happening behind closed doors.

Foreign Affairs, Trade and Development Canada (DFID) declined to make a representative available for an interview. An emailed statement supplied by ministry spokesperson Claude Rochon emphasizes that Canada is negotiating the TPP with national interests in mind.

“Canada’s policy with respect to intellectual property in the pharmaceutical sector seeks to strike a balance between promoting innovation and job creation and ensuring that individuals continue to have access to the affordable drugs they need,” the statement reads.

Don Davies, NDP MP for Vancouver Kingsway and opposition critic for international trade, told the Straight that secrecy around TPP negations mean Canadians likely won’t know what Ottawa agrees to until it’s too late for the public to have a say.

He however noted that a draft text leaked in November 2013 included significant pressure to extend patent monopolies that would delay the introduction of generic drugs for all the participating countries.

“We asked [a DFID official] specifically, whether or not TPP would cause pharmaceutical costs in Canada to increase, and she evaded that question,” Davies added. “She would not answer us. So it’s hard to know.”

He said that the TPP threatens to not only drive up drug costs for countries in the developing world, but for Canada as well.

“If you look at prescription costs, in the 1980s, drug expenses were 6.3 percent of our total health-care spending; in 2012, it was 14.6 percent, so a virtual doubling,” Davies continued. “So any measures in a trade deal that drive up the costs of prescriptions in Canada is going to hurt individuals…and it will up costs for the provinces.”