Leaked UK-India Free Trade Agreement text threatens NHS, NGOs warn

In a letter to the international Trade secretary, leading health and development NGOs have warned that the cost of NHS medicines, 25% of which are supplied by India, could be affected if the UK forces India to change national laws related to intellectual property as a result of trade negotiations.

Signatories to the letter from nine civil society organisations, including Oxfam GB and Médecins Sans Frontières UK, call for the UK to immediately withdraw the proposed intellectual property (IP) chapter, as well as to open up all negotiation texts to public transparency and parliamentary scrutiny.

They state that the leaked chapter of the UK-India Free Trade Agreement (FTA) contains provisions that will, amongst other things, allow pharmaceutical corporations to extend their monopolies and keep prices artificially high for years beyond the end of the original 20 year patent term. Another provision would see the end of “pre-grant” patent oppositions, a vital mechanism which is currently used to block unjustified patents before they are granted. Without this safeguard more products will be subject to – often spurious – patent monopolies, preventing the manufacture of generic versions.

Such provisions would do devastating damage to India’s ability to produce affordable life saving drugs, which in turn would also threaten the financial sustainability of the NHS and put patients’ lives at risk by delaying the availability of lower priced genetic alternatives to essential medicines, potentially for years.

Generic drugs manufactured by India save the NHS considerable cost; a year’s course of imatinib treatment, a cancer drug used to treat leukaemia, was previously priced at £27,200 per year under monopoly.

The patent for imatinib was rejected in India under provisions of their IP law that would be at risk of being removed by the UK demands detailed in the leaked text. The NHS now pays just £556.32 for a course of Indian-produced generic imatinib, almost a 98% price reduction.

The letter points out that this leaked text is a significant departure from previous IP agreements under past FTAs; going far beyond the World Trade Organisation’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS).

Taking this “TRIPS-plus” approach would undermine the Government’s manifesto commitment that the cost of NHS medicines ‘are not on the table’ and protecting the NHS is a ‘fundamental principle’ of UK trade policy as outlined in the Government’s own strategic approach to a UK-India FTA.


Carol Webley Brown, a Just Treatment Patient Leader, said:

“As an NHS nurse, I know how its budget has been stretched to breaking point and beyond. 

Our patients use high quality, affordable medicines from India every day. I simply cannot understand why the government would willingly push for changes through this FTA that would push up drug prices for the NHS and put its budget under even more pressure. That’s unless they simply care about their friends in the industry more than the lives of NHS patients. 

We’d be signing our own death warrants if we agree a deal with these terms – the government simply has to back down.”


Baroness Shami Chakrabarti said:

“If accurate, this text doesn’t just shame me as a British Asian, it risks India’s ability to produce life-saving medicines for millions of people around the world. I hope our Prime Minister knows what is being argued in his name and that India stands firm against corporate interests over people’s lives.

It is increasingly difficult to distinguish UK Government statements from those of Big Pharma trade bodies. Our Ministers resisted the Covid 19 vaccine intellectual property trips waiver that would have scaled up production and prevented many untimely deaths.”


Dr Andrew Hill, Senior Visiting Research Fellow, University of Liverpool Institute of Translational Medicine, said:

“The provisions set out in this leaked document would have extremely serious consequences for the NHS and global health, and the impacts would become more and more serious over time. 

By making it easier to secure patents and other forms of intellectual property monopolies on medicines, and much more difficult to challenge them, the UK government would be pushing the dramatic price-reducing effects of generic competition further and further into the future. Prices for the NHS will rise, patients will suffer. 

The naive idea that what is good for the pharmaceutical industry is good for patients and public health must be vigorously challenged. I urge the government to change course.”


Sakina Datoo, a Just Treatment Patient Leader, said:

“The leaked FTA text shows the UK government’s positions on monopolies and medicines are a disgrace. My father died in Tanzania because he couldn’t access the COVID vaccine, long after I was vaccinated here. Almost the entire world agreed that IP monopolies on those vaccines were a dangerous threat to the global pandemic response, but the UK sided with the pharmaceutical industry to block that deal then, and now this leak seems to confirm the government’s priority in this agreement is pleasing big pharma, rather than protecting the NHS or saving the lives of patients in the UK or around the world.”

Purchasing cheaper generic versions of medicines has dramatically reduced NHS costs. Earlier this year the NHS reported it had saved £1.2 billion in just three years; with the adoption of a single generic drug (adalimumab), following the expiry of the original patent in 2018, accounting for about one third of these savings. If implemented, the provisions in the leaked text would significantly delay generic competition from Indian suppliers for treatments for a range of conditions from cancer, to HIV, to heart diseases, locking the NHS into paying higher monopoly prices for longer and undermining healthcare around the world.



Notes to Editor:


The Missing Medicines Coalition (MMC) is an informal UK-based civil society network, hosted by STOPAIDS, that advocates for equitable and affordable access to medicines in the UK and worldwide. Members include: Oxfam GB, RESULTS UK, Global Justice Now, Médecins Sans Frontières UK, Health Poverty Action, and Just Treatment.

For more information or an interview please contact: jake@stopaids.org.uk or on +447887348161