From Dr Durhane Wong-Rieger.

Sir, Your report “Negotiators nervously eye China’s resistance in IT trade talks” (November 20) neglected to mention one of the most important issues at stake: the potential elimination of stiff tariffs on a wide range of IT-enabled medical devices and technologies that diagnose and treat cancer, cardiovascular diseases, diabetes, asthma and many other diseases.

For two years, Information Technology Agreement discussions have focused on expanding the list to cover new categories of products such as cutting-edge health technologies that rely on IT tools including software, wireless technology and machine-to-machine communication to improve performance. Examples include deep brain stimulators that can stop Parkinson tremors, and MRIs that convey vast, valuable patient-specific information to doctors. Some governments levy tariffs on a range of medical devices and technologies as high as 30 per cent ad valorem (resulting in a 30 per cent price increase or more paid by local governments, hospitals, and patients). Now we are down to a final round of talks, and unfortunately a few member states, among them China, continue to press for “exclusions” of medical technology products.

It’s sad but true that healthcare tariffs, while generally small or non-existent in developed countries, tend to be more significant in developing, least-developed and transition economies. Indeed, they are often highest in those countries with the greatest development challenges and hence, the lowest per-capita healthcare spending.

Failure to act now would be an enormous disappointment to the global patient community. We know the ITA can work: it’s partly to its credit that most of the world’s population enjoys little or no tariff on their smartphones. Isn’t access to potentially life-saving medical technology just as deserving?

For patients everywhere, World Trade Organisation negotiators in Geneva must agree to start taking down this wall to healthcare quality and equality, and work towards a world of healthcare without tariffs.

Durhane Wong-Rieger, Head, Institute for Optimising Health Outcomes, Toronto, Canada

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