The 11 governments that remain in the Trans-Pacific Partnership (TPP11) are being urged by leading health organisations to respond to their call to renegotiate the deal.
The representatives from each nation are meeting this week in Sydney.
The open letter to Ministers of Health and Trade has been signed by prominent national and international health organisations, including the World Federation of Public Health Associations and affiliates in Australia and New Zealand.
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The New Zealand Medical Association and the Public Health Association of New Zealand have also signed the letter.
Health, consumer, and patient groups who have signed include Médecins Sans Frontières, HIV/AIDs groups from Vietnam and Malaysia, the Latin American Alliance for access to medicines, and medical workers associations and unions from Japan and many other TPP11 countries.
The health experts who signed have warned repeatedly that TPP would have serious consequences for the health of the people in the participating countries.
University of Auckland law professor and prominent TPP critic Jane Kelsey said the situation was worsened by the fact these provisions were imposed by the US, which has since withdrawn from the trade deal.
In a statement, Professor Kelsey said since the US was no longer in the TPP it "makes no sense to keep those provisions, particularly without the projected gains from access to US markets".
The letter informs the respective ministers that the only truly acceptable approach to ensure adequate and effective protection of health and access to affordable medicine in all TPP11 countries is to renegotiate the entire deal.
Professor Kelsey said if the governments failed to heed their call and instead chose to suspend the most dangerous provisions of the deal until the US re-joins, then a minimum number of provisions would need to be frozen.
These would include rules affecting the availability of generic medicines, the ability of foreign corporations to sue governments over health protection laws, and the processes for approving pharmaceuticals for subsidies.
New Zealand Nurses Organisation pleads for re-negotiation
The New Zealand Nurses Organisation (NZNO) president Grant Brookes has also sent an open letter to all Ministers negotiating the deal.
NZNO warned that the TPP would have serious consequences for health, and has questioned why the Government would proceed with US-imposed provisions, in light of the lack of projected gains from access to US markets.
Mr Brookes said they were reiterating that the only acceptable approach was renegotiating the entire agreement.
"The Government must also conduct a comprehensive health impact assessment (HIA) before adopting any TPP text that could impact adversely on the health of people."