Trade negotiators must remove damaging provisions in the Trans-Pacific Partnership (TPP) trade deal or risk locking in high drug prices and endangering the health of millions of people for decades to come. So said the medical humanitarian organization Doctors Without Borders as TPP negotiations continue.

If approved in its current form, the TPP, which is being negotiated between the U.S. and 11 other Pacific Rim countries, will have a devastating impact on global health, according to the organization. It would strengthen, lengthen and create new patent and regulatory monopolies for pharmaceutical products that will raise the price of medicines and reduce the availability of generic competition.

“We have repeatedly warned that this is a terrible deal for access to affordable medicines,” said Manica Balasegaram, executive director of Doctors Without Borders’ Access Campaign. “Ministries of health, humanitarian groups and global health programs funded by the U.S. government all rely on affordable medicines to provide medical care. Despite repeated warnings, U.S. negotiators have pushed for provisions that benefit pharmaceutical companies at the expense of the more than 800 million people who need access to affordable generic medicines in current TPP countries.”

Some of the provisions of most concern to the organization concern patent evergreening, which would, according to Doctors Without Borders, force TPP governments to grant pharmaceutical companies additional patents for changes to existing medicines, even when those changes provide no therapeutic benefit to patients.

U.S. negotiators have also pushed for 12 years of data exclusivity for biologic medicines, according to the organization, which include vaccines and drugs to treat conditions such as cancer and multiple sclerosis. Data exclusivity blocks government regulatory authorities from allowing price-lowering generic competitors to enter the market with previously generated clinical data.

If pharmaceutical companies get their way, brand-name drugs and vaccines would not face direct competition for excessively long periods of time while patients, medical providers like Doctors Without Borders, and people in TPP countries endure unnecessarily high prices, the organization said.

“Extended monopolies, such as those being pushed by the U.S. in the TPP, are irresponsible and harmful to public health,” said Judit Rius Sanjuan, U.S. manager and policy Advisor for Doctors Without Borders’ Access Campaign.