Patients’ rights advocates in India have asked Prime Minister Narendra Modi to reject any US proposal to dilute India’s patents and price control regulations, arguing such proposals might threaten India’s ability to provide affordable medicines and medical devices to its people.

In a letter to Modi on Friday, ahead of his planned US visit, these public health groups also asked him to defend the Indian government’s right to impose price caps on medicines and medical devices.

The letter reflects concern among public health groups that India is discussing a possible trade agreement with the US that might lead to changes to India’s patents regulations and price control mechanisms on drugs and medical devices.

India’s patent regulations allow manufacturers to produce relatively inexpensive generic versions of many drugs, from anti-viral medications for HIV infections to anti-cancer medicines.

The letter highlighted that millions of Indians, the country’s health ministry and state governments rely on “domestically produced affordable generic medicines, devices and vaccines to prevent and treat communicable and non-communicable diseases”.

The signatories to the letter represent the All India Drug Action Network, the Cancer Patients’ Aid Association, the Jan Swasthya Abhiyan (People’s Health Movement) and other non-government organisations in the health sector. Two years ago, the Modi government had imposed price caps on coronary stents and hip implants, angering sections of industry that have been demanding differential prices that take into account the characteristics and features of the medical devices.

The health groups have also expressed concern that sections of US industry are pressing India to replace such price caps with regulations that curb trade margins. “In the absence of price caps, the affordability of medical devices will continue to be compromised because trade margin rationalisation is a much weaker form of regulation that will leave retail prices unchecked,” the All India Drug Action Network said. “We believe the attempt to secure trade margin rationalisation is a backdoor attempt to neutralise the price caps, which (are) the most effective way to make critical medical devices accessible to patients.”

Earlier this year, the Indian government, in response to a US move to withdraw certain trade benefits to Indian exporters, had defended its right to protect public interest.

“India, like the US and other nations, shall always uphold its national interest…. We have development imperatives and concerns and our people also aspire for better standards of living. This will remain the guiding factor in the government’s approach,” the government had said.

The health groups have urged Modi to “uphold” this stand.