The future of global health equity is being shaped in trade negotiation rooms. That was the case in 1994, when the TRIPS agreement was established. The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) by the World Trade Organization (WTO) is essential to healthcare access. This Agreement sets international standards for intellectual property protection. This protection includes pharmaceutical patents. Although this agreement first aimed to stabilize global trade and protect innovation, it has also significantly affected how countries produce, price, and access essential medications.
TRIPS requires the World Trade Organization (WTO) member states to provide broad and enforceable intellectual property protections. For pharmaceuticals, this includes 20 years of patent protection from the date of filing and extends patent rights not just to manufacturing processes, but to the drug itself. This protection prevents the production of genetic, or “knock-off”, versions of patented medicines.
Although TRIPS was initially built and drafted on the premise that patents would further competition and eventually increase innovation in fields, it has helped create an international pharmaceutical system that prioritizes monetary gain and makes affordable and accessible treatments out of reach for most of the world’s most vulnerable populations. For diseases such as HIV/AIDS, tuberculosis, and malaria, where treatment is lengthy and costly, inaccessibility can be a matter of life and death. While wealthier countries have access to the latest drug treatments and pipelines, poorer nations have to delay adoption or utilize older and outdated medications by default due to cost.
In 2001, a declaration was signed to allow and affirm the rights of WTO member states to use specific flexibilities in the TRIPS agreement to address healthcare emergencies. This declaration is called the Doha Declaration on TRIPS and Public Health. Some of the many key flexibilities that are included in this declaration are Compulsory Licensing under Article 31. This section allows for governments to allow for “knock-off” or generic production of patented drugs without the consent of the patent holder in cases of emergencies or public healthcare crises. This flexibility has already been used by countries like Brazil and Thailand to expand access to HIV/AIDS treatment. Additionally, another flexibility in this declaration is Parallel Importation under Article 6. This section allows for countries to import patented medicines from other nations where prices are lower. Furthermore, another flexibility called the Bolar provision allows for manufacturers to start the procedure of approving a patented drug before the patent expires. This provision helps make sure that generic and cheaper alternatives of medicine can reach the market quickly once a patent ends, cutting down on wait times for other options.
Despite such protections, many developing countries can’t take full advantage of these flexibilities and struggle to do so due to outside pressure, limited legal resources, or even because of fear of trade consequences. TRIPS was meant to protect and fuel innovation, but it has also reinforced a system where access to medicine depends less on need and more on where someone lives.
IMAGE CREDIT: Council on Foreign Relations
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