Corporate wealth or public health? WTO/TRIPS flexibilities and access to HIV/AIDS antiretroviral drugs by developing countries

Between 1994 and 2003, the TRIPS (Trade-Related Intellectual Property) Agreement of the WTO was refined to allow for flexibilities in the use of compulsory licences to import and export ‘generic’ varieties of pharmaceutical products, including ARV drugs for the treatment of HIV/AIDS. After summarising this process, and assessing its implications in practice for developing countries, the paper briefly places the current regime in a longer-term context of the institutional protection of patents in Britain and Europe dating from the nineteenth century. It traces how that that pattern, which benefits major patent holders, continues to be present in TRIPS. The paper goes on to demonstrate the continuity of corporate influence over the state as expressed in the ‘TRIPS-plus’ conditions, which are appearing in bilateral free-trade agreements between the USA and either individual developing countries or regional groupings. This array of what amount to institutional obstacles to the sustained availability of cheap drugs, at present and in the future, presents serious problems for future operations of the supply chain for many imported medicines and, in the case of HIV/AIDS, with negative implications for the long-term clinical effectiveness of the most widely used drugs.