Since the establishment of the World Trade Organization (WTO) in 1994 that brought intellectual property rules into the global trading regime via the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), there has been a concern that the trading regime would globalize the monopolies created by patent rights and therefore make it more difficult for low- and middle-income countries (LMIC) to ensure access to essential medicines for all those in need. Despite the landmark decision in Doha, there continue to be concerns about the extent to which the trading system is compatible with Sustainable Development Goal (SDG) 3, in particular access to medicines. Trading partners from high-income countries continue to pursue bilateral and regional trade agreements that seek intellectual property and investment protections beyond what is required by the TRIPS Agreement (TRIPS-plus). Those same partners also tend to limit the adoption and use of public health flexibilities in the TRIPS Agreement (TRIPS-flexibilities). The trade and investment policy is entering a new era of debate and (re)negotiation shaped by the graduation of many least developed countries (LDCs) who will need to adhere to TRIPS, and the review of multilateral and bilateral agreements in the US.
Many important knowledge gaps remain about the processes and factors that influence the implementation of trade treaties, which can explain the variation in implementation between countries and their effects on access to medicines. Furthermore, rigorous evaluation of the effects of trade treaties on access to medicines is restricted by the limited availability of data, and a lack of uniformity in indicators and weak study methods.Trade on Medicine Report-2019-GDP-Center
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