The adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement) within the framework of the World Trade Organization (WTO) dramatically altered the international landscape on intellectual property, particularly as it relates to access to medicines. One of the stated objectives of the TRIPS Agreement was  to contribute to technological innovation and to the transfer and dissemination of technology, to the mutual advantage of producers and users of technology in a manner conducive to social and economic welfare, and to a balance of rights and obligations. When efforts by developing countries to use TRIPS flexibilities  to increase access to medicines resulted in disputes between right holders and users of technology, developing-country WTO Member States sought clarification on the relationship between the TRIPS Agreement and public health. This led to the adoption of the Doha Declaration on the TRIPS Agreement and Public Health in November 2001.


This Discussion Paper commences with a discussion of the Doha Declaration’s contents and before exploring its importance to developing and Least Developed Countries (LDCs), if they are to realize commitments to universal access to treatment for HIV. The Paper discusses some of the successes and challenges encountered by developing countries when attempting to use public health related TRIPS flexibilities to increase access to HIV  treatment.  In doing so, the paper discusses some recent developments that have undermined the use of TRIPS flexibilities including the proliferation of free trade agreements and anti-counterfeiting legislation. The paper concludes by highlighting the importance of the Doha Declaration to  increasing access to treatment for non-communicable diseases (NCDs) as well as some outstanding issues that remain to be addressed if the scale up of  HIV treatment is to continue in future.

“Despite the rapid scale-up of treat­ment in the past decade or so, the sustainability of treatment is under threat – as patients move to newer and more expensive regimens, and funding the AIDS response flat-lines. It remains imperative that countries preserve policy space needed to regu­late medicine prices including the use of the TRIPS flexibilities, so as to promote competition and thereby reduce the price of the needed medicines, if patented.”