In the early 1990s, a subset of the health sector— patented drugs—burst quite unexpectedly into the international trade debate. The ongoing trade negotiations of the Uruguay Round were in disarray, and support from sectors that relied on the protection of intellectual property rights became essential to move them forward.1 Indeed, the Uruguay Round Agreement was signed in 1994 only because it included a then much praised Trade-Related Intellectual Property Rights (TRIPs) agreement.
Between 1994 and the 2001 Doha Ministerial of the World Trade Organization (WTO), the spread of AIDS reached pandemic proportions. Research had yielded a cocktail therapeutic of drugs, but in 2001 a typical treatment cost US$12 000 a year per person—a sum far out of reach for most people with AIDS in developing countries. This imbalance fuelled a debate about access to essential medicines so acrimonious that it came close to derailing the Doha Ministerial.2,3 A solution was reached only 2 years later, and only 2 weeks before the 2003 Cancún WTO Ministerial.