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Impressive advances in medicine and technology have boosted health and extended life expectancy – but not for everyone. Vital new medicines for diseases such as HIV/AIDS are priced out of reach of the millions of sick people in the developing world, in part due to global patent rules which restrict the availability of affordable generic versions of patented medicines. In 2001, all members of the World Trade Organization adopted the ‘Doha Declaration’, promising to prioritize public health over private patent rights and to promote ‘access to medicines for all’. This paper examines how the government of the United States is contravening this commitment by using technical assistance, bilateral and regional trade agreements, and the threat of trade sanctions to ratchet up patent protection in developing countries. This policy benefits the influential U.S. pharmaceutical industry while pushing medicines further out of the reach of poor people.

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