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This chapter explores the global trade regime, which viewed substantive equality as the first step towards true equality. It defines the terms substantive equality and barriers-to-trade, and then studies the WTO as a tool to discourage protectionist policies of member states to achieve the goal of reducing barriers to international trade. It looks at IP rights and protection, which is administered by the World Intellectual Property Organization (WIPO), and even summarizes the Trade-Related Aspects of the Intellectual Property Rights (TRIPS) Agreement. This chapter concludes with a discussion on the Doha Declaration and its consequences for poorer nations.

This lecture discusses how patent protection has been used in order to limit access to essential medicines. It considers how patents can be justified and shows how and why the ‘principle of balance’ has been subverted by the discourse of property rights. This principle lies at the heart of patent protection. The lecture concludes with a consideration of the Declaration on the TRIPs agreement and public health, which is also known as the Doha Declaration. It also presents an analysis of the inaction on the part of developing country governments, which have largely failed to take advantage of the breakthrough achieved at Doha.

In recent years there has been a proliferation of international rules, laws, and institutional forms in world politics. Some policy makers, a fair number of international relations scholars, and many international lawyers posit that these trends will lead to more rule-based outcomes in world politics. This chapter suggests a contrary position: institutional thickness paradoxically weakens global governance structures. Institutional proliferation erodes the causal pathways through which regimes ostensibly strengthen international cooperation. After a certain point, therefore, the proliferation of regimes shifts global governance from rule-based outcomes to power-based outcomes. To demonstrate these effects, the chapter examines two cases: the aftermath of the 2001 Doha Declaration on intellectual property rights and public health, and recent efforts to create a WMD interdiction regime that permits the boarding of ships on the high seas. These cases show that state power can break down “viscosity” within global governance structures.

This chapter explores how to navigate health-related human rights in the trade and public health complex by tracing the intersection of international trade and public health and examining the role of international trade in global health law. An intrinsic tension exists between international trade, public health, and human rights in this globalizing world. Even though growing global interconnectedness has generated economic growth and information sharing, it is also characterized by threats—to access to medicine, commercialization of health care, and widening health inequality. Although this tension was well recognized in the development of the World Trade Organization, it has become much more complicated in recent decades. By addressing critical questions surrounding trade and public health, examining the transformation of risks into opportunities through global efforts, it will be possible to investigate possible venues to resolve trade and public health tensions in light of human rights.

The TRIPS Agreement significantly altered the landscape relating to pharmaceutical patents but its impact has been far less substantial than proponents hoped for or critics feared. This chapter reviews the promise, expectations, and worries of and about the TRIPS, focusing on claims that TRIPS will improve protection of Intellectual Property Rights and decrease counterfeits, boost innovation, and result in or even cause a public health crisis. Moreover, this chapter evaluates some of the more interesting unsolved issues such as the scope and limits of jurisdictions to determine standards of patentability and perimeters of compulsory licencing, the consistency of seizing medicines in transit with the TRIPS, the increasing presence of TRIPS-Plus provisions in bilateral and regional trade and international investment agreements, and—perhaps the largest unresolved challenge—how the WTO and its Members can contribute to increasing access to medicines and improving global health throughout the developing world.

Organ transplantation has become a victim of its own success with the global need for organs outstripping supply. Organ trafficking and transplant tourism have developed as ways to circumvent the shortage. Responses from the United Nations and World Health Organization have condemned these practices and called for their elimination. There are increasing calls to permit legalized organ markets, claiming they would not only ease the organ shortage, but also reduce trafficking and transplant tourism. This chapter argues that organ trafficking, tourism, and trading are all inter-related and harm results to the vendors from all three. The arguments for legalized organ markets from philosophers, economists, and clinicians are presented and critiqued with a particular emphasis on the work of Janet Radcliffe-Richards. The criteria for an ideal organ market as outlined by Arthur Matas are then summarized and discussed, and followed by an exploration of the current situation regarding organ transplantation in Iran—the only country in the world to have a state-regulated organ market. A brief résumé of the history of organ markets is given, followed by an assessment of whether the Iranian model is one which should be followed as Western advocates of organ markets suggest, or whether it illustrates many of the problems of payment for organs of which opponents of such markets warn. It is concluded that the poor and vulnerable are overall the most likely to be the biggest losers in all forms of organ selling, whether by trafficking, transplant tourism, or trading in organ markets.

The signing of the World Trade Organisation (WTO) Agreement at Marrakesh in 1994 marked the beginning of a new international IP regime. As per Article 27 of the Agreement on Trade-Related Intellectual Property Rights (TRIPS), no member could discriminate among different technologies under their domestic patent law. India was, therefore, under an obligation to amend its domestic patent law to once again recognize pharmaceutical patents. After an initial failure to amend its domestic law, India was sued by the US and EU before the Dispute Settlement Body (DSB) of the WTO. Under the threat of WTO-authorised trade sanctions, India began the process of amending its patent law over three phases. This chapter explains the stormy decade between the signing of the Marrakesh Agreement and the enactment of the Patent (Amendment) Act, 2005 which finally recognized pharmaceutical patents with the caveat of Section 3(d).