Rethinking Trade Treaties and Access to Medicines after COVID-19: A Revised Research Agenda

Since the establishment of the World Trade Organization’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) in 2001, there has been a concern that the now-global rules governing intellectual property (IP) protection would present obstacles to securing access to medicines for populations in low- and middle-income countries (LMICs). A few years later, the Doha Declaration on TRIPS and Public Health was born out of a hope that global cooperation could begin to deliver on its promise of creating a multilateral system “for the benefit and welfare of [all] peoples.”

Nevertheless, 22 years and a global pandemic later, the world still wrestles with on-going large inequities in global public health.

In the wake of the COVID-19 pandemic, the Working Group on Trade and Investment Treaties and Access to Medicines hosted at the Boston University Global Development Policy Center convened in June 2023 to assess the current political, legal and technological landscape in the four years since their first meeting. In consultations within the group and with outside experts, they largely found that the scope and level of policy engagement, as well as the relevance of domestic IP protection mechanisms have shifted substantially as a result of the COVID-19 pandemic. These changes have made it necessary to significantly rethink the legal, econometric and political economy agenda for interdisciplinary research on IP, trade and access to medicines.

To that end, a revised research agenda was developed around three key topics:

• Impacts of TRIPS flexibilities. After 30 years of advocating for the need for and the use of TRIPS flexibilities, there is still an active debate about their use and usefulness. Research highlighting best practices, legal approaches and real-world impacts of implementing TRIPS flexibilities could support the narrative that these flexibilities are both useful and needed.
• Transparency, trade secrets and technology transfer. Manufacturers in the Global South need access to confidential information needed for production, which is currently protected as trade secrets. Researchers and policymakers need greater transparency on biopharmaceutical research and development, costs, pricing, supply and licensing agreements, clinical trial data, and IP and regulatory rules. For that reason, research will be needed to improve understanding of how best to increase transparency, as well as encourage technology transfer and the sharing of trade secret information, when necessary, especially in cases where time is of the essence.
• Importance of regional or national regulations. Since governments assess risk differently, and each country has its own regulatory capacity and other constraints, researchers must understand more about the national regulatory environments that contribute to and engage in regional supply chains.

In light of the changing landscape and newly identified research gaps, this revised research agenda presents as a jumping-off point to fill in knowledge gaps and better empower LMICs to introduce policies that increase their access to medicines.