Public Health of the Developing Country of South Africa Essay
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Studies and statistics have put the cost of one year requirement of standard essential medicines needed for the treatment of AIDS at $ 4000 to $ 6000 in developing countries like South Africa. This cost puts the medicines out of the reach of most of the people infected by HIV in the developing countries. In order to make the medicines available to all the needy people the cost should have been at least 95 percent less. The exorbitant price is because of the cost of the patents.
The drugs protected by the intellectual property rights were required to treat diseases like Tuberculosis, in addition to the treatments of HIV/AIDS. Such drugs also included Hepatitis-B Vaccine.
There has been a continuous criticism by the social activists and other public health associations, of the action by the World Trade Organization in making the developing countries implement the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement which deals with the protection of Intellectual Property rights relating to the essential drugs.
They have also been condemning the attitude of the multinational companies in indulging in excessive lobbying to insist on the implementation of the IP rights protection which will have the effect of enhancing their earnings by charging exorbitant prices for the drugs and for putting the essential drugs and health care beyond the affordability of scores of people in the developing nations including South Africa.
However under such circumstances the relationship between the government of South Africa and the international pharmaceutical companies had not been a conducive one – thanks to the implementation of the provisions of TRIPS Agreement. On the decision of the South African Government to pass the Medicines and Related Substances Amendment Act in the year 1997, 39 drug companies joined to initiate legal action against the government.
The plea of the drug companies is that the Act gave too much freedom of action to the Health Minister and he acted beyond the legitimate interpretation of TRIPS. It was the endeavour of South Africa to make life saving drugs available at affordable prices. The country wanted to effectively utilize the compulsory licensing opportunities opened by TRIPS so that the prices of the drugs could be put under check. But since the action of the government posed a threat to the earning capacity of the international pharmaceutical companies they went to the extent of entering into litigation with the government of South Africa.
TRIPS (Trade Related Aspects of Intellectual Property Rights) under the authority of the WTO were founded to protect worldwide intellectual property rights. The agreements, governing not only more general intellectual property rights but also those of the pharmaceutical industry, are fairly stringent causing many problems for developing countries especially South Africa which is being ravaged by epidemics which includes AIDS.
According to a statistical survey by United Nations 20 percent of the adult population in South Africa tests positive for HIV. The impact of the disease is such that the more than half a million children have been declared orphans. It is also reported that HIV/AIDS related diseases expect to reduce the average life expectancy in South Africa by 20 years in the year 2010. Therefore it can be inferred that the provision of treatment of HIV/AIDS in South Africa is a high priority issue.
It has been necessary for South Africa to circumvent part of the TRIPS agreements in an effort to protect its population. AIDS is taking great toll of the country leaving families without parents and health care hospitals totally unable to cope. The United States currently insists on the TRIPS agreement being strictly adhered to and seems unable, or unwilling, to find a way to help the developing nations with this problem. There have been some efforts made to help them in this respect, for example compulsory licensing and parallel pricing and these methods will be examined in a later section.
The negotiation of the TRIPS Agreement has been construed as one that was forcibly introduced by the developing countries against the objection of many of the developing nations. The industrial lobbies (multinational and transnational corporations) have convinced the governments of the developed countries to link the international trade with Intellectual Property Rights (IPR) so that the industrial advancement of the developing countries would be curtailed. This would automatically prevent imitation of technologies and increase the returns on research and development for the developed countries. Monopoly rights granted under IPR were mainly intended to deter the developing countries from advancing on the industrialization.
Thus TRIPS Agreement and the protection of IPR have been used to ensure the comparative advantage of the developed countries in terms of the technological development. Under TRIPS countries like India, Brazil which manufactures generic medicines would not have the right to export such medicines with effect from 01 January 2005. This is so despite the fact that the importing countries do have the respective patents covering the drugs.
Specifically the least developing countries have put a strong resistance to the requirements of TRIPS especially in the matter of granting the protection rights for the products and processes. While developing countries were required to implement the provisions within one year of reaching the Agreement, the developing countries were given time until the end of the year 2004. In the matter of protection of rights of pharmaceutical products the lease developing countries have been allowed to delay the implementation of TRIPS Agreement provisions till the year 2016.
The peculiarity with the provisions of TRIPS is that it allows any country to override the patent right under certain specific circumstances by using the compulsory licensing procedure. For instance when there is a shortage of drugs or the prices of the drugs are too high to make them unaffordable the country can override the patent if the prescribed procedures are followed. This provision of TRIPS presupposes that all the countries do possess the required manufacturing facilities which enable them to use the provisions to produce generic medicines under extraordinary circumstances.
But unfortunately many of the developing and least developing countries do not posses such facilities, and hence they would be left with shortage of such drugs. In addition they are also not allowed to import the generics from those countries that possess them. In any case these countries do not have enough power and administrative capabilities to invoke the TRIPS Agreement either due to the reason that they do not possess the know-how required to reengineer the drugs or they fear sanctions from the US and the West.
- TRIPS Agreement under WTO
The TRIPS Agreement is often thought of as one of the three “pillars” of the WTO (World Trade Organization), trade in goods and services being the other two.
TRIPS, initially part of GATT. But becoming part of the WTO brief, was founded to ensure that protection of intellectual property rights was not, of itself, an obstruction to trade and to increase cooperation between members. Under the TRIPS agreement each member state has an obligation to treat all other member states equally. The WTO negotiates between members and helps them to understand and carry out the rules and regulations they have signed up to. It also aids cooperation between members and acts as a watchdog to ensure that the agreement is adhered to.
Marketing rights of a patent, when first applied for, are given for a period of 5 years or until the patent is finally approved (whichever is the shorter period) but even during this period members must comply with the rules and regulations as set out in Articles 3 and 4.
Because of the nature of the agreement especially as regards pharmaceuticals, it was decided that minimum standards could be used, the USA prefers the higher standards but accepts the minimum as the developing world does not have the capacity to work to the higher standards at the present time. Public awareness of the serious issue of AIDS and other diseases has led to the belief (by the WTO) that health must, in the final analysis, come before agreements since the spread of AIDS cannot be the sole responsibility of one country.
In trying to bridge the gap between the pharmaceutical companies and the developing nations, TRIPS has endeavoured to bring the two sides together by allowing extensions to drugs’ patents but has also allowed some compulsory licensing.
Article 3(a) under the TRIPS Agreement states that treatment of all members must be equal, but Article 3(b) is a get-out clause and Article 4(b) states that all members are equal, unless an …agreement was entered into before the WTO agreement. However, the Council for TRIPS must be informed of any non-observance of Article 3(a) under Article 3(b).
The TRIPS Agreement ensures that members discharge their commitments to the World Intellectual Property Organisation (WIPO). Part of the United Nations WIPO was set up in 1974 specifically to direct international treaties and agreements. The Paris Convention on Industrial Property and the Berne Convention on Copyright, two of the major treaties have been brought under the TRIPS umbrella. The former states that “members must comply with the obligations they have towards each other” and “nothing must stand in the way of such obligations”. However, as noted, there is a get-out clause in cases of emergency which has to be acknowledged by members to the agreements. There is also an agreement that member countries monitor each other for infringements.
Most important in terms of worldwide health problems is Article 67 of TRIPS which states that developed countries must assist developing countries with the development of their intellectual property rights, it states:
“In order to facilitate the implementation of this Agreement developed country Members shall provide, on request and mutually agreed terms and conditions, technical and financial cooperation in favour of developing and least-developed country members”
“Such cooperation shall include assistance in the preparation of laws and regulations on the protection and enforcement of intellectual property rights as well as on the prevention of their abuse, and shall include support regarding the establishment or reinforcement of domestic offices and agencies relevant to these matters, including the training of personnel.”
Programmes to assist the developing nations have already been promoted and are being assisted by the WTO secretariat and WIPO.
- TRIPS Agreement in Relation to Medicines
Since most pharmaceutical research and development is carried out in developed countries the organisations involved feel that they should be better protected. Most drugs cost millions and take years to test and develop before being allowed onto the market, the industry naturally want returns by way of profits on sales. AIDS medication has been a particularly important breakthrough since: ‘HIV infects an estimated 45 million persons worldwide” but there are also “…1.86 billion cases of infection with mycobacterium tuberculosis” therefore, it is imperative that something be done to help alleviate this type of suffering which, with the ever growing number of tourists, should be the concern of not only those countries in which these epidemics are raging but every nation whose borders are open to travel from other countries.
The TRIPS agreement, currently, seems to err on the side of the drugs’ companies, probably because they have such powerful lobbies and are part of the new world-wide elite of corporations which, according to Janet Dine, are increasingly importing their own ethics into the developing countries and virtually taking over, creating in the process an impoverished and unhealthy nation, they, the indigenous population have to take what is offered often at less than subsistence wages and become more dependant on the corporations who have moved into their countries in search of ever increasing profits.
The money the corporations make from taking over in developing countries returns, not to the people of that region, but to their own countries. With tax incentives and a population who take any work they can get to survive at the lowest rates offered, these Corporations appear to be fuelling a crisis in health for some of the poorest nations in the world.
Although The TRIPS agreement does allow for compulsory licensing in an emergency, each country must first negotiate with rights’ holders and must use those drugs obtained under such a license only for the emergency period and not for any commercial gain.
Specific areas, such as South Africa, are going through a health crisis which needs the drugs already available to ameliorate it, however, in spite of clause 3(b), they are getting no further forward in their fight to help their citizens to overcome unprecedented death rates that the epidemics are producing.
In spite of Articles 30/31, which allow for compulsory licensing, the poorest and least developed nations are fighting against the cost of the use of patents and the epidemics themselves. Compulsory licensing does not adequately cover the needs of such nations in “sub-Saharan Africa since they do not have facilities to manufacture their own drugs.”
Protection of intellectual property is not part of the culture of many countries, nevertheless, the TRIPS Agreement was signed on 15th April 1994 by 117 nations. The agreement allows intellectual property rights to be “enforced by trade sanctions” and, although some countries were not in complete agreement, international trade is vital to their economic growth so, however reluctantly, they signed. Inhibitors, which have done much to control AIDS in the west, cost as much as $10.000 per head annually but international trade is the life blood of developing nations therefore they had little choice but to do so.
4. TRIPS and Developing Countries
It has been observed that implementing TRIPS Agreement and recognizing IPR on pharmaceutical products and processes would result in the following problems to the developing countries:
- The minimum 20 years protection to the IPR would grant a virtual monopoly for a pharmaceutical company over its patented drug and the company would be able to charge exorbitant prices on the drugs without competition which in turn would keep the drug prices very high during the period of protection. It is also not possible to bring any generic equivalent into the market due to the TRIPS Agreement. This would deny the patients cheaper alternative drugs.
- The product and process patents provide for the protection of the product as well as the technology. Under the TRIPS Agreement the countries are given the right to make application for the protection of patent rights on drugs for a period extending up to twenty years. After the expiation of this period the countries can get the protection extended for further periods to the processes being employed in the manufacture of the drugs. This no doubt creates a monopoly situation on the drugs.
- Such protection also throw the domestic pharmaceutical producers in the developing countries out of market as they have to compete with large multinational pharmaceutical manufacturers which is not possible for small producers in the developing nations who use cheaper generic alternatives. Moreover such production may not be carried out by them during the 20 year protection period.
- Under TRIPS Agreement patent rights need to be granted irrespective of the fact that the products are imported or domestically manufactured. This implies that the transnational corporations can supply global markets under the monopoly of patent rights even without producing any medicines in the developing countries by simply importing them into the developing countries. There will be no flow of technology or foreign direct investments into the developing countries as envisaged by the WTO
However under Article 66 of the TRIPS the least developed countries were allowed to postpone the application of the provisions relating to the patents for a period of 10 years on specific application.
5. Exceptions to the Patent Protection of Pharmaceuticals
Parallel importing – implying that the developing counties are allowed to import the drugs from the cheaper markets for resale in their respective countries and thereby lower the prices of drugs.
Compulsory licensing – under compulsory licensing scheme, the government acting through the courts of law is empowered to provide a license in favor of a third party. Such license may be granted by the government even without the prior consent of the license holder. However the compulsory licensing can be resorted to in cases of national emergencies. The license may also be compulsorily transferred to a third party in case of an extremely emergent situation or where there are circumstances implying any anti-competitive movements by the manufacturers. The compulsory licensing is resorted to by the governments to make the drugs easily available to the poor and needy people at affordable costs. It also ensures that the patent holder is provided adequate compensation for use of the patent.
6. Public Health in South Africa and the Impact of TRIPS Agreement
The need for cheaper drugs in South Africa can not be undermined. The impact of AIDS in the country poses the situation of an extreme emergency forcing the implementation TRIPS. The economy of South Africa is likely to get affected by a reduction of 1 percent every year because of the work force getting disintegrated. It is estimated that the life expectancy would be lowered to 50 years in 2010 from 70 years currently. These threats to the economy and population growth would as well be a threat to ‘peace and order’ situations in the country of South Africa.
In this context all the problems enumerated above for the developing nations have been faced by South Africa also. In addition when the government wanted to implement the Medicines and Related Substances Control Bill, the US Government vehemently objected to the passing of the law which allowed for parallel importing and compulsory licensing. However amidst lot of pressure on the government and the Parliament the South African government enacted the law in the year 1997.The pharmaceutical lobby backed by the transnational companies in the South Africa not only filed a suit against the promulgation of the law but also indulged in negotiations and threats to the government to change its stand.
The pressure was intense after the year 1997 when the South African government tried to implement a number of policy measures to lower the prices of drugs used in public health. “The SA policies have focused on such issues as mandatory generic drug substitution, restrictions on inappropriate marketing efforts, registration of generic versions of the cancer drug Paclitaxel (sold as Taxol by Bristol-Myers Squibb), parallel-imports, and compulsory licensing”.
It may be noted that despite Article 31 of the TRIPS Agreement that provides for the parallel importing and compulsory licensing the transnational pharmaceutical companies have vehemently opposed the attempts by developing countries like South Africa taking measures for implementing parallel importing and compulsory licensing as these practices would allow these countries to have their requirements of the medicines at cheaper prices which in turn would affect the profits of these transnational companies.
It was after the intervention of the AIDS activists and health activists that US came to an understanding in the issue. The government of South Africa insisted that it retains all the original provisions defending its position be retained. The government also wanted to make the fullest use of compulsory licensing and parallel importing which were considered as detrimental to the interests of the American Transnational Companies.
- How American Corporations Control the Business World
A- Business lobbies:
Large and small businesses in the United States have been organised into various associations, for example Business Round Tables are national Associations which include membership of the Chief Executive Officers (CEOs) of all the most important trans-national companies and the National Chamber of Commerce includes all sizes of firms.
Round Tables have been in existence since 1972, the first was formed by forty-two of the (then) biggest and most important U.S. companies including banks, retailers, Insurance, transport and most of the utilities’ companies. They were designed to enable business to proceed without the destructive competitive basis of the business world. They were described as:
“An association of chief executive officers who examine public issues that affect the economy and develop positions which seek to reflect sound economic and social principles. … the Roundtable was founded in the belief that business executives should take an increased role in the continuing debates about public policy.”
The raison d’etre for these firms was the idea that ‘what ever is good for business is good for the American people’. They argued that, employees, purchasers, suppliers etc all have an interest in a business. These associations, they say, represent a cross section of the American public.
The idea that ‘what is good for business is good for America’ is patently nonsense since most people are in fact excluded from any rights in this elite world. Employees have little or no say in the running of their firms and consumers must pay the prices asked, they do have the right ‘not to buy’ which is a somewhat negative view of the process of inclusiveness.
David C Korten says that most of the memberships of the Round Tables are confined to white males over the age of 50 whose salaries are enormous. They do not, as claimed, consider that what is good for business is good for America but rather endeavour to maximise their own profits and those of their shareholders by seeking to globalise in areas where they can have an almost free hand to carry out their business practices almost unhindered by the laws of any country they move into. 
Free Trade has long been an ideal of the American Corporate world which is why the Round Tables campaigned vigorously for the North American Free Trade Agreement (NAFTA and created USA-NAFTA to front their interests, the American public, nervous at so much control in so few hands, have been given country-wide blanket assurances through the media. In spite of the fact that NAFTA was supposed to be a really broad church of interests it is really part of the elite Round Table Associations and has many representatives on advisory committees.
The country might have been even more nervous if they had realised that at the time of the creation of these Round Tables the major companies were in fact laying aside their competitive differences to “reach a consensus on issues of social and economic policy for America”.
B- Influence of U.S. Democracy
Janet Dine claims “no single idea is more deeply embedded in modern culture than the belief that economic growth is the key to meeting most important human needs, including alleviating poverty and protecting the environment”  which accounts for the greatest growth area in Washington being public relations firms. These firms work hard to protect the images of their corporate clients against a rising tide of discontent which is now manifesting itself throughout the world. It could be thought that they are fighting a losing battle but “the top fifty public relations firms billed over $1.7 billion dollars in 1991” which gives rise to the question, why are these PR firms so necessary?
There is probably no single answer to this question but very little news is given directly to the public without some corporate employee looking at the effect it will have, news and advertising, according to Korten, are almost synonymous.
The political system of America has greatly changed in the post war period of more general affluence. The Democratic party has lost its basic identity the party of the people – as opposed to the Republicans who have always represented business and the wealthier side of the electorate – this being so the Democrats are far more dependant on the need to raise funds for their electioneering and have turned to the corporations who inevitably want quid pro quo for their donations.
The mass media are heavily behind the elitist values of corporate America and the amount they are able to pay to PR firms to put across an extremely one-sided policy and both the leading parties needing the financial backing of corporate America, this, says David C Korten, “This is the sorry state of American democracy”. He says that voters tend to be seen as a passive homogeneous mass of potential customers who can be told not only what to buy but also what to think and feel. What is worse, this idea of corporations is spreading, many trans-national companies rely heavily on the corporate idealism of what is good for them is good for the people they sell to. Mexico and Japan both use those same American firms to tell their populations what they should think and feel and ultimately what they should buy.
C- American Democracy for Sale:
“The Mexican government spent upwards of $25 million and hired many of the leading Washington lobbyists to support its campaign for NAFTA. … Japanese corporations were spending an estimated $100 million a year on political lobbying in the United States and another $300 million building a nationwide grassroots political network to influence public opinion”. 
Canada, Britain and the Netherlands’ governments employ public relations’ firms in America to help them lobby and draft laws that will be favourable to the business elites in their own countries.
These companies try to sell the idea of ‘corporate libertarianism’ which is supposed to allay the fears of those who have an idea that all is not well in the corporate world of business, it is possible to claim that these corporations are in fact in the act of ‘taking over the world’ and with the resources piling up behind them it could well happen in the not too distant future.
- The United States and Higher Levels of Protection.
To add to this theme of a world take-over by corporate America, the signatories to TRIPS have begun to rethink intellectual property protection. This is bad news for those under-developed countries which rely on drugs from the western world to protect their citizens from ravaging epidemics. Rosalyn S Park says:
“Poor, developing nations have been most affected by the patent protection laws and resulting high drug prices, yet these nations also harbor the highest number of HIV-positive people. Consequently, the vast majority of people in need of HIV/AIDS medicines simply cannot afford them”. 
In 2006 new protection laws will come into force which all members must adhere to. This will have a devastating effect on the millions of people in countries too poor to have their own drugs’ businesses, they will become more reliant upon those better protected, developed countries making vast profits from the countries least able to pay.
Neither the USA nor the European Union appear greatly interested in aiding those countries with the greatest needs and the least ability to pay. Admittedly concessions have been made as regards agricultural and textile concessions but this has been at the cost of allowing higher property rights which is a swings-and-round-a-bouts situation. It would be much more useful to South Africa specifically and to the developing world in general, if the costs of patented drugs could be either brought down or, as a common sense gesture of good will, eliminated completely until such time as the AIDS epidemic was at least brought down to manageable proportions.
In spite of “several different types of drugs on the market which help combat AIDS and AIDS related illnesses” not enough are getting through to the developing countries as the multinationals are still insisting on not just the status quo as regards intellectual property rights but even higher levels. They appear to be driven only by the profit motive and the perceived necessity for free trade paying little attention to the suffering caused in the developing world. Nor are they taking a long term view, highly contagious diseases are rife in the developing world, therefore, with the modern freedom of travel, no country can ever be safe from the same epidemics. Even with modern drugs to combat them, new strains will develop, new drugs will have to be found and costs will escalate.
Drugs now exist which allow people with AIDS to live a reasonably normal life including returning to work, it would in fact be in the interests of the drugs’ companies to allow South Africa to use them, dead people have no use for drugs nor anything else that the multi-nationals may wish to sell them.
The TRIPS Agreement was a milestone in patent protection of intellectual property rights and was considered to be a financial safeguard for research investment, however, it also had the effect of pricing some pharmaceuticals out of the reach of many nations most in need of the most recently patented medicines. Before the TRIPS agreement, governments had been able to make compulsory licence orders to produce drugs at lower prices in their own countries, after the agreement, although still possible, it is much more difficult and thus more difficult to protect their citizens from the epidemics which are wreaking havoc in their countries.
It is important to protect intellectual property rights but it is far more important to protect people’s lives but the balance currentlppears to be largely towards the greater protection of pharmaceutical industries.
TRIPS allows compulsory licensing and parallel pricing but underdeveloped countries such as South Africa are being prevented from using them because of the threat of trade sanctions and trade is vital to their economies.
It is necessary to protect peoples’ work and investment and research must be encouraged especially into life-threatening diseases. Corporations who invest time and money into producing drugs to cope with these scourges should reap the rewards of their labour. However, many drugs’ companies are seeing such enormous returns on their investments that concessions should be made to underdeveloped countries which so desperately need the medications produced by these huge giants of industry. In spite of concessions in the TRIPS agreement, corporations do appear to be protected at the expense of people’s lives.
Public health should be and is a priority in the west where governments can afford to buy the health of their citizens. Unfortunately, this is not the case in the poorer, less developed countries where governments are struggling to find ways to access drugs and yet to maintain a healthy trading relationship with the countries which hold the patents to these drugs.
Good health is the basic right of every citizen of every country wherever possible. More goodwill is necessary on the part of the western world and America in particular to allow compulsory licensing and parallel pricing to be used without the threat of trade sanctions. Epidemics do not respect borders, they can be carried by people to all corners the world, what was a third world problem yesterday is our problem today, world health is an issue that no country can ignore therefore although corporations must be allowed fair returns on their investments it must not be at the expense of world health.
It is quite apparent that TRIPS Agreement has not taken into account the public health needs of the developing nations while formulating the clauses relating to the protection of IPR in respect of pharmaceutical needs. The Agreement has not specified any particular obligations towards those governments granting the IPR for pharmaceutical products. The Agreement has also not considered the need for public health in the developing countries and grossly ignored the interests of the patients of these countries.
There are a number of factors that the developing countries have to take into account including the implication of the TRIPS Agreement and the patent protection under the Agreement in the provision of medical facilities and adequate public health to the people of the respective developing countries. “At the end of the day it must be recognized that the poorer residents of the world’s least affluent nations cannot pay even the marginal cost of drugs that might save their lives or permit them to become productive workers”.
- Conceicao Soares (2007)‘The HIV/AIDS crisis and corporate moral responsibility in the light of the Levinasian notions of proximity and the Third’ Business Ethics: A European Review Vol. 16 No 3 p 280
- David C Korten, When Corporations Rule the World, Earthscan Publication Ltd. London, p.144
- Duane Nash, “…VI, Foreign & International Law South Africa’s Medicines and Related Substances Control Amendment Act of 1997” 15 Berkeley Tech. L J. 485(lexis)
- Fact Sheet ‘Developing Countries’ Transition Periods’
- F.M. Scherer and Jayashree Watal ‘Post-Trips Options for Access to Patented Medicines in Developing Nations’ Journal of International Economic Law (2002) p 939
- Janet Dine, The Governance of Corporate Groups, Cambridge University Press, 2000.p.157
- J H Reichman, The TRIPS Agreement Comes of Age: Conflict or Cooperation with the Developing Countries? P.6
- John A. Harrelson, “ IV. Note: Trips, Pharmaceutical Patents, and the HIV/AIDS Crisis: Finding the Proper Balance Between Intellectual Property Rights and Compassion” 7 Wid. L. Symp. J . 175(lexis)
- Kara M. Bombach ‘The South African Medicines and Related Substances Control Amendment Bill and TRIPS’ <http://academic.udayton.edu/health/06world/africa01.htm> p1
- Lisa Foreman (2007)‘Trade Rules, Intellectual Property and the Right to Health’ Comparative Program in Health and Society Munk Centre for International Studies University of Toronto Ethics & International Affairs Vol. 21 No3 p 342
- Louise Sylvan ‘TRIPS: Protecting Intellectual Property or Putting Profits Before People’ Online Opinion
- Medecins sans Frontieres (1999) Access to HIV/AIDS medicines in Thailand, Medecins sans Frontieres Report to the National AIDS Committee of Thailand, August 1999, MSF website, www.accessmed-msf.org/msf/accessmed/accessmed.nsf/html/4DTS2? Open Document.p1
- N.B. Zaveri (1999) ‘Success often comes to those who dare and act’, paper presented at Brainstorming Workshop on WTO Agreements and People’s Concerns, New Delhi, Oct/Nov 1999 p1
- Patric Bond ‘US Policy toward South Africa and Access to Pharmaceutical Drugs’ Alternative Information and Development Centre <http://www.aidc.org.za/?q=book/view/156> p1
- Ross Brennan and Paul Baines (2005) ‘Is there a morally right price for anti-retroviral drugs in the developing world’ Business Ethics: A European Review Vol. 15 No 1 p32
- Rosalyn S Park, The International Drug Industry: What the Future Holds for South Africa’s HIV/AIDS Patients, Minnesota Journal of Global Trade, p.3
- Z. Mirza (1999) ‘WTO/TRIPS, pharmaceuticals and health: impacts and strategies’, The Network’s Drug Bulletin, Sept-Dec 1999, Vol. 8, No. 5/6, Association for Rational Use of Medication in Pakistan p 27
 United Nations (2004) Report on the Global AIDS Epidemic. Geneva: United Nations
 Ross Brennan and Paul Baines (2005) ‘Is there a morally right price for anti-retroviral drugs in the developing world’ Business Ethics: A European Review Vol. 15 No 1 p 32
 Conceicao Soares (2007)‘The HIV/AIDS crisis and corporate moral responsibility in the light of the Levinasian notions of proximity and the Third’ Business Ethics: A European Review Vol. 16 No 3 p 280
 www.wto.org (Frequently asked questions about TRIPS in the WTO).
 Duane Nash, “…VI, Foreigh & International Law South Africa’s Medicines and Related Substances Control Amendment Act of 1997” 15 Berkeley Tech. L J. 485(lexis)
 Janet Dine, The Governance of Corporate Groups, Cambridge University Press, 2000.p.157
 John A. Harrelson, “ IV. Note: Trips, Pharmaceutical Patents, and the HIV/AIDS Crisis: Finding the Proper Balance Between Intellectual Property Rights and Compassion” 7 Wid. L. Symp. J . 175(lexis)
 Z. Mirza (1999) ‘WTO/TRIPS, pharmaceuticals and health: impacts and strategies’, The Network’s Drug Bulletin, Sept-Dec 1999, Vol. 8, No. 5/6, Association for Rational Use of Medication in Pakistan p 27
 Medecins sans Frontieres (1999) Access to HIV/AIDS medicines in Thailand, Medecins sans Frontieres Report to the National AIDS Committee of Thailand, August 1999, MSF website, www.accessmed-msf.org/msf/accessmed/accessmed.nsf/html/4DTS2? Open Document. p1
 Fact Sheet ‘Developing Countries’ Transition Periods’
 Kara M. Bombach ‘The South African Medicines and Related Substances Control Amendment Bill and TRIPS’
 Patric Bond ‘US Policy toward South Africa and Access to Pharmaceutical Drugs’ Alternative Information and Development Centre <http://www.aidc.org.za/?q=book/view/156> p1
 Louise Sylvan ‘TRIPS: Protecting Intellectual Property or Putting Profits Before People’ Online Opinion
 N.B. Zaveri (1999) ‘Success often comes to those who dare and act’, paper presented at Brainstorming Workshop on WTO Agreements and People’s Concerns, New Delhi, Oct/Nov 1999 p1
 David C Korten, When Corporations Rule the World, Earthscan Publication Ltd. London, p.144
 David C Korten, When Corporations Rule the World, Earthscan Publication Ltd. London, p.144
 Janet Dine, The Governance of Corporate Groups, Cambridge University Press, 2000.p.156
 David C Korten, When Corporations Rule the World, Earthscan Publication Ltd. London, p.146
 David C Korten, When Corporations Rule the World, Earthscan Publication Ltd. London, p.147
 David C Korten, When Corporations Rule the World, Earthscan Publication Ltd. London,pp.147-148
 Rosalyn S Park, The International Drugs Industry: What the Future Holds for South Africa’s HIV/AIDS Patients, Minnesota Journal of Global Trade, 2002.p.1
 Rosalyn S Park, Minnesota Journal of Global Trade, 2000, p.2
 J H Reichman, The TRIPS Agreement Comes of Age: Conflict or Cooperation with the Developing Countries? P.6
 F.M. Scherer and Jayashree Watal ‘Post-Trips Options for Access to Patented Medicines in Developing Nations’
Journal of International Economic Law (2002) p 939