Access to medicines.

Medicines account for a major proportion of health costs especially in the developing world where it is estimated that one third of the population is unable to receive or purchase essential medicines on a regular basis. Most trade in medicines takes place between wealthy countries with the developing nations accounting for only 17 per cent of imports and 6 per cent of exports. Access depends on affordable prices and on rational selection and use of drugs. Prices which are most affected by globalization have direct implications especially for developing countries where 50 to 95 per cent of drugs are paid by the patients themselves. The sale of the same goods to different buyers at different prices so-called differential pricing aims to improve affordability of drugs while generating revenue for the pharmaceutical industry. This has reduced the cost in low-income countries of many antiretroviral (ARV) HIV/AIDS therapies by up to 90 per cent even though they continue to be sold at market price in developed countries. Other means to increase affordability include generic substitution promotion of competition and the use of safeguards compatible with the World Trade Organizations (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Parallel importation and compulsory licensing are recognized as TRIPS public health safeguards against a patent holder charging excessively high prices in a particular market. TRIPS also extends the transition period until 2016 in which least developed countries do not have to enforce or grant patents on pharmaceutical products. (excerpt)