Médecins Sans Frontières (MSF), an international medical humanitarian organisation, wants the incoming director general Roberto Azevedo of the World Trade Organisation (WTO) to focus on making access to affordable medicines a priority. This includes allowing least-developed countries to remain exempted from introducing WTO’s intellectual property rules, and maintaining the right of countries to use all legal flexibilities at their disposal to ensure access to affordable generic medicines.

Azevedo’s appointment comes at a crucial time as least-developed country (LDC) member states have requested to remain unconditionally exempted from implementing the Trade-Related aspects of Intellectual Property Rights (TRIPS) agreement until they are no longer classified as a LDC. The transition period for LDC member states that exempts them from introducing some of WTO’s intellectual property (IP) rules is set to expire next month. The transition period with regard to the waiver on pharmaceutical patents is due to expire in 2016.

“One of the first jobs for the new director general should be to ensure affordable access to medicines for all WTO member states as a key priority,” stressed Rohit Malpani, director of policy and analysis for MSF’s access campaign.

In November 2012, LDCs submitted a request before the TRIPS council for extension of the transition period. If accepted, this would entitle these countries to avoid granting twenty year patents on medicines, diagnostics and medical devices, which is essential in enabling access to low-cost versions of these products. LDCs have not only requested an extension of the deadline that exempts them from implementing their TRIPS obligations but are appealing for the lifting of the condition imposed in 2005 that prevents them from rolling back or amending any existing legislation that reduces the degree of IP protection. This condition directly interferes with LDCs actually using the extension to ensure access to affordable generic medicines.

Developed countries, including the United States and European Union, are resisting calls for an extension or to allow LDCs to roll back existing IP rules.

According to Dr Jennifer Cohn, medical director for MSF’s access campaign, “Least-developed countries already face an uphill battle to keep epidemics such as TB and HIV under control. It is critical to ensure access to affordable versions of newer medicines for these countries, and at this point asking them to apply stringent IP rules to the same level as developed countries would be catastrophic.”

MSF is also concerned that some member states– in particular, the US – are disregarding developing countries’ right to use TRIPS flexibilities to ensure access to medicines. In the recently published special 301 report, the US has placed India on its trade priority watch list over issuing a compulsory license to improve access to an expensive cancer medicine.

The US 301 report also heavily criticises  the Supreme Court of India’s recent precedent setting verdict in the area of pharmaceutical patents. The court rejected the Swiss company Novartis’ appeal for a secondary patent on the salt form of a life-saving cancer drug for failing to meet tougher patentability requirements under the Indian Patents Act.

“I hope that Azevedo will ensure that public health safeguards in the TRIPS agreement are respected by all member states and that countries which choose to implement those safeguards do so without fear of reprisal or reproach from other member states,” said Malpani. He further added that the ability of countries to implement TRIPS flexibilities is vital to ensure all people–particularly those in remote and resource-limited settings–have access to affordable medicines and essential medical care.