The Global Politics of Access to Medicines

Access to medicines has been a fierce battleground in global health, with the most polarising debates focused on medicine prices and the role of patent monopolies. The way ‘access to medicines’ has been framed has evolved considerably since the 1970s, when the focus was primarily on rational use of generic drugs widely available in developing countries. In the 1990s the advent of the WTO TRIPS Agreement clashed directly with a growing global HIV crisis; the politics of ‘access to medicines 1.0’ that emerged centred squarely on antiretrovirals for HIV/AIDS and intellectual property rules. Subsequently, significant ideational and political shifts have resulted in an ‘access politics 2.0,’ characterised by an expansion of concerns to all diseases, tighter linkages between innovation and access concerns, and shifting political dynamics as high-income countries began to experience directly the challenge of high drug prices. These shifts imply a more complex and potentially more consequential politics of access to medicines in the future.