Enter the two other characters in our story - the world's largest pharmaceutical companies and the World Trade Organisation. Four companies dominate the pharmaceutical industry - Merck, Pfizer, Glaxo SmithKline, and Eli Lilly, and they wield enormous financial clout. The Big Four operate like a cartel, and like all cartels seek to wield monopoly power. It is basic economics that monopolies lead to higher prices, which is why many governments use anti-trust legislation to break them up. To say that the Big Four do not like the idea of cheap drugs coming onto the market from developing countries is something of an understatement.
More competition equals lower share price.
But the financial muscle of the pharmaceutical companies also gives them enormous political leverage. Infringements of the Trips agreement are heard by a WTO disputes panel, and unlike in a criminal trial, the burden of proof put on the defendant country. In itself, the Trips - a protectionist clause in what was supposed a free trade agreement roused suspicions about the way in which the rules were being skewed to suit powerful interest groups in rich countries. However, some safeguards were included. Countries could cite a national emergency as a reason to infringe the Trips agreement.