Despite HIV becoming a manageable illness due to advancements in pharmaceuticals, over a million people still die every year due to AIDS – most of them poor, in the global South, who cannot afford to pay for treatment. What might allow them to secure medicines? My study of changes in trade policy shows that agreements originally designed to favour pharmaceutical companies can be implemented in ways that lead to increases in access to medicines for the global poor. I argue that domestic and international activism creates global public pressure, and is the key to altering the trajectory of trade policy implementation. Because access to affordable medicines for the global poor is more likely to occur when trade policies face public scrutiny, I call for transparent and accessible trade negotiations and enforcement in the WTO. In essence, I call for a democratization of the international trade regime.
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