ABSTRACT
This chapter addresses three phases of Access-to-Medicines (A2M) advocacy. The first phase ran between the late 1990s and mid-2000s when collaboration between A2M advocates ballooned as they confronted a scourge of HIV compounded by pharmaceutical companies and rich country governments. The second phase, starting in the mid-2000s, focused on strategies to address patents on medicines. Unfortunately, this phase resulted in differences within the A2M movement. In the third phase, new tensions arose about the impact of delinkage and transparency issues on ensuring equitable access to existing medicines in low- and middle-income countries. The phase of A2M activism draws on the earlier global institutional work of the commission on macroeconomics and health, the UK commission on intellectual property rights, and the world health organization commission on intellectual property rights, innovation, and public health. Paradoxically, the problem of access to affordable medicines is becoming acute in middle-income countries transitioning out of eligibility for donors' health assistance.
