The World Health Organization estimates that the deaths of 18 million people, one-third of all deaths, are caused by treatable medical conditions. In developing countries it has been a central point of concern and action for governments and health activists. In Brazil, the response to the Human Immuno-Deficiency Virus epidemic in the 1990s was based on a public policy of providing free antiretroviral treatment for all in need, which was possible especially through the local production of affordable generic drugs by national public laboratories. Since 2001, Brazil has adopted a double-step mechanism of examination of patent applications in the pharmaceutical sector. Argentina and Brazil have adopted public health safeguards in their national laws to reduce the negative impacts of intellectual property rules on access to medicines. Civil society organisations and patients’ groups have been engaged in litigation to use public health safeguards and also oppose attempts to introduce Trade Related Aspects of Intellectual Property Rights-plus provisions in the Indian law.