The Doha Declaration and Paragraph 6 decision were initially hailed as a triumph by public health advocates [ 12].
Despite being hailed as a "watershed in international trade", the Doha Declaration and Paragraph 6 decision have not resolved the problem of access to affordable medicines.
Instead, negotiations for simplified procedures under the Doha Declaration and Paragraph 6 decision, which enable the practical implementation of their measures, need to be initiated.
While the Doha Declaration and Paragraph 6 decision affirm important principles under the TRIPS agreement, regarding the protection of public health within international trade law, key challenges remain.
The limited progress in improving access to medicines through TRIPS, as affirmed by the Doha Declaration and Paragraph 6 decision, points to the need for reassessment.
Despite the affirmations provided by the Doha Declaration and Paragraph 6 decision, there remain a number of difficulties for LMICs seeking to implement them in practice.
Neither the Doha Declaration nor Paragraph 6 decision address the fundamental issue of underinvestment in R&D for health conditions that predominantly impact LMICs.
The legal status of the Doha Declaration and Paragraph 6 decision after 2007, therefore, remains uncertain, along with how its measures can be used to improve access to medicines.
The provisions for protecting public health provided by the Doha Declaration and Paragraph 6 Decision are reviewed in terms of challenges for implementation, along with measures to protect intellectual property rights (IPRs) under selected regional and bilateral trade agreements.
The first is the capacity of LMICs to actually implement the flexibilities afforded under TRIPs, the Doha Declaration and Paragraph 6 decision amid stark inequalities in health resources and the world trading system as a whole.
