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Gaëlle Krikorian INTRODUCTION Countries signing free trade agreements (FTAs) are led to adopt more restrictive intellectual property (IP) standards than required by the World Trade Organization’s (WTO) agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS) and to relinquish some of the latter’s major flexibilities. The increase in protection includes expansion of patentability criteria, extension of term of patent protection, creation of exclusive rights on marketing approval data, limitation of compulsory licensing use and parallel import, and creation of linkage between patent status and drug marketing approval. Since these measures either institute new monopolies or strengthen existing ones, they typically have an impact on access to medicine. As more and more countries negotiate and sign bilateral or regional agreements, the list of nations adopting such standards continues to grow. At a time when reliance on generic medicine is more imperative than ever, it may seem surprising to see governments adopt trade policies inconsistent with their declared health policies and the needs of their populations. In order to understand the position of the governments as far as health and trade are concerned, we need to look closely at the way these bilateral negotiations unfold and the role played by the various actors – namely, the negotiators formally involved in the process, the industries involved informally, and the civil society largely involved despite the will of the political leaders. The bilateral negotiations central to this analysis follow several recent events of great importance in the history of health and intellectual property:...