Winning and losing pairings in access to medicines: A practical guide

Drawing on the last four decades of conflicts over access to medicines and intellectual property the paper identifies a pattern in which there are losing and winning pairings of norms and networks. In short form the pairings are as follows: (i) Principles > Rules, (ii) Rule Complexity > Principles, (Iii) Private Rule Complexity > Public Rule Complexity, (iv) Targeted Public Informal Networks > Private Rule Complexity, (v) The Private-Public Monopoly Network > Public Health Network. The pairings and their outcomes are derived from experience and represent what can be thought of as probabilistic outcomes. The paper concludes with a discussion of whether smart public health regulation of pharmaceutical monopoly capital is possible.