Accessing affordable medicines in a post-TRIPS environment: the case of Bangladesh

The cost of medicines in Bangladesh is among the lowest in the world. Over the last forty years, Bangladesh, a Least Developed Country (LDC), has nurtured a local industry based on strong industrial policy and a pharmaceutical patent-free system. Of the 46 LDCs in the world, it is the only one to have a thriving industry of this kind. In this paper, we explore how a relatively poor LDC managed to take on the dominance of MNCs in the global production of pharmaceuticals. We focus on the 1982 National Drug Policy (NDP) which transformed the pharmaceutical sector in Bangladesh from one in which three-quarters of drugs were supplied by just eight MNCs to one where almost all domestic demand is met by local industry. The thriving local pharmaceutical industry also exports generic medicines to 147 different countries. In 2026, Bangladesh is due to graduate to ‘Developing Country’ status, at which time, as a member of the WTO, Bangladesh will have to abide by the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement. Under TRIPS it will have to change its patent regime to allow for the registration of pharmaceutical patents by 2029. Using interview data with key Bangladeshi experts, we argue that TRIPS compliance could potentially wipe out this flourishing local pharmaceutical industry, leading to steep increases in the cost of essential medicines, with dire implications for the right to health. We explore policy options open to the Bangladesh government to protect affordable drugs in the country, in particular protection for the production of domestic generics in a post-TRIPS environment. We also argue that there are ways in which Bangladesh and India could co-operate to protect the affordability of high-quality medicines for domestic and international markets.