Deborah Gleeson

Many countries all over the world have become more interested in the compulsory‐license policy tool since the COVID‐19 pandemic. The World Trade Organization's Agreement on Trade‐Related Aspects of Intellectual Property Rights allows Member States to adopt legislation that enables them to issue compulsory licenses for matters in the public interest and beyond. Compulsory licensing has been shown to decrease the prices of essential medicines and increase access to treatment for the target population. It is especially important for middle‐income countries that are commonly excluded from voluntary licenses. Using a quantitative scoring system, this study explores the extent to which 15 selected middle‐income countries have adopted TRIPS flexibilities into their compulsory licensing legislation, comparing their national laws with practices deemed by experts to maximize the effectiveness and useability of such laws. Findings demonstrate that all the study countries fall far short of what is allowable in terms of adopting TRIPS flexibilities relevant to compulsory licensing and should make legislative changes to increase the possibility of issuing effective compulsory and government use licenses. However, changing national laws is only one step toward effective use of compulsory and government use licenses to increase access to medicines.

The arms industry and the global trade in weapons pose significant direct and indirect risks to population health and equity. While health-harming industri

Background: Hospital falls and associated injuries are a global issue associated with harm and significant costs to individuals and society, especially for older adults. Hospital standards specify the minimum level of care required to optimise patient safety, quality and outcomes. Standards are often used during hospital accreditation. This investigation analysed the content and quality of hospital falls standards across the globe. Methods: Hospital standards were located by searching online databases (PubMed, CINAHL, Google Scholar, MEDLINE), ChatGPT, the grey literature via internet search engines, and websites of accreditation agencies, government agencies, and other relevant organisations. We searched for standards from the 60 largest countries by population plus the 60 countries with the highest gross domestic product ( n = 82 after accounting for duplicates). For inclusion, hospital standards had to mention ‘fall/s’. Data were analysed using a deductive framework synthesis and content analysis to identify emergent themes. Results: Forty‐one standards used by at least 72 countries were identified from our search. Sixteen were excluded from detailed analysis because they did not mention falls and 3 could not be retrieved. A total of 22 standards were included in the final detailed analysis. Included standards showed wide variations in content and quality. Seven were assessed as high quality, 12 medium quality, and 3 were deemed to be of low quality. Some lacked details on hospital falls screening, assessment, prevention, and management. Consumer engagement in development, implementation, or evaluation was not mentioned in all standards. Procedures for falls data collection and reporting were seldom documented. Hospital standards infrequently referred readers to contemporary research or clinical practice guidelines. Conclusion: There are variations in the quality and content of standards on hospital falls. International collaboration is recommended to increase the consistency and validity of hospital falls standards across nations, in order to optimise healthcare outcomes. Impact: The findings of this global analysis of hospital falls standards have the potential to impact falls rates and fall‐related injuries in hospital patients by providing data to inform the content, evidence base and use of hospital standards to optimise the safety and quality of care delivery. The findings inform the review, design and implementation of hospital accreditation procedures to improve patient outcomes, patient experiences, and service quality.

The renegotiation of the Canada-United States-Mexico Agreement (CUSMA) is slated to begin in 2026. The US pharmaceutical industry has voiced a number of concerns about various aspects of Canadian pharmaceutical policy including intellectual property rights and drug prices. These issues are likely to figure prominently in the talks. Here we argue that a Canadian priority should be to ensure that IPR on pharmaceutical products are not strengthened in order to keep drug prices at an affordable level. We conclude by offering our recommendations about what actions Canada should take as a result of its review.

Legal provisions in trade agreements, including those related to intellectual property (IP), can impede access to medicines. The 12-party Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) is currently undergoing a review. This provides an opportunity to update the CPTPP’s Intellectual Property Chapter to remove certain provisions that were negotiated in the context of its precursor, the Trans Pacific Partnership (TPP), many of which have been suspended. These include several ‘TRIPS-Plus’ provisions – IP provisions exceeding the requirements of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). This paper reviews the CPTPP’s TRIPS-Plus provisions, including those suspended and those still in place, and argues for their removal based on evidence of their likely effects on medicines access and recent changes in the political environment. Since the CPTPP was signed in 2018, accumulated evidence has demonstrated that TRIPS-Plus provisions negatively impact access to medicines. Lack of access to COVID-19 medical products in low- and middle-income countries has highlighted major problems with TRIPS. Furthermore, the US has diverged from a TRIPS-Plus agenda, rendering the suspended provisions obsolete. Removing the CPTPP’s TRIPS-Plus provisions, while challenging, would preserve Parties’ policy flexibility to design their laws in ways that protect access to medicines.

Cambodia is a least developed country (LDC); however, it may graduate from the LDC status by 2029 Membership in the World Trade Organisation, will require Cambodia to provide patent protection for medicines that meet standard criteria. This qualitative policy analysis examines Cambodia's readiness for LDC graduation in terms of protecting access to medicines and explores how it can prepare to mitigate the impact of graduation on access to medicines. The study employed a single case study design that included analysis of key informant interviews and documents retrieved from a targeted literature review and website scans. The Health Policy Triangle framework informed the research design, methods, data collection, and analysis. While Cambodia has established structures and processes to facilitate preparations for LDC graduation and engaged with UN agencies that support sustainable graduation, there has been little focus on the implications of graduation for access to medicines. To prepare for graduation Cambodia will need technical assistance to reform its patent‐related laws and policies. This study demonstrates that LDCs are poorly equipped for the introduction of patent protection and agencies tasked with supporting LDC graduation need to provide assistance to protect access to medicines in countries planning graduation.

Ireland has regulated for all packaged alcohol products to include a health warning that states that ‘there is a link between alcohol and fatal cancers’. This warning is being opposed in the World Trade Organization by 12 member states who are raising that the warning is an unnecessary barrier to trade. The World Health Organization is supporting Ireland. Countries should not oppose Ireland's warning which is defensible from legal and public health perspectives.