A/HRC/11/12 page 21 and models to assess the impact of these provisions on access to medicines including in relation to affordability have also emerged.74 Such initiatives should be encouraged to assist developing countries and LDCs in making decisions about the implementation of TRIPS flexibilities. 65. Few LDCs have local manufacturing capacities or any technological base to fully take advantage of TRIPS or TRIPS flexibilities.75 In this regard, concrete steps towards the specific obligation under article 66, paragraph 2, of TRIPS of developed countries to provide incentives to promote and encourage technology transfer to LDCs in order to enable them to create a sound and viable technological base should be encouraged. 66. The lack of capacity and external pressures imposed by developed countries, significantly contribute to difficulties faced by developing countries, especially LDCs, in the use of TRIPS flexibilities. Therefore there is a real need for developing countries and LDCs to seek appropriate means to build up their capacity, and for developed countries to refrain from hampering the use of TRIPS flexibilities. 67. The next section of the report examines the effect of standards imposed beyond TRIPS (TRIPS-plus) by FTAs on access to medicines and the right to health. Due to space constraints, not all issues arising out of existing or proposed international trade agreements that affect access to medicines will be discussed. III. FREE TRADE AGREEMENTS, THE RIGHT TO HEALTH AND ACCESS TO MEDICINES A. Background 68. Many countries have signed or are currently engaged in negotiations on extensive trade agreements, including bilateral investment treaties (BITs), FTAs, economic partnership agreements (EPAs) etc. Such agreements have extensive implications for pharmaceutical patent protection, which can directly impact access to medicines. Some developed countries, for example have negotiated FTAs which reflect their standard of IP protection.76 69. These agreements are usually negotiated with little transparency or participation from the public, and often establish TRIPS-plus provisions. These provisions undermine the safeguards and flexibilities that developing countries sought to preserve under TRIPS.77 Studies indicate that 74 See for example, “Impact Assessment of TRIPS-plus provisions on health expenditure and access to medicines” report of a workshop organized by the Ministry of Public Health, Thailand and WHO, Bangkok 22-24 Nov. 2006; Miguel Ernesto Cortes Gamba, “Intellectual property in the FTA: impacts on pharmaceutical spending and access to medicines in Colombia”, Mision Salud and Fundacion IFARMA, Bogota, 2006. 75 See footnote 69 above, p. 137 . 76 US Trade Promotion Authority Act (2002), 116 STAT. 933, s. 2102 (b) 4 (A) (II). 77 Several authors have written on this subject. See, e.g., C. Correa, “Implications of bilateral free trade agreements on access to medicines”, Bulletin of the World Health Organization,

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