A/HRC/17/43 well as other marginalized and vulnerable groups who are often discriminated against in terms of access to medicines, are ignored or underestimated. 45. States have the primary responsibility for enhancing access to medicines; as the Millennium Development Goals recognize, however, this is a shared responsibility. If there is to be an increase in access to medicines, numerous national and international actors have a role to play. Pharmaceutical companies are among those who share this responsibility owing to their evident impact on the ability of Governments to realize the right to the highest attainable standard of health.8 The expert consultation identified the need for a reliable system for the supply of good-quality medicines that are affordable to all, including those living in poverty and other disadvantaged groups. 46. From the right to health perspective, access to medicines must be equitable. Additionally, more research and development is needed to promote the availability of new drugs for those diseases causing a heavy burden on developing countries. Within a framework of international assistance and cooperation, States should resort to a variety of incentives to influence research and development for these specific health needs. 47. While intellectual property rights have the important function of providing incentives for innovation, they can, in some cases, obstruct access by pushing up the price of medicines. The right to health requires a company that holds a patent on a lifesaving medicine to make use of all the arrangements at its disposal to render the medicine accessible to all. As patents create monopolies, limit competition and allow patentees to establish high prices, they consequently have a significant impact on access to medicines. While some countries lack sufficient awareness about the use of TRIPS flexibilities and have limited technical capacity to implement them, others have not streamlined their patent laws sufficiently to facilitate use of such flexibilities. Furthermore, pressure from developed countries and multinational pharmaceutical corporations have played a prominent role in shaping the implementation of TRIPS flexibilities in developing and least developed countries. For example, a number of developing countries, while attempting to implement TRIPS flexibilities to address public health concerns, have experienced pressures from developed countries and multinational pharmaceutical corporations. 48. A new challenge for the health sector is ensuring access to medicines for noncommunicable or chronic diseases. As for any other general essential medicine, equitable access (including rational selection of medicines, affordable prices, sustainable financing and reliable health systems), availability, safety and quality must also be ensured for medicines for non-communicable diseases. Another challenge for these drugs is the creation of clinical guidelines for them, including diagnostic standards and an international agreement on when to start medical treatment. The international pharmaceutical industry is heavily engaged in non-communicable diseases owing to the long-term market potential of chronic treatments. For this reason, a potential conflict of interests between industry, patient organizations, professional associations, health insurance companies and public sector bodies must be carefully indentified and managed. This also applies to low- and middle-income countries, where many locally produced and branded generic medicines are aggressively marketed. 8 GE.11-11842 See A/63/263, annex. 13