The public international backlash against the TRIPS Agreement and the global pharmaceutical industry that followed in the wake of the March 2001 lawsuit brought by 39 pharmaceutical companies against the government of South Africa prompted a critical investigation into how the current order came into being and how it might be in a process of changing. To do this the thesis follows Cox’s insight in Critical IPE that each successive historical structure generates the contradictions and points of conflict that bring about its transformation (Cox, 1995: 35). The research therefore first looks at the making of the patent provisions in TRIPS as a case study in institutional capture by the transnational drug industry (TDI), dominated by American interests. This question is developed theoretically as well as empirically by first developing a theoretical framework that explains continuity in the global political economy (GPE) as a way of intimating how the TDI was able to secure all of its demands for pharmaceutical patents under TRIPS despite the prevalence of conflict and opposition from developing countries in the Uruguay Round (UR), and notwithstanding the single undertaking of the UR package. The thesis then examines the negotiations on patents in the UR to determine the nature of decision-making and to probe the questions of conflict and contradictions in the present that provide a framework of analysis on the shakiness of the prevailing order.\ud \ud The thesis then looks at how, why and under what circumstances the initial ‘capture’ of TRIPS by the TDI was arguably successfully challenged by probably the weakest global economic actor, the African Group (AG) at the WTO. Specifically looking at the role of conflict in change this question probes further points of conflict and contradictions in the present to set the scene for the wide scale offensive against TRIPS as a result of its implications for access to healthcare in the poorest countries which already suffer overwhelmingly from a high disease burden. The post-TRIPS challenge mounted by transnational civil society and the AG (the two constituting a counter-society) take the thesis from its analysis of continuity in the GPE, towards theorising the circumstances under which the prevailing historical structure can at least partially be transcended to render legitimate the demands of the poor. The thesis advances its contribution, both theoretically and empirically, to Critical International Political Economy, particularly as it concerns the work of Robert Cox
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