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Some two decades will shortly have passed since the WTO's Trade Related Aspects of Intellectual Property Rights agreement came into force in 1995. TRIPS is widely considered to have had a negative impact on access to medicines through its rules on pharmaceutical patents. This volume is the first cross-country analysis of how TRIPS has affected the capacity of 11 major low or medium income countries to produce generic drugs and assesses the wider political economy of drug production and consumption in the Global South.