It wasn’t long ago that Big Pharma saw great opportunity in the developing world. Now it sees a painful patent war. Multinational drug companies are fighting to protect their intellectual property in a conflict that pits them against the governments of developing nations. It’s a battle that illustrates the sometimes competing interests of companies’ IP rights and poor people’s access to medicine. And the conflict seems to be spreading.

The principal battleground is India, which has been dubbed “the world’s pharmacy” because of its successful generic drug manufacturing industry. In recent years companies have watched the country’s patent authority reject applications, dismiss infringement suits, revoke existing patents, and even order a pharmaceutical company to issue a compulsory license to a generic drug maker for one of its patented drugs. The world’s largest drugmakers, which once thought that India would be a lucrative new market, now fear that generic drug makers will supplant their business there.

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