Sir,

When the trade ministers meet tomorrow in Sydney, they must give priority to revising the iniquitous and inefficient patent rules that blight poor people's access to vital medicines. At the World Trade Organisation meeting in Doha a year ago, ministers made a joint declaration resolving to bring about reform, especially in the restrictive rules governing the use of generic medicines, by the end of 2002. Yet, with only six weeks before the deadline, no such reform has occurred, while there is mounting evidence of blocking at the behest of powerful pharmaceuticals companies.

There is also, in effect, a remarkable double standard in the way patent laws operate under the trade-related aspects of intellectual property rights (Trips). The government of a rich, industrial country can override a patent on medicine using a "compulsory licence" and commission a domestic company to produce a generic equivalent. This facility directly expands access in these privileged countries to vital medicines and vastly enhances the bargaining power of these governments to negotiate reasonable prices with the patent holders. In contrast, the developing countries that do not have domestic manufacturing capacity to produce generic equivalents at all, or at an economic price, cannot use this route. Nor, absurdly, are they allowed to import "generics" from low-cost producers abroad, because Trips prevents any producer country, under the jurisdiction of the patent laws, from exporting these generics to other countries, such as those that lack productive capacity altogether.

These restrictions not only have the effect of severely limiting access to inexpensive medicines in some of the poorest countries, which are often in tremendous need of these medicines (for example, for the treatment of Aids) but they also discourage global trade and competition as well as economies of scale in the production of generic medicines. The trade ministers must urgently follow up what was promised in Doha to remedy an inefficient as well as unjust set of rules, which jeopardises the lives of the least fortunate people in the world.

Amartya Sen, Master of Trinity College, Cambridge, and Honorary Adviser to Oxfam John Sulston, Wellcome Trust Sanger Institute, Cambridge