The power of the weak: Advocacy networks, ideational change and the global politics of pharmaceutical patent rights

This dissertation examines changes in the extraterritorial protection of pharmaceutical patent rights. It argues that the emergence of new international intellectual property (IP) regimes, including the agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), resulted from the efforts of leading knowledge-based American corporations which operated in alliance with the US government. These corporations have framed IP as a private property right inextricably linked to trade and used US economic power to coerce countries that failed to cooperate with their objective of globalizing IP protection. The dissertation also shows how transnational advocacy networks have subsequently challenged TRIPS, and primarily its requirements for pharmaceutical patent protection. In alliance with developing countries, these networks have successfully defended more lenient patent rules for drugs both domestically and internationally by mobilizing and organizing a wide-range of actors at different levels of policymaking, and by making strategic use of ideas. In particular, they have generated cognitive and normative shifts by demonstrating the perverse effects of patents on access to essential medicines among the world's poor---especially in the context of the spread of HIV/AIDS---and by recasting intellectual property as a human rights issue. Networks have also helped to construct, articulate and coordinate the interests of developing countries regarding IP and health, ensuring their cohesive position in international negotiations. IP constitutes a hard case for transnational advocacy, mostly because of the asymmetries in power and expertise it involves. Since their target is the hegemonic state, activists have been incapable of using material leverage. Rather, they have had to rely solely on strategies of shaming and persuasion, and have effectively pressured the US from within. The dissertation underscores the importance of agency and particularly of non-state actors in constructing and reconstructing international regimes; as well as the ways in which these actors transform ideational structures to reach their goals. By highlighting the role of coercion and persuasion in international regime construction, the dissertation also rejects mainstream functional regime theories. It employs a method of process tracing, using data from in-depth interviews as well as policy documents collected in the US, Brazil and Geneva.