Compulsory Licensing: How Governments Override Patents to Protect Public Health

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Jan, 3 2026

What is compulsory licensing, and why does it matter?

Compulsory licensing is a legal tool that lets governments allow other companies to make or use a patented product-like a life-saving drug-without the patent holder’s permission. The catch? The patent owner still gets paid. It’s not about stealing intellectual property. It’s about making sure people can get medicine when they need it most.

This isn’t theoretical. In 2012, India issued a compulsory license for Nexavar, a kidney and liver cancer drug made by Bayer. The original price? Over $5,500 a month. After the license, a local company started producing a generic version for about $175 a month. Thousands of patients who couldn’t afford the drug suddenly could. That’s the power of compulsory licensing.

How did compulsory licensing become part of international law?

The modern rules for compulsory licensing come from the TRIPS Agreement a 1994 global treaty under the World Trade Organization that sets minimum standards for intellectual property protection. Before TRIPS, countries could do what they wanted with patents. After 1994, they had to follow rules-but with important exceptions.

Article 31 of TRIPS says governments can issue compulsory licenses if there’s a public health emergency, if the patent isn’t being used locally, or if the patent holder refuses to license voluntarily. But there’s a catch: they usually have to try negotiating first. Except in emergencies. Then, they can skip the negotiation step entirely.

The Doha Declaration a 2001 WTO statement affirming that public health rights override patent rights in emergencies made this even clearer. It said countries have the right to use compulsory licensing to protect their populations-even if it means going against a drug company’s wishes.

How does it work in the U.S.?

The U.S. has compulsory licensing laws, but they’re rarely used. There are three main ways:

  1. Title 28, U.S.C. § 1498 - Lets the federal government use any patented invention without permission, as long as it pays compensation. This is how the government got access to flu antivirals during the 2009 pandemic.
  2. Bayh-Dole Act march-in rights - If a company got federal funding to develop a drug and isn’t making it available to the public, the government can force a license. The NIH has received 12 requests since 1980. They’ve denied all of them.
  3. Environmental laws - The Clean Air Act lets the government license patented pollution-control tech if it’s needed to meet air quality standards.

Between 1945 and 2020, the U.S. issued only 10 compulsory licenses-almost all under § 1498. The system works, but it’s designed to be slow and difficult. That’s by design.

How do countries like India and Brazil use it?

India has become the global leader in using compulsory licensing for medicines. Since 2005, it has issued 22 licenses-mostly for cancer drugs. The process requires proof that the patent holder hasn’t made the drug affordable or available locally. In 2013, Natco Pharma got a license to make Sorafenib, a liver cancer drug. The price dropped from $5,500 to $175 per month.

Brazil’s approach was more targeted. Between 2001 and 2017, it issued three compulsory licenses-all for HIV drugs. In 2007, it forced Merck to license efavirenz. The price fell from $1.55 per tablet to $0.48. That saved the government millions and kept thousands alive.

Thailand did something similar in the mid-2000s. It issued licenses for HIV and heart drugs, cutting prices by 65% to 90%. Abbott’s lopinavir/ritonavir went from $1,200 a year to $230. Bristol-Myers Squibb’s efavirenz dropped from $550 to $200.

Split scene: expensive drug hoarded vs. same drug made cheaply in India for patients.

Why don’t more countries use it?

Just 12 countries have ever issued a compulsory license for pharmaceuticals-even though 34 have the legal right to do so. Why?

One reason is pressure. The U.S. government has a list called the Special 301 Report an annual U.S. trade review that names countries with weak intellectual property enforcement. Countries that issue licenses often end up on it. That can lead to trade threats or delays in trade deals.

Another reason is complexity. Issuing a license isn’t just signing a paper. It requires legal expertise, manufacturing capacity, and the ability to negotiate fair compensation. The World Health Organization found that 60% of low- and middle-income countries don’t have the technical skills to do it right.

And then there’s the fear of retaliation. Drug companies threaten lawsuits. They lobby governments. They warn that compulsory licensing will kill innovation. That’s why many countries wait until a crisis hits-like a pandemic-before acting.

What happened during the COVID-19 pandemic?

When the pandemic hit, 40 countries-including Canada, Germany, and Israel-prepared to issue compulsory licenses for vaccines, tests, and treatments. Some, like Spain, passed emergency laws that waived the need to negotiate with patent holders.

But here’s the irony: very few actually used them. Why? Because vaccine manufacturers made voluntary deals. Moderna pledged not to enforce its patents during the pandemic. Pfizer and BioNTech offered low-cost licenses to middle-income countries.

Still, the threat worked. In many cases, companies lowered prices just to avoid being forced to license. That’s the silent power of compulsory licensing-it doesn’t always need to be used to be effective.

What’s changing now?

In June 2022, the WTO agreed to a temporary waiver for COVID-19 vaccine patents. It lets developing countries produce vaccines without permission until 2027. But so far, only 12 facilities in 8 countries have been approved to use it. The process is still too slow.

The European Union is pushing new rules. Its 2023 Pharmaceutical Strategy says drug companies must respond to licensing requests within 30 days-or risk an automatic compulsory license.

Meanwhile, the WHO is drafting a new Pandemic Treaty. Draft Article 12 would make compulsory licensing automatic during declared global health emergencies. No negotiation. No delays. Just access.

Global map with drug arrows and a hand breaking chains to release affordable medicines.

Does it hurt innovation?

Drug companies say yes. A 2018 study in the Journal of Health Economics found that countries with active compulsory licensing programs saw 15-20% less pharmaceutical R&D investment. The IFPMA claims each license announcement causes an 8.2% drop in stock prices for affected companies.

But critics point out that most compulsory licenses target drugs that are already profitable. The real problem isn’t innovation-it’s pricing. In the U.S., a single course of cancer drugs can cost over $100,000. In India, the same drug costs $1,500 after a license.

Dr. Brook Baker, a law professor, says the threat of compulsory licensing has already forced voluntary price cuts on 90% of HIV drugs since 2000. That’s not killing innovation. That’s making it serve people.

Who benefits-and who pays?

Generic manufacturers win. Teva Pharmaceutical made $3.2 billion extra between 2015 and 2020 from drugs produced under compulsory licenses.

Patients win. In low-income countries, compulsory licensing cut the price of first-line HIV drugs by 92% between 2000 and 2020.

Governments win. They save billions on public health spending. Brazil saved $1.2 billion on HIV drugs between 2001 and 2017 thanks to its licenses.

Patent holders still get paid. In India, compensation is 6% of net sales. In the U.S., courts use the Georgia-Pacific factors to calculate fair royalties-15 criteria including comparable licenses and market demand.

The real cost? It’s not money. It’s political will. Most countries don’t issue licenses because they’re afraid of trade pressure, not because the law won’t let them.

What’s next for compulsory licensing?

Experts predict a 40% increase in compulsory licensing between 2023 and 2028. Why? Antimicrobial resistance. Climate adaptation tech. Mental health drugs. These are the next frontiers.

By 2030, 75% of licenses will likely be limited to emergencies or specific diseases-not broad, open-ended use.

The key will be speed and clarity. Countries that build fast, transparent systems will get the drugs they need. Those that wait for crises will pay more-in lives and money.

15 Comments

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    Jay Tejada

    January 4, 2026 AT 21:55
    India did what the West wouldn't. $175 instead of $5,500? That's not a price drop-it's a moral victory. People die waiting for corporate mercy. We shouldn't need a crisis to do the right thing.
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    Allen Ye

    January 6, 2026 AT 06:02
    Let’s not romanticize this. Compulsory licensing isn’t some noble rebellion-it’s a symptom of a broken system where innovation is monetized at the expense of human life. The TRIPS Agreement was never about health; it was about market control disguised as law. The fact that we’re still debating whether a cancer drug should cost less than a used car says more about our values than our legal frameworks. We’ve built a world where patents are sacred and patients are expendable. The real question isn’t whether licensing works-it’s why we still treat access to medicine like a privilege instead of a right.
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    Justin Lowans

    January 6, 2026 AT 13:35
    It's fascinating how the same entities that champion intellectual property as the engine of progress suddenly become defensive when that engine is used to save lives. The math is simple: if a drug costs $100,000 in the U.S. and $1,500 in India after licensing, the difference isn’t in R&D-it’s in profit margins. Innovation thrives when there’s incentive, yes-but it shouldn’t require suffering to justify it.
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    Michael Rudge

    January 8, 2026 AT 09:53
    Oh wow, so now we’re punishing companies for inventing life-saving drugs? Next they’ll take away your phone because someone else can’t afford an iPhone. Wake up. If you want cheap drugs, stop letting governments steal IP and start demanding better healthcare systems. This isn’t justice-it’s envy dressed in a lab coat.
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    Jack Wernet

    January 10, 2026 AT 01:25
    The ethical dimension here is undeniable. Patent law was never intended to be a tool for monopolistic price-gouging. When a government issues a compulsory license, it is not eroding innovation-it is recalibrating the balance between private profit and public good. The fact that this remains controversial speaks volumes about our societal priorities.
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    bob bob

    January 10, 2026 AT 04:20
    Honestly, I don’t get why this is even a debate. If someone invents a drug that saves lives, great. But if they charge enough to make a billionaire out of it while people die outside their office? That’s not capitalism. That’s cruelty. And if a country steps in to fix it? More power to them.
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    Abhishek Mondal

    January 10, 2026 AT 08:36
    You say India is a leader? Hah. They have no manufacturing capacity for complex biologics. The $175 drug? It’s a crude approximation. The real molecule? Half the potency. And you think patients don’t notice? This isn’t access-it’s dangerous compromise. And don’t get me started on the quality control... or the lack thereof.
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    Oluwapelumi Yakubu

    January 11, 2026 AT 14:29
    My brother in Lagos died waiting for HIV meds because Pfizer said ‘the market isn’t viable.’ Now Brazil cuts prices? That’s not magic-that’s courage. Africa ain’t begging for scraps-we’re demanding seats at the table. Compulsory licensing? It’s not theft. It’s restitution.
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    en Max

    January 13, 2026 AT 09:58
    The economic externalities of compulsory licensing are non-trivial. While short-term cost reduction is statistically significant, the long-term disincentive effect on R&D investment-particularly in orphan drugs and novel modalities-creates a negative-sum outcome. The Georgia-Pacific framework, while imperfect, remains the most empirically grounded mechanism for equitable royalty determination.
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    Vikram Sujay

    January 13, 2026 AT 14:12
    The real tragedy isn’t the patent holders-it’s the silence of the nations that could act but choose not to. The law allows it. The need is undeniable. What’s missing is the will. Compulsory licensing isn’t radical. It’s routine in every other industry. Why is medicine the one exception we treat like a holy relic?
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    Mandy Kowitz

    January 13, 2026 AT 15:04
    Oh look, another ‘corporate villains’ story. Next you’ll say the sun is a capitalist conspiracy. People, if you want cheap drugs, stop paying $100 for a bottle of aspirin and start voting for people who want to nationalize pharma. Or just don’t get sick.
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    Roshan Aryal

    January 14, 2026 AT 01:37
    India’s success? Pure theft. Bayer spent billions. India spent nothing. Now they call it ‘public interest’? This is why no foreign company dares invest here. You don’t build innovation by stealing it. You build it by protecting it. And if you don’t like that? Move to Venezuela.
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    Jason Stafford

    January 15, 2026 AT 17:20
    THIS IS THE NEW WORLD ORDER. The WHO, WTO, and Big Pharma are working together to strip American innovation and hand it to rogue nations. The pandemic waiver? A Trojan horse. They’re not saving lives-they’re dismantling the U.S. economy. Mark my words: next they’ll come for your Tesla patents. They want you dependent. They want you powerless.
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    Enrique González

    January 16, 2026 AT 08:16
    We’ve seen this movie before. When the price drops, quality follows. But when you look at the data-thousands alive in India, Brazil, Thailand-it’s clear the trade-off is worth it. This isn’t about politics. It’s about people.
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    Aaron Mercado

    January 18, 2026 AT 06:24
    I can't believe we're still having this conversation... after everything... the fact that a country can just... take... someone's... invention... and... give it away... for pennies... it's... it's... just... wrong... and... I'm... so... tired... of... this...

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