Concerned that FTA may cut access to medicines in India, rest of the developing world: Médecins Sans Frontières writes to EU

Médecins Sans Frontières (MSF), also known as Doctors Without Borders, has formally urged the European Union to reconsider key provisions in its proposed free trade agreement (FTA) with India, warning that stricter intellectual property rules could severely limit access to affordable medicines in India and across much of the developing world.
In a letter sent to senior EU trade officials, MSF expressed alarm that negotiations may include clauses that go beyond the requirements of the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The humanitarian organization argues that such measures could extend patent protections on medicines, delay the introduction of low-cost generic drugs, and undermine global public health efforts.
India is widely regarded as the “pharmacy of the developing world” because of its ability to manufacture and export affordable generic medicines for diseases such as HIV/AIDS, tuberculosis, malaria, and hepatitis C. MSF warned that weakening India’s generic drug industry would have ripple effects far beyond the country’s borders.
“Any trade agreement that restricts India’s capacity to produce and export generic medicines will directly threaten the lives of millions of patients who depend on affordable treatment,” MSF said in its letter.
Fears Over ‘TRIPS-Plus’ Measures
At the heart of MSF’s concern are so-called “TRIPS-plus” provisions that the EU has previously sought in trade agreements with other countries. These measures can include longer patent terms, data exclusivity rules that delay the approval of generics, and limits on compulsory licensing, which allows governments to authorize the production of cheaper versions of patented drugs during public health emergencies.
MSF argues that such provisions would make it harder for Indian manufacturers to produce low-cost alternatives to expensive branded medicines. This could raise treatment costs dramatically for patients in low- and middle-income countries.
“In many places where MSF operates, generic medicines from India are the only affordable option,” the organization said. “Introducing stronger monopoly protections would slow competition and drive prices up.”
Public health advocates have echoed these concerns, noting that similar trade provisions in other regions have led to delays in the availability of life-saving drugs. They point to past experiences in Latin America and Southeast Asia, where stricter intellectual property rules were followed by price increases for cancer drugs and antiviral treatments.
India’s Role in Global Health
India supplies more than half of the world’s generic medicines used in HIV treatment programs and is a major exporter of vaccines and antibiotics to Africa and parts of Asia. International health agencies and donor-funded programs rely heavily on Indian pharmaceutical companies for affordable supplies.
MSF officials said that any disruption to this system would be particularly damaging at a time when many countries are struggling with fragile healthcare systems, rising disease burdens, and limited budgets.
“The global health community depends on India’s ability to produce quality medicines at scale,” said a senior MSF policy adviser. “Weakening that capacity would undo decades of progress in expanding access to treatment.”
The organization also expressed concern that new patent rules could discourage innovation in neglected diseases, where profits are already low and public funding plays a critical role.
EU Response and Trade Negotiations
The European Union has defended its trade policy, arguing that intellectual property protections are necessary to encourage pharmaceutical innovation and ensure high safety standards. EU officials have said that any agreement with India would balance commercial interests with public health needs.
A spokesperson for the European Commission stated that the EU “remains committed to safeguarding access to medicines” and that negotiations are still ongoing. However, the Commission did not comment directly on whether TRIPS-plus provisions would be included in the final text.
Trade talks between India and the EU were revived after several years of stagnation, with both sides seeking to deepen economic ties and expand market access. The agreement is expected to cover a wide range of sectors, including pharmaceuticals, digital trade, agriculture, and services.
Indian officials have previously resisted stronger intellectual property rules, citing the country’s constitutional obligation to protect public health. Domestic pharmaceutical companies have also warned that tighter patent protections could harm the industry’s competitiveness.
Civil Society Mobilizes
MSF’s letter adds to growing pressure from civil society groups, patient organizations, and health activists who fear the FTA could undermine affordable healthcare. Several groups have called for greater transparency in the negotiations and for public health safeguards to be written explicitly into the agreement.
“These talks cannot happen behind closed doors when the outcome affects millions of lives,” said a representative of an international access-to-medicines coalition. “Trade rules should not come at the expense of patients.”
Activists are urging the EU to exclude pharmaceutical intellectual property from the trade deal or to reaffirm the primacy of public health under international law.
Broader Implications
Experts say the dispute highlights a long-standing tension between trade policy and global health priorities. While pharmaceutical companies argue that patents are essential for funding research and development, humanitarian groups counter that excessive monopoly protections restrict competition and delay access to treatment in poorer countries.
The issue has taken on renewed urgency following the COVID-19 pandemic, which exposed deep inequalities in vaccine and medicine access worldwide. Many countries are now re-examining how trade and patent systems affect health security.
“If we learned anything from the pandemic, it is that global cooperation on medicines saves lives,” said a public health economist. “Policies that reduce access are not just ethically questionable; they are strategically short-sighted.”
Uncertain Path Ahead
As negotiations continue, MSF has urged the EU to ensure that the FTA does not include provisions that would harm India’s generic drug industry or restrict the use of public health safeguards. The organization says it will closely monitor the talks and continue advocating for patient-centered policies.
“The EU and India have an opportunity to create a trade agreement that supports innovation while protecting access to medicines,” MSF concluded. “Failing to do so would have consequences far beyond their borders.”
With both sides under pressure from industry and civil society, the outcome of the negotiations will likely shape not only trade relations but also the future of global access to essential medicines for years to come.