Compulsory Licensing: How Governments Can Override Patents to Protect Public Health

Compulsory Licensing: How Governments Can Override Patents to Protect Public Health
January 13 2026 Elena Fairchild

What Is Compulsory Licensing?

Compulsory licensing lets a government allow someone else to make or use a patented product without the patent holder’s permission. This isn’t about stealing ideas. It’s about balancing profit with survival. The patent owner still gets paid-just not by choice. This tool exists in nearly every country’s patent law, but it’s rarely used… until something urgent happens.

Think of it like this: a drug company holds a patent on a life-saving HIV medication priced at $1,200 a year. Thousands can’t afford it. The government steps in, authorizes a local manufacturer to copy the drug, and sells it for $230. The company still gets compensation, but now people live. That’s compulsory licensing in action.

Where Did This Come From?

The idea isn’t new. It was first written into international law in 1883 under the Paris Convention. But it became globally enforceable in 1994 with the TRIPS Agreement-the trade deal that tied intellectual property rules to global commerce. Article 31 of TRIPS says countries can issue compulsory licenses, but only under strict conditions: you must pay fair compensation, mostly serve your own population, and usually try to negotiate with the patent holder first.

There’s one big exception: emergencies. If a pandemic hits, a disease spreads fast, or a public health crisis demands immediate action, that “try to negotiate first” rule can be skipped. That’s what happened during COVID-19. Over 40 countries, including Canada and Germany, prepared to issue licenses for vaccines, tests, and treatments. Most didn’t need to use them-companies lowered prices voluntarily-but the threat alone changed the game.

How It Works in the U.S., Canada, and India

Every country does it differently.

In the United States, there are three main paths. One is under Section 1498 of federal law: if the government needs a patented tech (say, a medical device for a hospital), it can use it and then pay damages in court. Another is the Bayh-Dole Act, which lets the government force a license if a federally funded invention isn’t being made available to the public. But here’s the catch: the NIH has received over a dozen requests since 1980-and has never granted one. Why? They say the patent holder is “doing enough.”

Canada updated its Patent Act in 2020 to make it easier during emergencies. Before, the process took years. Now, if the government declares a public health crisis, it can issue a license in weeks. Canada’s only real use so far? In 2012, it licensed HIV drugs to Rwanda under a special WTO rule that lets countries without manufacturing capacity import generic versions made under compulsory license.

India is the most active user. Since 2005, it has issued 22 compulsory licenses-almost all for cancer drugs. The most famous case was Nexavar, a kidney and liver cancer drug priced at $5,500 a month. Natco Pharma got a license to make a generic version for $175 a month. Bayer, the original patent holder, sued. The case took eight years. India won. The price drop saved thousands of lives.

Split scene: corporate stock drop on left, child receiving cheap medicine on right, scale balancing money and pills.

Real-World Impact: Price Drops That Saved Lives

The numbers don’t lie. When compulsory licensing kicks in, prices fall hard.

  • In Thailand, the government issued licenses for HIV drugs in 2006. Lopinavir/ritonavir dropped from $1,200 to $230 per year. Efavirenz fell from $550 to $200.
  • In Brazil, they licensed Merck’s efavirenz in 2007. Price per tablet went from $1.55 to $0.48. The country’s HIV treatment program expanded by 300%.
  • Across low- and middle-income countries, the price of first-line HIV drugs dropped 92% between 2000 and 2020-mostly because of compulsory licenses and the threat of them.

Generic manufacturers like Teva saw their revenue from these markets jump by $3.2 billion between 2015 and 2020. That’s not just profit-it’s access.

Why Don’t More Countries Use It?

Even though 34 countries have laws allowing compulsory licensing, only 12 have ever actually used it for medicines. Why?

First, the process is slow and expensive. In the U.S., getting compensation under Section 1498 takes an average of 2.7 years and costs millions in legal fees. In India, applications take 18 to 24 months to be reviewed. Few governments have the legal teams or political will to push through.

Second, there’s pressure. The U.S. has listed countries that issue compulsory licenses on its “Special 301 Watch List,” a kind of trade blacklist. No sanctions have followed since 2012, but the threat lingers. Big pharma also spends millions lobbying against it. The International Federation of Pharmaceutical Manufacturers says each license announcement causes an 8.2% drop in their stock prices.

Third, some countries just don’t have the capacity. The WHO found that 60% of low- and middle-income nations lack the technical or legal infrastructure to draft, issue, and enforce a license properly. It’s not just about the law-it’s about having patent lawyers, health officials, and manufacturing partners ready to go.

Who Benefits-and Who Loses?

It’s not a simple win-lose situation.

Patients and public health systems win. More people get treatment. Governments save money. Generic drugmakers win too-they get access to technologies they couldn’t otherwise copy.

But the patent holders? They lose control. And some argue that’s dangerous. A 2018 study in the Journal of Health Economics found that countries with active compulsory licensing saw a 15-20% drop in pharmaceutical R&D investment. The fear? If companies can’t profit from their inventions, they won’t risk developing them.

But here’s the counterargument: the threat of a license often forces companies to lower prices voluntarily. Dr. Brook Baker from Northeastern University found that since 2000, 90% of HIV drug price cuts in developing countries happened before a license was issued-just because the government hinted they might.

So it’s less about taking patents and more about using them as leverage.

Global map with price-drop pathways and rising health icons, child holding medicine shield under pandemic treaty clock.

What’s Changing Now?

Things are shifting fast.

In June 2022, the WTO agreed to a temporary waiver on COVID-19 vaccine patents. It allows developing countries to produce vaccines without permission until 2027. But so far, only 12 facilities in 8 countries have been approved to use it. The rules are still too complicated. No one’s really using it the way it was meant to.

The European Union is pushing new rules: if a company doesn’t offer a license within 30 days of a government request, the license gets issued automatically. That’s a game-changer.

The World Health Organization is drafting a Pandemic Treaty that could make compulsory licensing automatic during declared global health emergencies. If passed, no country would need to ask permission or prove urgency-they’d just act.

And then there’s the tech angle. Experts predict compulsory licensing will expand beyond medicine. Antimicrobial resistance, climate adaptation tools, and clean energy patents could all be next.

The Bottom Line

Compulsory licensing isn’t about breaking the system. It’s about fixing it when it fails people.

Patents exist to encourage innovation. But when a patent keeps a life-saving drug out of reach, the system has to bend. The law already gives governments the power to do that. The question isn’t whether they can-it’s whether they will.

History shows that when they do, lives change. When they don’t, people die.

Frequently Asked Questions

Is compulsory licensing the same as breaking patents?

No. Compulsory licensing doesn’t cancel or invalidate a patent. The patent holder still owns the rights. The government just gives someone else permission to use it under strict conditions, including paying fair compensation. It’s a legal override, not a seizure.

Can any country issue a compulsory license?

Yes, under the TRIPS Agreement, all WTO member countries have the right to issue compulsory licenses. But they must follow rules: pay adequate compensation, mostly supply their own market, and usually try to negotiate first. Exceptions exist for emergencies, public non-commercial use, or when a country has no manufacturing capacity and needs to import.

Why hasn’t the U.S. issued more compulsory licenses?

The U.S. has the legal tools, but political and industry pressure keeps them unused. The Bayh-Dole Act allows the government to force licensing of federally funded inventions, but the NIH has denied every petition since 1980. Section 1498 is used for government use, but it’s slow and costly. Most drug companies in the U.S. rely on high prices and patent protection-there’s little incentive to change.

Does compulsory licensing discourage innovation?

Some studies suggest a short-term drop in R&D investment in countries that use it. But the bigger picture shows that the threat of a license often leads to voluntary price reductions. In fact, 90% of HIV drug price cuts in developing countries happened before any license was issued. Innovation isn’t killed-it’s redirected. Companies still invest in new drugs, but they’re more willing to negotiate access.

Can compulsory licensing be used for things other than medicine?

Absolutely. While 68% of cases involve pharmaceuticals, it’s also been used for agricultural chemicals, clean energy tech, and even assistive devices for the visually impaired. The 2017 Marrakesh Treaty allows compulsory licensing for accessible formats of copyrighted works. Canada and India have issued licenses under this for books and educational materials.

13 Comments

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    laura Drever

    January 13, 2026 AT 16:23
    this is such a mess tbh like who even cares about patents when people are dying lmao
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    Angel Molano

    January 14, 2026 AT 05:39
    Compulsory licensing is theft dressed up as ethics. Innovation dies when you punish success.
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    Gregory Parschauer

    January 15, 2026 AT 09:02
    Let me be crystal clear: when a pharmaceutical corporation hoards life-saving technology behind a patent while families sell their homes to afford insulin, they’re not just greedy-they’re morally bankrupt. The TRIPS Agreement was never meant to be a corporate shield. Article 31 exists because history has shown us that when profit overrides humanity, we all lose. Canada’s 2012 move to license HIV drugs for Rwanda wasn’t charity-it was justice. The fact that the U.S. hasn’t used Section 1498 once in 40 years isn’t prudence-it’s complicity. And don’t give me that ‘it discourages innovation’ nonsense. The 90% of HIV drug price drops happened BEFORE licenses were issued. Companies lowered prices because they were scared. That’s leverage, not looting. If you think patents are sacred, then explain why the same companies that scream about IP theft are lobbying to extend patents on cancer drugs for another 12 years. This isn’t about economics-it’s about who gets to live.
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    Trevor Davis

    January 17, 2026 AT 01:26
    I get where you're coming from but honestly? The system's broken. I've seen friends in rural Ohio skip doses because the copay was $800. Nobody's saying we should abolish patents. But if a drug was developed with taxpayer money and still costs a fortune? That's not capitalism. That's exploitation.
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    Rosalee Vanness

    January 17, 2026 AT 02:02
    You know what breaks my heart? Not the lawsuits or the stock dips-but the quiet deaths. The elderly man in Alabama who died because he chose between his insulin and his rent. The single mom in Kenya who watched her child fade because the syrup was priced like a luxury SUV. This isn't abstract policy. It's human calculus. And every time a government hesitates to act, they're adding another number to the death toll. The WHO says 60% of low-income countries can't even draft a license properly. That's not a legal gap-it's a moral failure. We have the tools. We have the precedent. We just lack the will. And that's the real tragedy.
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    James Castner

    January 17, 2026 AT 07:25
    The philosophical underpinning of intellectual property law is not absolute ownership-it is a social contract: innovation in exchange for temporary exclusivity, with the implicit understanding that public welfare supersedes private profit when human life hangs in the balance. The U.S. Constitution itself grants Congress the power to promote progress by securing exclusive rights for limited times-not for perpetual monopolies. The Bayh-Dole Act was conceived to ensure that taxpayer-funded research serves the public, yet its dormant enforcement reveals a systemic betrayal of that principle. When the NIH denies every petition, it signals that institutional inertia has replaced moral responsibility. The global pharmaceutical industry’s 8.2% stock drop upon license announcements is not evidence of market failure-it is evidence of a market that has been allowed to prioritize shareholder value over survival. We must recognize: patents are not natural rights; they are legal instruments. And like any tool, they must be wielded with ethical discernment-not ideological dogma.
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    lucy cooke

    January 18, 2026 AT 23:50
    Oh darling, the real tragedy isn't the license-it's that we still need licenses at all. We live in a world where a single molecule can be owned like a castle, and children die because the keys are locked in a boardroom in Jersey. This isn't capitalism. It's feudalism with a Bloomberg terminal. The WTO waiver? A performative gesture. Twelve facilities? That's not access-that's a charity bake sale for global health. And let's not pretend India's 22 licenses are radical. They're the bare minimum. The real rebellion? When a company lowers prices because they smell the blood in the water before the license is even filed. That's power. That's fear. And frankly? It's beautiful.
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    John Tran

    January 19, 2026 AT 03:40
    I mean like... think about it. If you invent a cure for cancer and then charge $100k a dose, are you a genius or a monster? I know people who lost their homes just to buy meds. And then you got these CEOs on TV talking about "risk" and "R&D" like they're astronauts. Bro, you didn't risk anything. You had a lab, a billion in funding, and a team of 200 scientists. The real risk was the kid in Uganda who never got to see 10. And yeah, maybe some innovation slows down-but at what cost? I'd rather have fewer miracle drugs and millions of lives than one billionaire and a graveyard.
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    Trevor Whipple

    January 20, 2026 AT 20:31
    lol so now we're gonna let third world countries steal our tech? next they'll be printing our money. this is why america is falling
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    Lethabo Phalafala

    January 21, 2026 AT 00:35
    I come from a place where mothers carry their children for three days to the clinic and leave empty-handed because the medicine is too expensive. I don’t care about patents. I care about breath. I care about laughter in a child’s voice before it fades. When the U.S. and Europe lecture us on innovation, I hear silence. When they say "fair compensation," I hear the sound of a mother crying over a small coffin. Compulsory licensing isn’t a threat-it’s a lifeline. And if you think it’s wrong, then you’ve never held a child who can’t breathe because a patent says no.
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    Adam Vella

    January 21, 2026 AT 23:01
    The economic externalities of compulsory licensing are not adequately accounted for in popular discourse. The opportunity cost of suppressed R&D investment-particularly in niche therapeutic areas such as orphan drugs-must be weighed against the immediate benefit of price reduction. Empirical studies indicate a statistically significant decline in venture capital inflow into biotech startups in jurisdictions with aggressive compulsory licensing regimes. Furthermore, the legal uncertainty generated by such mechanisms undermines long-term contractual planning. While moral appeals are emotionally compelling, policy must be grounded in sustainable incentive structures. A more efficacious approach would be tiered pricing models and voluntary licensing pools, which preserve innovation while enhancing access.
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    Adam Rivera

    January 21, 2026 AT 23:12
    I just want to say thank you for writing this. I work in public health and see this every day. People think this is just politics, but it’s real. One day last month, a 7-year-old girl came in for her asthma inhaler. Her mom cried because she had to choose between the inhaler and groceries. We gave her a generic. She hugged me. That’s what this is about. Not patents. Not profits. Just a kid breathing.
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    Randall Little

    January 23, 2026 AT 03:26
    So let me get this straight. We're supposed to reward countries that copy our drugs with global praise, but punish the innovators? Meanwhile, the same countries that issue licenses refuse to pay for their own healthcare infrastructure. It’s not about access-it’s about avoiding responsibility. If you want cheap medicine, fix your hospitals. Don’t steal my innovation.

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