South Centre Report, March 2026
Global Activism to Make Patented Drugs More Accessible: An ITPC Case Study of Bedaquiline for Treatment of Tuberculosis
By Priti Patnaik
This report documents efforts by civil society organizations (CSOs) in various countries, including Brazil, Ukraine and Thailand, to make Bedaquiline more accessible by using the flexibilities provided in the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) – the safeguards in the intellectual property system that take into account public health needs. The case study was undertaken during 2023-2024.
Tuberculosis remains a major global health crisis, with drug-resistant forms requiring newer more effective treatments like Bedaquiline which offers shorter treatment times and fewer side effects than older regimens. The report offers an overview of global and country-specific efforts by CSOs to challenge patents held by Johnson & Johnson on the tuberculosis (TB) drug bedaquiline (BDQ) to improve patient access and affordability. CSOs primarily focused on opposing “evergreening” secondary patents that extend Johnson & Johnson’s monopoly beyond the original patent expiration, arguing that these patents lack inventive merit and artificially inflate prices. Successful actions, such as patent rejections in India and Thailand and Johnson & Johnson’s agreement not to enforce patents in 134 low- and middle-income countries (LMICs), are discussed alongside challenges, including judicial difficulties, insufficient political will, and the strategic importance of pursuing pre-grant patent oppositions.