A 2003 agreement eased the requirements of the domestic market and allows developing countries to export to other countries where there is a national health problem as long as the exported medicines are not part of a trade or industrial policy.  Drugs exported under such a regime may be packaged or coloured differently to prevent them from harming the markets of industrialized countries. Since the entry into force of TRIPS, it has been the subject of criticism from developing countries, scientists and non-governmental organizations. While some of this criticism is directed at the WTO in general, many proponents of trade liberalization also see TRIPS as bad policy. The wealth concentration effects of TRIPS (the movement of money from people in developing countries to copyright and patent holders in developed countries) and the imposition of artificial shortages on citizens of countries that would otherwise have weaker intellectual property laws are common bases for such criticism. Other criticisms focused on TRIPS` failure to accelerate the flow of investment and technology to low-income countries, an advantage advanced by WTO members before the agreement was created. World Bank statements indicate that TRIPS has not been able to tangibly accelerate investment in low-income countries, although this has been done for middle-income countries.  The long periods of validity of patents under TRIPS have been examined to indicate that they excessively slow down market entry for generic drug substitutes and competition in the market. In particular, the illegality of preclinical studies or the filing of samples for approval until a patent expires has been held responsible for the growth of a few multinationals and not producers in developing countries. The 2002 Doha Declaration reaffirmed that the TRIPS Agreement should not prevent members from taking the necessary measures to protect public health. Despite this recognition, less developed countries have argued that flexible TRIPS provisions, such as compulsory licensing, are almost impossible to enforce. Less developed countries, in particular, cited their young domestic manufacturing and technology industries as evidence of the imprecision of the policy.
TRIPS conditions that impose more standards beyond TRIPS were also discussed.  These free trade agreements contain conditions that limit the ability of governments to create competition for generic drug manufacturers. In particular, the United States has been criticized for encouraging protection far beyond the standards imposed by TRIPS. U.S. free trade agreements with Australia, Morocco, and Bahrain have extended patentability by requiring patents to be available for new uses of known products.  The TRIPS Agreement allows for the issuance of compulsory licences at the discretion of a country. The more ad hoc conditions provided for in the free trade agreements between the United States and Australia, Jordan, Singapore and Vietnam have limited the application of compulsory licenses to emergency situations, antitrust measures and cases of non-commercial public use.  The World Trade Organization (WTO) is the international organization that deals with the rules of trade between nations. Since February 2005, 148 countries have been members of the WTO.
By being admitted to the WTO, countries undertake to comply with the 18 specific agreements annexed to the agreement establishing the WTO. You cannot choose to participate in some agreements, but not in others (with the exception of some „plurilateral“ agreements that are not mandatory… .