Abstract

The Covid-19 pandemic exposed critical weaknesses in the global intellectual property (IP) regime, particularly the pre-existing flexibilities within the World Trade Organization’s (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), in ensuring equitable access to essential medical technologies. This study critically examines how these TRIPS flexibilities failed to facilitate timely and equitable access to Covid-19 vaccines, therapeutics, and diagnostics across low- and middle-income countries (LMICs) in sub-Saharan Africa. Using The Gambia as a focal case, the study applies a desk-based legal and policy analysis, thematic content analysis, and comparative case study approach. Findings reveal that procedural complexity, political pressure, and limited technology transfer hindered the operationalisation of compulsory licensing (art 31) and voluntary initiatives, while gaps in trademark enforcement exacerbated the circulation of counterfeit medicines. The paper proposes targeted reforms, including integrating automaticity into TRIPS flexibilities, mandating binding technology transfer obligations in the Pandemic Accord, and strengthening regional manufacturing hubs. These interventions aim to embed equity, resilience, and global solidarity into the IP system, ensuring that intellectual property protections support, rather than undermine, public health during future emergencies.