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In 2001, a modified World Trade Organization agreement ushered in a new era of access to medicines by giving countries the right to sidestep drug makers that charged unaffordable prices. But since then, the number of instances in which a country has pursued any of the sanctioned measures was believed to be rather small, especially since the pharmaceutical industry has often raised strenuous objections.

Now, though, a new analysis finds that 89 countries made extensive use of the trade agreement provisions between 2001 and 2016, a fact that was not previously reported. In all, there were 176 instances involving medicines used to treat 14 different diseases, and 87 percent were implemented, according to the analysis, which was published in the Bulletin of the World Health Organization.

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