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In a bid to expand access to pricey cystic fibrosis treatments, a coalition of families and activists are petitioning four governments — South Africa, India, Brazil, and Ukraine — to make it possible to obtain generic versions of a medicine sold by Vertex Pharmaceuticals. And the coordinated effort underscores the growing global battle over equal access to medicines.

The gambit largely involves the use of compulsory licenses, which lets a country grant a license to a public agency or a generic drugmaker to copy a patented medicine without the consent of the brand-name company that owns the patent. The right to take this step, which can be used to lower the cost of a prescription medicine, was memorialized in a World Trade Organization agreement.

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