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.  Unlike other intellectual property agreements, TRIPS has an effective enforcement mechanism. States can be disciplined by the WTO dispute settlement mechanism. 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. The Agreement on trade aspects of intellectual property rights (TRIPS) was negotiated between 1986 and 1994 as part of the Uruguay Round of the General Agreement on Tariffs and Trade (GATT), which led to the creation of the World Trade Organization (WTO). The TRIPS Agreement establishes minimum levels for different types of intellectual property (IP) protection, including copyright, trademarks, patents, industrial design and trade secret protection. Accession to the WTO implies the obligation to respect the TRIPS Agreement. According to the WTO, the agreement attempts to strike a balance between long-term social benefits to society by increasing innovation and short-term costs to society due to lack of access to the invention (World Trade Organization: Protection and Enforcement). .