Most of the heated critics that complained that western governments-the United States and Switzerland uppermost-were going to keep patented drugs away from sick people in Africa and Asia, became warm voices as the negotiations came up with a document that allows poor nations to put public health issues ahead of patent rights in crisis situations.

Even before the final wording of the text was agreed upon, nongovernmental organizations who have been crying foul for years, welcomed the language, which in the final s draft, said, "We affirm that the agreement can and should be interpreted and implemented in a manner supportive of WTO members' right to protect public health and, in particular, to promote access to medicines for all."

According to James Love of consumer Project on Technology, the language is "the strongest and most important international statement yet on the need to refashion national patent laws to protect public heath issues. It is a road map for using flexibility of the TRIPS to protect public heath and sets a standard to measure any new bilateral or regional trade agreement."

Michael Bailey of OXFAM said, "Doha is a big step forward in the battle for affordable medicines."

"It'll now be much harder for the FUS and the drug companies to bully poor countries over their parent policies."

Like others, Bailey tempered his acceptance with a little caution.

"We would have liked to see a stronger declaration but there is a clear political statement that public heath concerns must override commercial interests," he said. "The declaration as it stands is a good first step," said Cecilia Oh of the Third World Network.

"It is a definite step forward though it could be stronger," said Zafar Mirza of Health Action International.

Daniel Berman of Medecins Sans Frontieres (Doctors without Borders) said, "Here in Doha, more than 80 countries came together and negotiate en mass. It was this solidarity that led to a strong affirmation that "TRIPS can and should be interpreted and implemented in a manner to protect public health. In practical terms, it means that countries are not at the mercy of multinationals when they practice price gouging. The victory in Doha is really for people who need or will need access to life-saving or extending medicines," he said.

Ellen Hoen, also of Medecins Sans Frontieres, said, "Countries can ensure access to medicines without fear of being dragged into a legal battle. Now it is up to governments to use this power to bring down the costs of medicines and increase access to life-saving treatments."

Khailil Elouardighi of Paris Act Up, said: "The political need to come back from Doha with some semblance of success made the Brazilian delegate cave in to the rich countries' position and agree to forget legally binding wording as well as clarification of experts for generic versions of patented drugs.

"India and the Africa group resisted a bit, but were not imported with enough political commitment to the issue to make this a deal breaker," he said.

Brazil and India have generated attention in the fight against AIDS by producing and distributing medicines patented elsewhere. Brazil provides all the AIDS drugs free of charge to any registered AIDS patient who requests them, and claims that the health benefits have saved the government $500 million a year on hospitalization and treatment costs. In the end it never came close to being a deal-breaker. Much of the debate was about two words: whether the agreement "shall" or "should" be interpreted in a manner that supports the countries' rights to protect public health.

Speaking from an enforced rule of strict anonymity, a diplomat who was intimately involved in the negotiations from the side of the developed country, said his research had shown that if the terminology dispute reached the WTO's appellate infrastructure, the legal minds there would "probably determine that the two words mean the exact same thing anyway."

At the beginning of the debate high ranking American officials repeatedly drove home in briefings the theory that a paragraph that flatly put "all aspects of public health above all aspects of property rights" would wind up hurting the poor in the long run as drug companies would not bother to develop new drugs if they did not stand to make a profit from them.