Abstract
<jats:title>Abstract</jats:title> <jats:p>This chapter looks back to the Covid-19 context in order to recontextualize the public-health failings of the present day. From the TRIPS Waiver controversy to the lack of utilization of existing, accepted IP flexibilities by governments, it highlights the inherent insufficiencies of IP norms as well as the disconnect between global policy discourses and local realities. The position of public health—recognized by various international and domestic instruments as a human right or fundamental right—as secondary to trade demonstrates the need for more realistic, pragmatic multilateralism that accounts for power imbalances and local contexts. Various options such as differential pricing, governmental actions, and patent pledges are considered in the broader call for an alternative framework. In asserting the imminent need for alternatives, the chapter examines whether a different framework is needed for pragmatic multilateralism that can enable global health-care equity. Such a framework would place public health at the center, as a fulcrum for trade rather than an adjunct. The chapter lays the groundwork for such a framework, possibly as a formal public-health treaty, that keeps health as such a fulcrum, to ensure that global health is pursued in tandem with the innovation and trade paradigm rather than at its expense.</jats:p>