In global health negotiations, debates over the measures appropriate and necessary to transfer rights in technology and manufacturing know-how have been challenging. One area of controversy concerns the role of voluntary or non-voluntary measures. Voluntary measures are important, but when they are not available or adequate, regulations or mandatory measures need to be available.

In the IHR negotiations, the agreement on footnote on page 17 of the document A77/9 provides a useful clarification. References in the IHR text to voluntary mutually agreed terms for the transfer of technology and know-how are without prejudice to other measures that are consistent with the WTO TRIPS Agreement.