Simply put, WTO members must decide whether to relinquish patent protection for Covid-19 therapies developed in the West so that poorer countries can make their own lower-cost vaccines. What the meeting needs to do is reach a meaningful agreement that will cover the removal of patent rules not only for the current but any future pandemic. If it does, the WTO will live to fight another day. All other annoying issues – and there are many of them – will be bypassed or resolved along the way. If, on the other hand, the status quo (or something close to it) prevails, it is difficult to see much of a future for the WTO as a multilateral organization. The message from the governments of the rich developed countries to the developing countries will come loud and clear: we take care of our own. The richest countries are making all the fuss about the need to share the benefits of the innovations made to combat Covid-19, but in practice they have been dragging their feet for the past two years. Switzerland, the EU, the United Kingdom and the United States – which have strong and powerful pharmaceutical sectors – have tried to make any waiver of TRIPS (trade-related intellectual property rights) as weak and limited as possible. In a sense, this is inevitable. Trade negotiations are not really about which parts of a country’s economy are open to competition. concern the sectors and interest groups that a country seeks to protect. The argument put forward by Western pharmaceutical companies is that developing new drugs is a long, costly and dangerous business, so without patent protection there would be fewer medical discoveries. The poorest countries do not dispute the need to reward good ideas. What they oppose is a system that has led to a global divide offering general Covid protection in the West, with less than 18% of people in low-income countries taking at least one dose. Led by India and South Africa, developing nations are pushing hard for the WTO to remove intellectual property rights so that they can build their own versions of the treatments that are widely available in rich countries. They see the current regime as a consolidating “apartheid vaccine”. Negotiations will culminate in this week’s cabinet meeting and the figures are not good. Successful international meetings tend to involve ministers coming at the last minute to resolve some outstanding issues that can be agreed upon with a little political bargaining. Meetings where there is a lot on the agenda and a lot that divides the various parties are prone to collapse. And there are many other issues at stake – agriculture, fisheries, e-commerce and trade dispute resolution – in addition to intellectual property rights. All this makes this a week of success for the WTO and for the Director General of Ngozi Okonjo-Iweala. The former Nigerian finance minister was chosen to head the WTO, in part because she was a political figure rather than a trade expert. The talks in Geneva were mired in occult disagreements between the technocrats: what was needed was for someone to hit a few heads together. As Okonjo-Iweala herself admits, it was more difficult than she imagined and her efforts to accelerate her progress were not always going well. However, as its predecessors at work found out, the operation of the WTO is not an easy concert, for reasons that are both complex and simple. Complex because trade agreements are by nature highly technical cases offered for protracted disputes. Simple, because in essence the WTO is the most dysfunctional of the multilateral organizations. Developed Western nations have controlled the World Bank and the International Monetary Fund since they were founded at the Bretton Woods Conference in 1944. The decision-making mechanism does not reflect the world economy in its current form, but the suffocating US and its Western allies. means that decisions can be made. Subscribe to the daily Business Today email or follow the Guardian Business on Twitter at @BusinessDesk The WTO is designed to be different. Decisions are taken unanimously, so in principle, a small country can hinder progress. In practice this never happens, but even so the system of government makes it more difficult for rich western governments to table their proposals. The major emerging markets – including China, India, Brazil and South Africa – have shown a strong willingness to resist EU and US efforts to reach an agreement and then impose it on the rest of the world. Commercial officials in Washington and Brussels would have preferred it if the old bilateral model still existed, but it does not. There is pressure for the WTO to become more of a multilateral body, where groups of countries conclude their own agreements. Unsurprisingly, the largest developing countries see no reason why the WTO should act in the interests of business groups in Europe and North America. That is why vaccines are such a topical issue. As Nick Dearden, of the Global Justice Now campaign team, puts it, ” for the purpose “. The WTO’s task in the coming days is to prove that Diarden was wrong. At the moment, it seems great order.