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Negotiating public-health driven licences is the core work of the Medicines Patent Pool, and is based on an assessment of needed HIV medicines from both a clinical perspective and in terms of where patents may post barriers to generic competition.

On 1 December 2010, the Medicines Patent Pool sent out letters to key patent holders inviting them to formally begin negotiations to license their HIV/medicines patents to the Pool, and requesting a reply by January 31, 2011. 

As of July 2011, the Pool has now received responses from all of the patent holders, has signed its second licence agreement (the first with a major pharmaceutical company) with Gilead Sciences, and is in negotiations with 6 other HIV medicines patent holders. The Pool received its first licence in September 2010 from the US National Institutes of Health (NIH), and is in ongoing discussions regarding further licensing opportunities with the NIH.

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