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South Africa grants almost every patent application it receives, making its patent regime one of the world’s most lenient. While pharmaceutical companies cash in, patients face staggering healthcare costs, and medicines like cancer treatments, third-line antiretrovirals (ARVs) and treatments for drug-resistant tuberculosis (DR-TB) are often priced out of reach. According to activists from Médecins Sans Frontières’s (MSF) Campaign for Access to Essential Medicines and the South Africa AIDS lobby group the Treatment Action Campaign (TAC), easy patents mean companies can extend their exclusive right to manufacture and sell certain drugs, a process known as evergreening.