The year 2020 marks the 25th anniversary of including intellectual property rights within the larger agenda of trade. While the marriage between trade and intellectual property was always uncomfortable, COVID-19 exposed the flaws, failures and the inadequacy of the trade agenda to harmonise intellectual property rights, particularly for patents in pharmaceuticals. Typically, the United States through its questionable United States Trade Representative (USTR) process exposed the vulnerabilities of the intellectual property systems of the rest of the world. COVID-19 exposed the manner in which the so-called ‘superior’ intellectual property regime of the US left the country with a weak health-care system. Testing, cost of medical care, lack of treatment, lack of quick access to doctors are all barriers that generally place the United States as having one of the worst health care systems compared to other developed economies. The onset of COVID-19 merely exacerbated the existing flaws to expose these vulnerabilities.