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Proponents of an IP maximalist agenda increasingly have been rebuffed in recent years. Developing country governments, NGOs, and Access to Knowledge (A2K) advocates have thwarted their efforts to ratchet up standards of intellectual property protection in multilateral intergovernmental forums such as the World Trade Organization, the World Intellectual Property Organization, and the World Health Organization. A2K advocates challenge the premises behind ever higher and broader intellectual property protection and seek, if not a rolling back of IP rights, at the very least a standstill. They argue that in the balance between rights and obligations, IP maximalists assert their rights without recognizing their obligations. IP maximalists always have seen TRIPS as a floor, not a ceiling. Ever since the WTO TRIPS negotiations that ended in 1994, they have been using every opportunity to increase intellectual property protection and enforcement beyond TRIPS. They have been relentless, focused, and have devoted untold resources to their quest for higher global standards of intellectual property protection and enforcement. Undaunted by recent setbacks at the multilateral level, IP maximalists have launched a major, almost surreptitious, anti-A2K campaign focused on “counterfeiting”, “piracy” and “enforcement.