The global biopharmaceutical industry, which operates within a wide and interconnected innovation ecosystem, has long supported a strong international trading system rooted in the World Trade Organization’s (WTO) core principles regarding openness, fairness, and predictability. These principles, as established by the WTO’s key agreements, have played an essential role in helping to ensure that innovative pharmaceuticals, vaccines, therapies, and diagnostics can be developed, manufactured, and distributed to health systems and patients around the world. The WTO’s Twelfth Ministerial Conference (MC12) presents an opportunity for WTO members to formalize and pursue a robust trade and health agenda that builds on these principles and further strengthens the open and rules-based international trading system in response to COVID-19 and future health crises.