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DOHA, Qatar, Nov. 12 — Negotiators all but clinched a deal today that would give developing countries greater access to cut-price drugs to fight epidemics, defusing the most inflammatory dispute between rich and poor nations that had threatened to scuttle trade talks here.

The breakthrough created a sense of momentum as mediators worked through the night to forge consensus on a multiyear agenda for global trade liberalization. But negotiators warned that substantial differences remained to be worked out on other sensitive issues before the scheduled close of talks on Tuesday.

The United States was instrumental in brokering the deal, working closely with Kenya and Nigeria, despite strong opposition from multinational pharmaceutical companies, which say that dilution of patent protections will discourage them from seeking cures for the diseases that afflict the poor.

The compromise, which was in the final stages of negotiation tonight, would assure developing countries that patent rules do not stand in the way of producing or importing generic drugs when they face epidemic health crises like AIDS and malaria.

Even though the text was called a political declaration rather than a legally binding contract, pharmaceutical company representatives roundly criticized it. Two countries that have championed the cause of creating a broad public health exception to global patent rules, India and Brazil, appeared satisfied, however.

The compromise was arranged by Robert B. Zoellick, the United States trade representative, and helped break a stalemate that prevailed through the first three days of talks here in this Persian Gulf nation.

Mr. Zoellick also signaled that the United States was prepared to allow negotiations on antidumping rules that allow nations to retaliate against imports sold below cost. Japan, South Korea and some developing nations contend that the United States and others abuse the rules to protect influential industries and insist that the issue must be on the trade agenda.

"Americans are showing a great deal of leadership and I hope it will be contagious," said Sergio Marchi, Canada's ambassador to the trade organization.

Though the trade issues under discussion here affect many billions of dollars in cross-border sales, only the drug issue involves life and death.

The virus that causes AIDS has infected a quarter of the population in some African countries, and almost none of them have access to drug cocktails that could save lives. African countries often do not have the medical infrastructure for delivering the drugs, but most cannot afford the drug themselves.

African nations and health activists have worked in recent years to obtain generic knockoffs of popular AIDS drugs, but they say they have met legal resistance from multinational drug companies and, in some cases, the United States.

India and Brazil took up the matter this year and used their combined leverage in the trade organization to push for a public health exception to patent rules. The proposal gained momentum a few weeks ago when the United States briefly appeared ready to challenge a patent to obtain large supplies of Cipro at low cost to fight anthrax.

But Switzerland, Canada, Japan and others in the United States objected strenuously, contending that the existing intellectual property rules are flexible in health emergencies and that too broad an exception would allow nations to break patents on all kinds of medical goods, from textbooks to dialysis machines.

The compromise limits such exceptions to health "crises," defined as AIDS, tuberculosis, malaria and diseases likely to spread broadly. But it goes a long way to meeting the demands of medical activists.

"This is a strong step in the right direction," said Daniel Berman of Medicine Sans Frontiers, who has been working on the drug issue for two years. "It makes clear that health comes before trade and gives government the leeway to save lives."

But Harvey Bale, a lobbyist for the International Federation of Pharmaceutical Manufacturers Associations, said it sent the wrong signal to drug companies, who need assurances that they can recoup heavy investments in new drugs.

"This is a defeat for drug companies doing research in AIDS, tuberculosis and the like," he said.

An American trade official said tonight that the United States saw a settlement of the drug dispute as necessary to "create a positive dynamic" in the talks. The official said the declaration on patents could answer the legitimate complaints of some African countries, while removing a moral trump card that India was using to rally opposition to a variety of American and European trade proposals.

But while that concession and Mr. Zoellick's signal that he will talk about antidumping may propel the talks, they may also rile powerful domestic constituencies, including the steel and drug industries and their supporters in Congress.

The House overwhelmingly passed a resolution last week urging Mr. Zoellick not to put antidumping on the table. American trade officials say they will seek to focus negotiations on the application of antidumping rules rather than on the rules themselves, but Congress may not focus on such fine points.

"I would like to have a new round of trade talks, but not if that means we have to reopen antidumping," said Sander M. Levin, a Michigan Democrat who plays an active role in Congressional trade debates.

Mr. Zoellick has drawn a much firmer line on a third sensitive issue for Americans here: textiles. India has sought to force the United States, Canada and some other nations that protect their textile and clothing makers to phase out quotas and tariffs faster than planned. Mr. Zoellick has declined to consider major new negotiations on the subject.

One person involved in the talks said the United States knew it would have to compromise on trade issues important to people back home if it was to persuade trading partners to talk about agriculture, services and other American priorities. It chose the concessions that would not inflict concentrated pain. Support for the textile industry is narrow, but deep.

Officials also hope that by moving off entrenched positions, they put pressure on the European Union, Japan and India to do the same.

Negotiators say that countries outside Europe have spoken with one voice against the region's comprehensive export payments to farmers and made clear that the trade talks would stall unless the Europeans agreed to phase them out. Even Japan, which imposes very high tariffs on imported rice and has often sympathized with Europe's position on helping farmers, withdrew its support.

But the issue is political dynamite in Europe, especially in France, which has upcoming presidential elections.