Intellectual property rights (IPRs) are about wealth and about who owns and controls knowledge. IPRs ultimately delineate the way in which knowledge – 'the new capital' – is created, owned, controlled and diffused both domestically and globally. But knowledge is also a public good in its own right, and impinges on the provision of other public goods such as health and education. It is precisely this dual nature of knowledge both as capital and as a public good that lies at the heart of any IP regime and contests over it. This book focuses primarily on the contests over intellectual property rights and access to affordable medicines that emerged in the 1990s and are still unfolding presently. It explores their origins, the actors involved in them and their outcome at the World Trade Organisation and in other fora of global governance. By doing so, it sheds light not only on the complex developments that have so far produced an arrangement that ensures wealth for some rather than health for all, but also to broader concerns that stem from a global governance system that operates without a shared social purpose.