It is no secret that millions of people across the world lack the freedom to access life-saving medicines as and when they need them. For decades, people have fought to put this right, though as the Covid-19 pandemic made sickeningly clear, vast swathes of humanity are still left without. The reason: billions of people are actively denied access to affordable medicines by outdated patent rules and economic policies dominated by neoliberalism. It is no accident, and it is not due to the pharmaceutical industry alone. Tahir Amin and Rohit Malpani, two leading figures in the movement for access to medicines, examine the origins of this system of rules that champions monopolies and the false god of innovation over the public interest and human well-being. They tell the story of how, move by move, governments have ceded control and then empowered pharmaceutical companies, making it increasingly hard to undo the damages wreaked along the way. From their unique vantage points and experiences, they critique global health initiatives and philanthropists for maintaining the status quo and warn of a future dominated by financial markets and artificial intelligence that will reinforce the worst practices of yesterday and portends new injustices for everyone. Ultimately, their book questions the foundations of international efforts to improve access to medicines and calls for a new way forward that can rekindle a movement for justice.