This paper seeks to put the spotlight on the ongoing contestations in the area of trade negotiations, global intellectual property rights (iprs) and access to medicines. It aims to shows that these contests are real and have important consequences for how global public health needs are met and on the form and shape of the emerging global iprs regime. More specifically, it shows how the coalition of some developing countries and international health ngos has scored some victories and lost ground elsewhere in the iprs-access to medicines battle which is taking place both at the multilateral and bilateral level. It concludes that the coalition of developing countries needs to be both on the offensive and on the defensive, so as to defend past victories, cut losses and win new victories simultaneously.