International trade and public health have long been in tension, with intellectual property law partially to blame. Patent protections have created strong pharmaceutical monopolies, making medicines unaffordable in many countries, blocking access to healthcare, and disrupting global supply chains. Attempts to remedy these public health failures have largely been fractured, with stop-gap efforts failing to meaningfully resolve the structural issues at the intersection between access, innovation, and regulation. Rather than treating these areas as separate domains, this book advocates for a holistic regulatory approach that centers public health while recognizing the deep interconnections with IP and trade. The authors argue that advancing innovation and global development requires recalibrating legal and policy frameworks to prioritize global public health as a necessary foundational requirement for robust trade and development. Tracing the evolution of these tensions across six chapters, the book critiques current regulatory reform efforts and proposes principles for a new public health framework: a treaty that places health not in opposition to trade and IP, but firmly at the center.