The research-based pharmaceutical industry, in various public-private partnerships (PPPs), has been improving access to medicines in the least developed countries of the world since the 1950’s. Over the past two decades, the most significant gains have been made by the industry and its partners in improving both access to medicines and health outcomes in the poorest of the world’s nations. The greatest barriers to access and improved health are not drug prices or patents but “on the ground” barriers such as market failure, corruption, nonexistent health human resources and infrastructure, and the lack of both local and international political will. A basic right in law is to retain possession of one’s own ideas and discoveries. Sustainable development is the way of the future for both North and South and, for there to be sustainable healthcare enterprise and optimal health outcomes in the least developed countries, there must also be the necessary infrastructure, health human resources, political stability, and professional administrative legal structures. Even though existing medicines for HIV/AIDS has reduced mortality rates in developed countries by 70%, adherence and compliance are two major obstacles, amongst many, to the successful deployment of these drugs in developing countries. WHO’s list of essential medicines is comprised of over 95% off-patent products – the remainder being primarily second-line anti- AIDS medicines. Patents pose no barrier to essential medicines being affordable and accessible throughout the world. If it wasn’t for patent protection none of those medicines would have been available in the first place, producing revenue from developed countries that now allows 100 medicines and vaccines to be in development to tackle malaria, multidrug resistant tuberculosis, dengue fever, and all the other scourges of the developing world. The real barriers to access are money, power, politics, and ideologies. Decades of market failure and corruption have denied least developed countries the rule of law, efficient infrastructure and roads by which to distribute and administer medicines, access to potable water, and trained health personnel. This report demonstrates beyond a reasonable doubt that, contrary to the opinion of many, intellectual property protection (IPP), in the form of patents or other devices, does not impede access to medicines in the least developed countries of the world; in fact, IPP fosters access.